Oropharyngeal Strengthening and Rehabilitation of Deglutitive Disorders

Abstract

This chapter provides an overview of the theory and evidence supporting oropharyngeal strengthening therapy for dysphagia rehabilitation based in principles of exercise, sensorimotor learning and neuromuscular functional interrelationships in the oropharynx. Comprehensive information is provided on anatomy and physiology of the tongue and related musculature/structures as well as therapeutic outcomes with healthy elders and specific patient populations including patients post-stroke and those with head and neck cancer. Strengthening protocol parameters such as frequency, repetition and duration are reviewed relative to published evidence as well as a side-by-side comparison of available devices for facilitation of oropharyngeal strengthening. Dysphagia therapy historically has focused on compensatory and dietary modification. While still useful options, evidence provided in this chapter supports the concept that patients with dysphagia caused, at least in part, by oropharyngeal weakness that complete progressive oropharyngeal strengthening exercises are capable of making significant gains in swallowing kinematics with associated improvements in bolus flow, safety and quality of life.