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The Guardian Way®
Adult Training Course 1.35 ASHA CEU’s
All New Training Modules coming 2016!
t (800) 643-1917
f (877) 290-2511
“The training was awesome! I already have started two
patients on NMES and they are doing well!” ~Lynn B, SLP
"Thank you so much Marissa!! I am loving my device
and have had wonderful results! My facility (100 beds)
is down to only 3 people on thickened liquids!! WOW!!"
Dysphagia Treatment | Foot Drop Therapy
A comprehensive course designed to teach advanced dysphagia treatment modalities for the adult population.
Designed by physical therapists to help rehabilitate stroke, multiple sclerosis, and partial spinal chord injury.
A comprehensive course designed to teach advanced dysphagia therapy modalities for the pediatric population.
Learn why Guardian is the the most advanced NMES/Biofeedback device on the market and compares to other electrical stimulation methods.
See our full line of dysphagia therapy electrodes for adults.
See our full line of pediatric dysphagia therapy electrodes.
Who We are
Our mission at Spectramed is to lead the way in the advancement of rehabilitation tools to restore function to the highest level possible to improve the quality of life for all patients. We believe clinicians and patients alike should have access to the most comprehensive therapy suite in a global market.
Our dedicated team of experienced, creative and passionate staff has created products and educational programs with a focus on our 5 core values.
-Compassion for patient care -Innovative rehabilitation tools -Commitment to superior quality -Loyalty -Fiscal responsibility to create and optimize affordable solutions
Our dedication is to the physical, psychological, social and spiritual well being of the patients and communities we serve. We believe our team of therapists, engineers and sales associates exemplifies the best and the brightest which drives our world-class patient care. We believe we can make a difference. We will make a difference; because we care. The Guardian Way®, it’s fundamentally different.
What is The Guardian Way®?
The Guardian Way® uses a protocol, which utilizes fundamental electrophysiological principles of NMES that have been used successfully for over thirty years in neurorehabilitation and applies these principles to the treatment of dysphagia across the lifespan.
Developed by expert speech-language pathologists, Teresa Biber and Marissa Barrera, Guardian Therapy is a fundamentally different approach for the treatment of dysphagia. Guardian Therapy uses Neuromuscular Electrical Stimulation (NMES) and surface electromyography (sEMG) to promote improved strength, timing and reeducation of swallowing musculature.
Guardian Therapy is a non-invasive, painless treatment administered by a certified speech-language pathologist that utilizes a small portable stimulator that generates customizable electrical pulses. These pulses flow through a wire (lead) to a pair of small pads (electrodes) placed in the space right under your chin known as the submental region. The electrical current passes through the electrodes into the body and stimulates the motor nerves that results in a muscle contraction. Treatment sessions last only 30 minutes long and use of Guardian Therapy can re-educate muscles, prevent muscle disuse atrophy, strengthen weak swallowing muscles, reduce the occurrence of aspiration, and increase the speed of swallowing.
This highly efficacious treatment technique is safe, affordable, painless and can prevent the occurrence of deadly complications. The goal in the rehabilitation of dysphagia should be to restore swallow function to the highest level possible in order to prevent further complications and promote optimal quality of life.
In short, Guardian is … A clinical philosophy, not a device, driven by passion and innovation A method and tool designed by clinicians for clinicians. A never ending quest to address the specific needs of specific populations. Its always about the patient!
Define NMES and describe the properties of electrical stimulation and its impact on of the electricity on muscle tissue. Define sEMG and describe its impact function in detecting the electricity on of muscle movement tissue. Identify the medical conditions for which NMES is indicated for the treatment of dysphagia. Determine candidacy criteria for use of NMES for the treatment of dysphagia. Identify the characteristics of the NMES stimulation unit and discuss the importance of the properties of electrodes. Discuss and demonstrate the application of the Guardian therapeutic protocol in the treatment of dysphagia Describe and justify why there is a continued need for traditional swallowing exercises in conjunction with NMES. Explain why variable adjustable electrical stimulation parameters maximize therapeutic outcomes. Explain the rationale behind the electrical parameters of the Biber NMES Protocol. Demonstrate effective communication skills for patient education regarding the treatment of dysphagia and the use of NMES and sEMG.
Our Happy Customers
"…Marissa and Michaela, They are both excellent presenters and the course was very informative. The course was an eye opener on the proper technique and utilization of NMES. Thank you, Marissa and Michaela for providing such get knowledge! Hopefully you will have others courses in the near future."
"…I would also love more info for the next company I may work for to persuade them to switch to guardian as I will never go back to VS."
"Thank you Marrisa for such a great experience with Guardian!! I have been using it all week, unfortunately with Vital Stim electrodes, until Guardian electrodes come in!!Your course was truly a game changer for me !!!"
"I just had my first success story yesterday! Had a MBSS post stroke 3 weeks ago in hospital. Pt was noted c penetration c NTL and aspiration of large sips of NTL, aspirated thin liquids inconsistently with chin tuck. After 2 weeks of NMES 3 times a week (maybe 7 times total), pt upgraded to thin liquids post FEES. No penetration or aspiration c NTL and no aspiration or penetration c small sips of thin liquids. Only noted mild penetration c large sips, pt able to clear penetration c subsequent swallow!!! Pt is going home Wednesday."
"She has just completed 8 weeks of NMES. She is doing very well. She is eating just about anything including steak! She has gained weight and is maintaining her weight with a regualr diet, thin liquids and 2-3 cans of Ensure a day. She has less xerstomia and secretions are thinner. She feels good and is getting back to cooking meals for her family! My question is this…she has quite a bit of lymphedema involving the anterior neck. The NMES has been amazing and within 10 minutes of treatment, the neck drains. The fluid doesn’t build back up for several hours. She massages her neck multiple times a day…and this helps, but not like the NMES!"
"Wow! I am still absorbing all of it! Guardian makes so much sense! thank you for everything!"
"I spoke to my other SLP’s about our conference. I just want to tell you that I have been a big supporter for what I thought was NMES and am very excited (yet slightly disturbed) by what you have taught me today. I am advocating that my other SLP’s get onboard to do this as well. Currently we have 6 patients on vital stim. I will find out from Clemente how we will go about getting them trained as well as my CF and our new employee (making a total of 6 therapists if possible).I can’t wait to see what Thursday brings!Sincerely,"
"Marissa is an excellent presenter. She did an amazing job explaining us the role of NMES in Dysphagia. The information was clearly and give us hands-on examples to use in treatment. We watched videos with the practical application of concepts presented. After the training, I started to use the NMES with children with Down Syndrome and Autism. They like the sensation of the electrical stimulation while I keep them engaged with the I pad. They are doing well. Thank you!"
"Hi Marissa, I just wanted to let you know that I really loved the NMES course and am very excited to start using this new modality. I tried it out on a patient today (the one with no CP segment opening, whom I mentioned to you) and he tolerated it really well! I am going to also start using with the MS patient I have. I just placed my first order with Spectramed!So, thanks again! Really great course! I hope to keep in touch!"
"Hi Marissa, Thank you again for conducting the Guardian training. It was truly a great learning experience! I’m so happy that even as a student I was able to participate. I very much enjoyed it and am looking forward to using it with patients in the future."
"In any electrical stimulation protocol we have to be aware of the anatomical structures and physiological process as well as the patient’s safety. Throughout my doctoral studies I had the opportunities to study the Teresa Biber approach to neuromuscular electrical stimulation (NMES) and found great results in my research. Upon leading one of the largest Speech Pathology programs in the country I found another aspect of electrical stimulation that was important, cost. I found that a lot of locations could not offer e-stim to patients due to the overwhelming cost of the treatment. Biber’s recommended alternative electrode placement in the submental region allows me to target the appropriate anatomical structures and physiological process as well as train my own clinicians in dysphagia as well as the modality of NMES. Through time outcome data was collected and showed that the program was producing tremendous outcomes according to the American Speech-Language and Hearing Association (ASHA) National Outcomes Measurement System (NOMS). I would recommend the approach that Teresa Biber has developed from a clinical standpoint, safety standpoint, evidenced based standpoint and from an operational/cost standpoint."
"The training was awesome! I already have started two patients on NMES and they are doing well! Please send me the pink boot for my Guardian.Happy Thanksgiving"
"Every clinician treating dysphagia should attend this course. The speakers are highly intelligent and compassionate clinician who presented the material in a way that was easy to understand. Now I feel very comfortable with NMES and I’m very excited to use this modality with my patients. Guardian is a fabulous company!"
"Just writing to give an informal report on how the “Guardian” NMES dysphagia tx tool is working. I’ve just received more electrodes in the mail, so thank you. I’m still amazed how long these electrodes are lasting and how well the patients are responding. Typically I’m getting ready to order more after a month or so.The placement/fit remains appropriate. One resident reports a smoother swallow since switching from vital stim to the Guardian. I find myself having to perform LESS tasks for stimulating and eliciting a swallow, it occurs more naturally for the patient. The head band keeps electrodes in place and is easier to put on than wrapping the pt with bandage wraps. Also I am now able to visually see when a person swallows, before this was blocked by electrodes and the wrapping. The resident may need min cues to perform swallow at time of vibration but the rest time and ramp up/down I feel is much more approp than constant pulsing. Overall, I’ve seen improvements in swallowing function in last week (out sick tues/wed last week, started with guardian Fri). Sincerely, Jamie!"
"One of my outpt therapists has been using it with her pts and the feedback has been positive. She has been able to get 3-4 sessions out of the blue gel electrodes, the variance being how oily their skin is. She said that they are adhering a lot better than the Alternative electrodes. Pt feedback has been that it “grabs” more and the pt can tolerate a higher mamp…other pts have reported that it feels about the same. No one has said anything negative. On the inpt side, I think they have been trialing the product on themselves only at this point. Again they feel that your product is more comfortable than the vital stim product.!"
"I knew you could provide it at your fingertips. Thank you and we are seeing positive results. The SLP at our facility in Winston-Salem, The Oaks, is ecstatic that the electrodes can be used 4x, and not just suggested, but she is really actually able to use them 4x."
"I finally got through one set on a patient. They lasted at least 5 times, but I’m still using some on other patients on the 6th or 7th use. The ones that I just threw out were not because it stopped working but because the gummy stuff got so sticky it was just gross. I find that different people have different skin. They don’t stick well on dialysis patients, but I think that is because they are on dialysis. These new ones are more comfortable because I rarely have to tie them on with gauze unless someone has a lot of extra skin. They also have allowed me to place and replace them as I need to, which the other ones never allowed. They are very good for what I need."
"from Amanda Anderson to Everyone: I feel sick for all the patients that I submitted to vital stim. My “excuse” is I didn’t know. Can you all send a letter or email to all certified Vital STim providers explaining some of the fundamentals we learned without “slander: of Vital Stim."
"“The Guardian way NMES training is justifiably a fundamentally different program for Speech Language therapists who work closely with Dysphagia patients. It sticks to the basics of NMES and empowers the trainees with the knowledge of how NMES works for dysphagia. It is an interesting tool for SLPs who wish to add NMES to their box. This definitely looks promising as it facilitates swallowing preserving the normal aspects of swallowing. What more you need as an SLP if you could manipulate the parameters of NMES with a thorough understanding?! Lovely learning experience! My propagation of this training starts here!”"
"Hey there,Just wanted to say THANK YOU so much for everything. You’re both the BEST! Best class ever. I have sent three colleagues who are not impressed w/vital stim (sorry…just can’t bring myself to capitalize it) emails and told them they really should get certified on the Guardian and why. Paying it forward."
"Good afternoon Marissa, This is Paola L. I just took your course in August. I wrote to you about a patient for his plan of care including NMES and about goals. He was a 74 year old male, that had Subdural Hematoma, verbal aphasia oropharyngeal dysphagia, esophageal dysphagia and was on a PEG. I just wanted to follow up and let you know his progress. He came into the SNF NPO on a peg. He began NMES with puree solids and honey thick liquids. His speech was intelligible 50% of the time. After 4 weeks trials of different textures while on NMES and different skilled omex, Patient was 90% intelligible, peg was removed and went home with a mechanical chopped solids, nectar liquids and pleasure feedings of thin liquids. I haven’t been able to contact you by phone but I wanted to make sure that I shared his progress. I have many patient’s on my caseload for dysphagia and I can see a huge difference in their feeding and swallowing abilities.They see the progress and they feel motivated to continue with tx. Thank you,"
"Hi Marissa,THANK YOU, THANK YOU, THANK YOU!!!I don’t even know where to start in telling you how much I have learned from this course. This was truly eye-opening AND a complete game-changer for me in how I approach my treatment of dysphagia. I appreciate ALL of the additional resources that you emailed to us. What a tremendous value this course has been. BEST CEU money spent to date!!!Marissa, YOU are an extremely talented presenter…you posses a true gift. It’s difficult at ‘best’ to create an engaging webinar training, yet you managed to do that and then some. I truly could have listened to you present for days. Your students must LOVE you and your classes:-)"
Original Equipment Manufacturer
The Aspire2 is based specifically on the industry standards withheld by the APTA for traditional NMES therapy.
The Aspire2 comes standard with 4 preset NMES protocols. The device can also be customized to create custom NMES treatments.
Outcome Data Collection
FDA, ISO13485, CMDCAS Cleared, Reusable Electrodes
In this module students learn about electrode composition and uniform current distribution across the electrode surface.
- Define NMES and describe the properties of electrical stimulation and its impact on muscle tissue.
- Define sEMG and describe its function in analyzing and recording the electrical energy of muscle movement
- Identify the characteristics of NMES stimulation and discuss the importance of the properties of electrodes
Sign up for our next Dysphagia Therapy Training Course and learn for yourself why The Guardian Way® is fundamentally different.Sign up now