By Jan C. Pryor M.A., CCC-SLP, BRS-S
Exercise of the Month: The “Effortful” Swallow (aka the Modified Valsalva maneuver, or the “Hard Swallow”)
Sometimes the best practice for swallowing is swallowing itself. How you do it, can make all the difference. The exercise is just as the name implies, you swallow with effort or HARD! That’s right, with GUSTO. The goal of this technique is to recruit more motor units, increase the demand and create a muscle training/strengthening effect. This technique is used to protect the airway. How does using this technique protect the airway? When there is muscle weakness due to various conditions, such as head and neck cancer, stroke or general de-conditioning, the muscles of the tongue and pharynx may not be doing their part to push, lift or squeeze to propel food out of the mouth and throat. The result of a weak muscle contraction(s) is often that food or liquids “pool” in the mouth or pharynx (throat) after the swallow. After swallowing, residual food and liquid in the mouth and throat are likely to overflow into the unprotected airway and cause what is known as aspiration.
by Jan C. Pryor M.A., CCC-SLP, BRS-S
I have been a practicing speech and language pathologist for over 25 years specializing in Dysphagia, yet I am constantly in the process of learning from my patients. Here are some direct quotes and hard won lessons from the men and women that I have had the privilege of working with. Their strength and bravery are the valuable “pearls of wisdom” they have shared with me, that I am now happy to pass along to you.
Surgeon Peter Belafsky had been tinkering with ways to treat oropharyngeal dysphagia–a swallowing disorder that, when severe, can prevent people from being able to swallow at all–for years.
But it wasn’t until he took his two daughters to get their ears pierced–and noticed the woman behind the counter with piercings in her nose, eyebrow, and even cleavage–that he realized how to do it, and a device to manually open and close the esophagus was born.
Oropharyngeal dysphagia (OPD) is common and costly. In order to improve quality of life for patients and costs to society, better treatments than currently available are needed. The author hypothesized that manual control of the upper esophageal sphincter (UES) is possible by pulling the larynx directly forward with anterior traction on the cricoid cartilage. The purpose of this investigation was to evaluate the effectiveness of manual control of the UES as a possible therapy for OPD.