Swallowing Rehabilitation Techniques

Supraglottic Swallow

Purpose: To tightly close the top of the airway so no food or liquid enters the airway and thus the lungs.
Method: Forcefully hold your breath during the swallow and immediately after the swallow clear your throat and swallow again.

Mendelsohn’s Maneuver

Purpose: To close the airway and stretch open the top of the esophagus (food tube) as long as possible during a swallow.
Method: The larynx (throat) is represented by the Adam’s apple on the front of your neck. Start by feeling your Adam’s apple go up and then down when you swallow. Stop your swallow when your Adam’s apple is in its highest position and hold it there for one to three seconds. Complete the swallow by allowing the Adam’s apple to return to a resting position.

Shaker Head Raise

Purpose: To increase the opening of the top of the esophagus.
Method: Lie flat on your back on a supportive surface. Lift your head long enough to see your feet and then lower your head. Repeat.

Shaker Head Raise (Extended Hold)

Method: Lie flat on your back on a supportive surface. Lift your head to look at your feet, and hold for up to 60 seconds. Rest for 60 seconds.

Showa’s Maneuver

Purpose: To strengthen mouth and throat muscles.
Method: Push the tongue flat against the top of your mouth while you perform a long hard swallow during which you squeeze all the muscles of the face and neck (like you are swallowing a golf ball).

Masako’s Technique

Purpose: To strengthen and increase the movement of the back of the throat during a swallow.
Method: Stick out your tongue (you may choose to hold the tongue with gauze during this exercise) and swallow hard (with no food or liquid) without pulling your tongue into your mouth.

Lee Silverman Voice Treatment (LSVT)

Purpose: To strengthen the muscles involved with speech and swallowing by using them to their maximum ability. Usually thought of as a speech treatment, LSVT has been shown to benefit swallowing as well in certain situations.
Method: A series of exercises that use the muscles for speech and swallowing that are based on the “get loud” theory.

Respiratory Muscle Strength Training (RMST)

Purpose: To strengthen the breathing muscles and thus improve the movements for speech and swallowing. RMST can include Inspiratory Muscle Strength Training (IMST) or Expiratory Muscle Strength Training (EMST)
Method: A person blows into a device to see how strong their breathing muscles are. Then a small, hand-held blowing device is set to the person’s appropriate blowing level and they blow into it a certain number of times a day. This strengthens the muscles of breathing and thus speech and swallowing.

Tongue Strengthening Techniques

Purpose: To increase the strength of the tongue and other mouth muscles in order to improve the oral stage of swallowing and the start of a swallow.
Method: Perform different movements and positions with your tongue (some of which may be against resistance).

Sensory Therapies

Purpose: To increase sensation in the mouth and throat and thus improve the speed and completeness of a swallow.
Method: Stimulate different portions of the mouth and throat with cold, sour, or electrical current.

References