Exercise Flashcards
Effectivness
- high intensity, aggressive therapy is more effective than diet monitoring
Swallowing Therapeutic Exercises
- Effortful Swallow
- Supraglottic Swallow
- Super-Supraglottic Swallow
- I-PRO: Isometric Progressive Resistance Oropharyngeal Therapy
- Lingual exercise with resistance
- Masako Maneuver
- IDR
Oral Motor Exercises
- Must have a specific target
- Approach must be “load based” with high frequency and intensity
- Include range of motion, sensation, resistance
Shaker Exercise
- Target UES opening
- Shaker is flat on plinth, hold head up to look at toes for 60 sec, rest 60 sec x 3. Lift head 30 times, complete 3 times
- Neck Slimmer:
- Mimics Shaker exercise with different resistive springs
- ISO Swallowing Exercise Device:
- Open jaw against it- more movement, but like neck slimmer
Chin Tuck Against Resistance (CTAR)
If cannot do Shaker
- Can sit upright and complete the same tasks as chin tuck
- Use device to push chin against partially deflated ball
- Less strenuous than Shaker; greater submental activity
Back of Tongue Exercises
Not Evidenced Based
- Yawn
- Gargle- not moving tongue base the way it should for a swallow
- /k/; /g/
Tongue Hold Maneuver- Masako Maneuver
- For pharyngeal clearance- increasing tongue base retraction and pressure
- Do not do with food/bolus
- Stick out tongue, bite down gently, and swallow
- 10 reps, 10 times a day
- Use resistance, and assistance
I-PRO: Isometric Progressive Resistive Oropharyngeal Therapy
- Lingual Strength
- Tongue depressors for resistance and endurance building
- 3 sets, 10 reps, 3 times a day (anteriorly, elevated, laterally)
- Devices give the pt biofeedback that tongue depressor doesn’t have
IOPI- Iowa Oral Performance Instrument
- Exercise addressing lingual strength
MOST- Madison Oral Strengthening Therapeutic
- Tongue muscle strength
- Facilitating I-PRO strengthening of the tongue and related muscles
McNeill Dysphagia Therapy Program (MDTP)
- Incorporates the exercise principles of specificity and intensity with frequent therapy sessions and variety to facilitate enhances coordination during swallowing
- Patients receive daily therapy sessions that are structured to evoke mass practice of swallowing. Swallowed materials are introduced sequentially to facilitate progressive resistance or speed and coordination of swallowing
Respiratory Muscle Training (RMT)
- Exercise based treatment targeting inspiratory and expiratory muscles
- Handheld trainer device provided resistance against inspiration and expiration
- 4–12-week treatment timeframe
Expiratory Muscle Strength
- Pt exhales into spring loaded device
- Blow into 25 times ( 5 sets of 5), 5 days a week
- Complete inhalation as well
- Improves cough for airway protection
- Improved afferent stimulation to brain stem
- Velar closure
- Increased hyoid elevation
- Increased activation of submental muscles
Jaw Opening Exercise/ Jaw Opening Against Resistance (JOAR)
- Increased hyoid movement
- Increased PES opening
- Hold jaw open for 10 seconds; rest 10 seconds; repeat 5 times
- 2 sets a day for 4 weeks
- With or without resistance
- Can use neck slimmer also
