Swallowing Strategies

Rehabilitation Strategies

Effortful swallow

Mendelsohn Maneuver

Shaker Excercise

Chin Tuck Against Resistance

Masako

Lingual Resistance Exercises.

Effortful swallow increases

Tongue base retraction, pharyngeal pressure, hylolaryngeal excursion.

Effortful swallow is used for

Pharygneal residue and reduced tongue base contract.

Effortful swallow instructions

Swallow hard and squeeze all your throat muscles.

Menelsohn Manuever increases

duration of hylolaryngeal elevation and duration of UES opening.

Menelsohn Maneuver is used for

reduced laryngeal elvation and UES opening.

Mendelsohn maneuver instructions

Swallow and hold your Adams apple up for a few seconds

Shaker Excercise Increases

Suprahyoid muscle strenght, anterior hylolaryngeal excursion, and UES opening.

shaker excercise is used for

reduced ues opening and post-swallow pyriform residue

Shaker exercises instructions

lifte head while lying down and hold.

Chin Tuck Against Resistance (CTAR) goals

suprahyoid muscle strength and increased UES opening.

CTAR is used for

reduced hylolaryngeal excursion

CTAR instructions

chin down against a ball or resistance device.

Masako (Tongue Hold) increases

posterior pharyngeal wall contact, tongue base contact, and pharyngeal constrictor engagement.

Masako is used for

reduced tongue based retraction

Masako instructions

Hold tongue between teeth and swallow.

Lingual Resistance Excercises Increase

Tongue strength and bolus control

Lingual Resistence Excercies are used for

Oral Phase weaknesses

Lingual Resistance Excercie instructions

push tongue against resistance.

Compensatory Strategies

Chin Tuck Posture

Head Rotation

Supraglottic Swallow

Super Supraglottic Swallow

Chin Tuck posture helps

narrow airway entrance and move epiglottic posteriorly.

Chin tuck posture is used for

delatyed swallow and reduced airway protection.

Chin tuck posture instructions

Tuck your chin to your chest while swallowing.

Head rotation helps to

Close the weaker side of pharynx, direct bolus to stronger side, reduce UES pressure.

Head rotation can be used for

unilateral pharyngeal weakness

Head roation instructions

Turn head toward weak side while swallowing.

Supraglottic Swallow works to

close vocal folds before swallow and protect the airway.

Supraglottic swallow is used for

reduced airway protection

Supraglottic swallow instructions

hold breath then swallow then cough.

Super supraglottic swallow is used to

create a stronger airway closure and increase arytenoid tilt.

Super supraglottic swallow is used for

significant airway protection deficits.

Super supraglottic swallow instructions

bear down and hold your breath then swallow then cough.