Rosemary Martino

Rosemary Martino
University of Toronto | U of T · Department of Speech-Language Pathology

PhD

About

138
Publications
76,604
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
5,478
Citations

Publications

Publications (138)
Article
Full-text available
Bedside dysphagia assessment protocols are not well developed in acute pediatric stroke unlike adults. The objective of this study was to identify items deemed relevant and feasible by expert consensus to inform the development of a bedside dysphagia screening tool for acute pediatric stroke. A two-phase study was conducted: (1) literature review a...
Article
Full-text available
Introduction Early detection and tracking of bulbar dysfunction in amyotrophic lateral sclerosis (ALS) are critical for directing management of the disease. Current clinical bulbar assessment tools are lacking, while existing physiological instrumental assessments are often inaccessible and cost-prohibitive for clinical application. The goal of our...
Article
Full-text available
Background: Few Brazilian studies investigated risk factors for dysphagia and associated complications in a large cohort. Objective: To investigate frequency, predictors, and associated outcomes of dysphagia in patients up to three months post-stroke. Methods: Prospective cohort study of consecutively admitted patients in a specialized center...
Article
Full-text available
Background Dysphagia (swallowing difficulty) is one of the most common and debilitating sequelae of head and neck cancer (HNC). Patient-reported outcome measures (PROMs) are a fundamental component of dysphagia outcomes evaluation, as they inform treatment consequences that cannot be captured by objective clinician measures. Many PROMs for dysphagi...
Article
Objective Despite increasing recognition of the importance of functional outcomes for patients with head and neck cancer, post-treatment neck fibrosis remains poorly understood. We sought to develop and validate a patient reported outcome measure for head and neck cancer patients with neck fibrosis. Study Design Prospective multiphase cross-sectio...
Article
Full-text available
Background Swallowing therapy is commonly provided as a treatment to lessen the risk or severity of dysphagia secondary to radiotherapy (RT) for head and neck cancer (HNC); however, best practice is not yet established. This trial will compare the effectiveness of prophylactic (high and low intensity) versus reactive interventions for swallowing in...
Article
Full-text available
Background Out-of-pocket costs (OOPC) associated with treatment have significant implications on quality of life and survival in cancer patients. Head and neck cancer patients face unique treatment-related challenges, but to date OOPC have been understudied in this population. Aims This study aims to identify and measure OOPC for patients with hea...
Article
Full-text available
Brazil has a higher rate of dysphagia in stroke patients compared to developed countries, but does not have a fully validated method for early identification of dysphagia in this population. The aim of this study is to translate the TOR-BSST© into Brazilian Portuguese and assess the newly translated version for reliability and validity with Brazili...
Article
Background Early identification of dysphagia aims to mitigate the risk of health consequences in adults poststroke; however, the evidence from experimental trials alone is inconclusive. This meta‐analysis assessed dysphagia screening benefit from both trial and observational data. Methods and Results Seven electronic databases were searched to Dec...
Article
Full-text available
Purpose Dysphagia occurs as a component of a wide variety of diseases and conditions. When unrecognized or poorly managed, dysphagia can result in malnutrition, volume depletion, and reduced quality of life, as well as aspiration, pneumonia, and death. This document focuses specifically on oropharyngeal dysphagia. The modified barium swallow study...
Article
Background and purpose: Following adult stroke, dysphagia, dysarthria, and aphasia are common sequelae. Little is known about these impairments in pediatric stroke. We assessed frequencies, co-occurrence and associations of dysphagia, oral motor, motor speech, language impairment, and caregiver burden in pediatric stroke. Methods: Consecutive ac...
Article
Background: Our study assessed post-radiation therapy (RT) G-tube presence, duration, and clinical predictors in patients with head and neck cancer (HNC). Methods: We identified those 1-5-years post-RT with stage III/IV nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, or unknown primaries. Logistic regression identified predictors of po...
Article
Full-text available
Background The impact of tongue dysfunction on deglutition in persons diagnosed with amyotrophic lateral sclerosis (ALS) is not well understood. This information is needed to improve our understanding of the mechanisms of swallowing impairment, for identifying risk factors of dysphagia, and for establishing impairment-specific treatments aimed at s...
Article
Full-text available
Introduction Advanced oral cancer and its ensuing treatment engenders significant morbidity and mortality. Patients are often elderly with significant comorbidities. Toxicities associated with surgical resection can be devastating and they are often highlighted by patients as impactful. Given the potential for suboptimal oncological and functional...
Article
Full-text available
Previous studies based on magnetic resonance imaging (MRI) or computed tomography (CT) have shown that pharyngeal airway diameter during wakefulness is different between healthy controls and patients with a high risk of sleep-disordered breathing (SDB). However, MRI and CT are expensive and not easily accessible. Conversely, ultrasonography is more...
Article
Background: The treatment of head and neck cancer (HNC) may cause significant financial toxicity to patients. Herein, the authors have presented the development and validation of the Financial Index of Toxicity (FIT) instrument. Methods: Items were generated using literature review and were based on expert opinion. In item reduction, items with...
Article
Background and Purpose— We aimed to create a novel prognostic risk score to estimate outcomes after direct enteral tube placement in acute stroke. Methods— We used the Ontario Stroke Registry and linked databases to obtain clinical information on all patients with direct enteral tube insertion after ischemic stroke or intracerebral hemorrhage from...
Article
Background To develop and examine user acceptance and content validity of a structured program to facilitate safe but challenging oral intake during radiotherapy (RT) delivered by a speech language pathologist (SLP)—the Eat‐All Through Radiation Therapy (EAT‐RT) program. Methods EAT‐RT was developed through expert consensus of SLPs at the Princess...
Article
Full-text available
Introduction Carcinomas of unknown primary site (CUP) of the head and neck have historically been worked up and managed heterogeneously. Failure to identify a primary site may result in large radiotherapy mucosal volumes. Transoral approaches such as Transoral Robotic Surgery (TORS) may improve the yield of identifying hidden primaries. We aim to a...
Article
Background: Direct enteral feeding tube (DET) placement for dysphagia after stroke is associated with poor outcomes. However, the relationship between timing of DET placement and poststroke mortality and disability is unknown. We sought to determine the risk of mortality and severe disability in patients who receive DET at different times after st...
Article
Full-text available
A combination of outcome measures are required to provide important information on the physiological profile and associated impact of dysphagia in head and neck cancer (HNC). Choosing the most appropriate tool can be a difficult and time-consuming process. The aim of this study was to identify and then compare the content of tools commonly used to...
Article
Full-text available
Dysphagia and its associated complications are expected to be relatively more frequent in stroke patients in Brazil than in similar patients treated in developed countries due to the suboptimal stroke care in many Brazilians medical services. However, there is no estimate of dysphagia and pneumonia incidence for the overall stroke population in Bra...
Article
Full-text available
Background Radiation-associated dysphagia is a common and debilitating consequence of treatment for head and neck cancer (HNC). Since commonly employed dysphagia therapy programs for HNC patients still lack authoritative efficacy, some speech-language pathologists (SLPs) have started employing manual therapy (MT) techniques in an attempt to prevent...
Data
Supplemental material for Application of Manual Therapy for Dysphagia in Head and Neck Cancer Patients: A Preliminary National Survey of Treatment Trends and Adverse Events
Article
Introduction: Temporal features of swallowing physiology vary with age in healthy normals and have the potential to impact swallow safety and efficiency in patients with dysphagia. We conducted a meta-analysis to assess the relation between temporal features of swallowing with penetration, aspiration and residue in adult patients with dysphagia re...
Article
Full-text available
Early identification of bulbar involvement in persons with ALS is critical for improving diagnosis and prognosis; however, efficacious diagnostic markers have not yet been identified. The purpose of this study was to determine whether kinematic changes of the tongue and jaw during swallowing, measured using 3D electromagnetic articulography (EMA),...
Article
Aim This systematic review targeted frequency estimates of dysphagia (feeding and swallowing problems), related health outcomes, and caregiver burden in children with stroke or unilateral cerebral palsy (CP). Method Six electronic databases were searched from their inception to November 2017 along with a manual search of eight relevant journals. T...
Article
Full-text available
Early identification of dysphagia by screening is recommended best practice for patients admitted to hospital with acute stroke. Screening can reduce the risk of pneumonia and promote stroke recovery, yet some institutions do not utilize a formal screening protocol. This study assessed the accuracy of informal dysphagia detection prior to implement...
Article
Objective To determine predictors of direct enteral tube (DET) placement after acute stroke. Methods We used the Ontario Stroke Registry to identify patients who received direct enteral tubes (gastrostomy or jejunostomy) during hospital stay after acute ischemic stroke or intracerebral hemorrhage from July 1, 2003 to March 31, 2013. We used multiv...
Article
Purpose: The objectives of this scoping review were to summarize, understand, and disseminate findings from a broad body of literature on rehabilitation interventions used with survivors of head and neck cancer. Method: Searches were conducted in six databases. Inclusion criteria were studies of adult head and neck cancer survivors with a predefine...
Article
Background: The relationship between timing of direct enteral feeding tube (DET; gastrostomy/jejunostomy) placement and outcomes after stroke is unknown. Methods: We used the Ontario Stroke Registry and linked administrative databases to identify patients with acute stroke between 2003-2013 who received DET during hospital admission. We used multip...
Article
Full-text available
Background The rehabilitation planning consult (RPC) is a novel, transdisciplinary rehabilitation intervention for survivors of head and neck cancer. The study aimed to: (1) estimate recruitment and withdrawal rates, and adverse events; and (2) estimate the effect on rehabilitation indicators in survivors of head and neck cancer. Methods A single...
Article
Full-text available
Background and aims: Our aim is to review the literature and provide guidelines for the assessment of uninvestigated dysphagia. Methods: A systematic literature search identified studies on dysphagia. The quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development, and Evaluat...
Article
Background Patients undergoing radiotherapy with or without chemotherapy (C/RT) for head and neck cancer (HNC) often develop dysphagia. Interventions from speech-language pathologists aim to maintain or improve swallow physiology and function; however, it is unclear which interventions have the greatest benefit. Purpose A systematic review was con...
Article
Objective: To compare complications, disability, and long-term mortality of patients who received direct enteral tube vs nasogastric tube feeding alone after acute stroke. Methods: We used the Ontario Stroke Registry to identify patients who received direct enteral tubes (DET; gastrostomy or jejunostomy) or temporary nasogastric tubes (NGT) alon...
Article
Purpose: A systematic review was performed to (1) evaluate the effectiveness of augmented visual feedback-based treatments for motor rehabilitation in Parkinson’s disease, and (2) examine treatment design factors associated with enhanced outcomes following these treatments. Methods: Eight databases were searched from their start-date up to January...
Article
Cancers of the head and neck and the treatments required to control them frequently result in serious and persistent impairments that can affect participation and quality of life. Increased recognition of the needs of cancer survivors and their caregivers has prompted research focused on the unique concerns of this complex group. Unmet needs have b...
Article
Full-text available
Background: Resource limitations affect the intensity of speech-language pathology (slp) dysphagia interventions for patients with head-and-neck cancer (hnc). The objective of the present study was to assess the feasibility of a prospective clinical trial that would evaluate the effects on health and patient costs of early slp dysphagia interventi...
Article
Full-text available
Background Dysphagia following prolonged intubation after cardiovascular (CV) surgery is common occurring in 67% of patients; however, this population’s swallowing physiology has never been prospectively evaluated using standardized methods. Hence, prior to conducting a larger study, our primary objective was to determine the feasibility of assessi...
Article
Background Dysphagia screening is recommended after acute stroke to identify patients at risk of aspiration and implement appropriate care. However, little is known about the frequency and outcomes of patients undergoing dysphagia screening after intracerebral hemorrhage (ICH). Methods We used the Ontario Stroke Registry from 1 April 2010 to 31 Ma...
Article
Purpose: Suprahyoid muscles play a critical role in swallowing. The arrangement of the fiber bundles and aponeuroses has not been investigated volumetrically, even though muscle architecture is an important determinant of function. Thus, the purpose was to digitize, model in three dimensions, and quantify the architectural parameters of the suprah...
Article
Full-text available
Background In contrast with other major chronic conditions such as heart disease and stroke, cancer care does not routinely integrate evidence-based rehabilitation services within the standard continuum. The objectives of the present project were to develop a rehabilitation planning consultation (rpc) for survivors of head-and-neck (hn) cancer, to...
Article
Full-text available
Background: Dysphagia is a common and devastating complication after acute stroke. Percutaneous endoscopic gastrostomy (PEG) tubes are often placed for persistent dysphagia. However, little is known regarding outcomes after PEG tube placement. Methods: We used a 10-year Ontario Stroke Registry to shed light on the clinical outcomes of patients with...
Article
Full-text available
Background: In patients with acute stroke, nasogastric (NG) tubes are commonly inserted for feeding when dysphagia is identified, and percutaneous endoscopic gastrostomy (PEG) tubes are placed for severe or persistent dysphagia. However, little is known regarding predictors of PEG insertion. Methods: We used the Ontario stroke registry from 2003-20...
Article
Purpose: To review current evidence on the relationship between executive control (EC) and post-treatment language gains in adults with post-stroke aphasia. Method: Electronic databases (CINAHL, Cochrane Trials, Embase, MEDLINE, MEDLINE-in-Process and PsycINFO) were systematically searched (year 2000 - present). Abstracts and full-text articles...
Article
Systematic reviews were conducted to identify risk factors associated with the onset and progression of 14 neurological conditions, prioritized as a component of the National Population Health Study of Neurological Conditions. These systematic reviews provided a basis for evaluating the weight of evidence of evidence for risk factors for the onset...
Article
Background and purpose: Guidelines advocate screening all acute stroke patients for dysphagia. However, limited data are available regarding how many and which patients are screened and how failing a swallowing screen affects patient outcomes. We sought to evaluate predictors of receiving dysphagia screening after acute ischemic stroke and outcome...
Article
ALS is a multisystem disorder affecting cognitive and motor functions. Bulbar-onset ALS (bALS) may be preferentially associated with language/cognitive impairments, compared with spinal-onset ALS (sALS), stemming from a potentially unique neuropathology. The objective of this systematic review was to compare neuropathology reported for bALS and sAL...
Article
Full-text available
Background: Due to the high post-stroke frequency of dysphagia, dysarthria, and aphasia, we developed comprehensive neuroanatomical, clinical, and demographic models to predict their presence after acute ischemic stroke. Methods The sample included 160 randomly selected first-ever stroke patients with confirmed infarction on magnetic resonance imag...
Article
Background and purpose: Systematic reviews of research evidence describing the quality and methods for administering standardized outcome measures are essential to developing recommendations for their clinical application. The purpose of this systematic review was to synthesize the research literature describing test protocols and measurement prop...
Article
Aim: To compare quality of life (QOL) between standard (SFX) chemoradiotherapy (arm A) and altered fractionation radiotherapy (AFX) with panitumumab (PMab; arm B). Methods: Patients with T any N + M0 or T3-4N0M0 squamous cell head-neck carcinoma were randomised to SFX (70 Gy/35/7 wks) plus cisplatin (100 mg/m(2) IV × 3) versus AFX (70 Gy/35/6 wk...
Article
Full-text available
Objectives: To conduct a systematic review to elucidate the frequency, recovery, and associated outcomes for poststroke aphasia over the long-term. Data sources: Using the Cochrane Stroke Strategy, we searched 10 databases, 13 journals, 3 conferences, and the gray literature. Study selection: Our a priori protocol criteria included unselected...
Article
This paper presents an overview of genetic variation associated with the onset and progression of 14 neurological disorders, focusing primarily on association studies. The 14 disorders are heterogeneous in terms of their frequency, age of onset, etiology and progression. There is substantially less evidence on progression than onset. With regard to...
Article
Full-text available
Purpose: The goal of this study was to identify the effects of amyotrophic lateral sclerosis (ALS) on tongue and jaw control, both cross-sectionally and longitudinally. The data were examined in the context of their utility as a diagnostic marker of bulbar disease. Method: Tongue and jaw movements were recorded cross-sectionally (n = 33 individu...
Article
Oropharyngeal dysphagia is a frequent consequence of several medical aetiologies, and even considered part of the normal ageing process. Early and accurate identification provides the opportunity for early implementation of dysphagia treatments. This Review describes the current state of the evidence related to dysphagia therapies - focusing on tre...
Article
Dysphagia is a devastating complication of stroke and can lead to malnutrition, immobility, aspiration pneumonia, and death. Guidelines advocate screening all patients with acute stroke for swallowing impairment. However, previous research suggests only 60% are screened, and it is unclear what factors contribute to receiving dysphagia screening. Me...
Article
Bedside dysphagia screening is recommended for all patients with acute ischemic stroke, in order to detect swallowing impairment early and prevent complications. However, limited data are available on outcomes associated with failing a dysphagia screen. Methods: We used the Ontario Stroke Registry to identify patients who were admitted to Regional...
Article
Full-text available
Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and...
Article
Studies have noted several factors associated with the occurrence of Cerebral Palsy (CP), yet considerable uncertainty remains about modifiable factors related to disease onset. A systematic review was performed to identify existing systematic reviews and primary studies pertaining to targeted factors associated with the onset of CP. The following...
Article
The purpose of this study was to systematically review, assess, and prioritize factors (including biological, socioeconomic, environmental, psychosocial, comorbid, and genetic) for the onset and natural progression of Muscular Dystrophy. Comprehensive review of current literature of these factors was carried out in order to provide a basis for poli...