,1-2-3'-EXERCISE

Myofunktional Exercise  Collection

Application:

This exercise may be used in its most simple form (see ’Discussion’) as a regulation to gain an early control on the muscle actions during the course of the swallow reflex when it is deranged. It seems rather difficult to provide informations bout the exact target area as in the deglutition an entire of muscles from the rima oris down to the oesophagus are involved. (Chapter Anatomy: 1.2 Areal II, Die Zungenuskulatur / 1.3.5, Die Physiologie des Schluckaktes).

Contents:

Coordination exercise for a reflex construction by a methodical step-by-step process guidance after the relevant pre-exercises.

Materials:

Not required, optional MEMOS like the ‘Elastic’ ring etc.

Procedure:

- Previous exercises:

The pre-exercises may suit the mode cited in ‘Discussion’, this is, the progress in the entire scheme of treatment. In the simplest form the POINTPOSTURE should be mastered.

-Starting position:

 Unspecific, possibly: The mouth opens and the tongue-tip shows up slightly.

- Step-by-step-Description:

-1 Tongue-tip to the POINT (when using MEMOS, an elastic or the like: Position the elastic on the tongue-tip.)

-2 Set upper and lower molars slightly against each other, LIPS OPEN.

-3 Swallow (For monitoring the action of the swallow motion the therapist positions one finger at the “voice box” to feel its lifting-up.)

-4 Open the mouth and check the correct ring position, then, back to the start.

- Timing:

With one turn of 5 seconds the sequence takes a frequency of 3 repetitions, the series about 5 sequences.

Characteristics:

Reflex exercise, heterostereognostic feed-back, coordination, manipulation.

Remarks:

In case of problems with deglutition the mouth may in between be moistened with a sip of liquid (water). For a better motivation this may also be done before step 1 with a pipette or a wash bottle. For the use of the Elastic see comment in ELASTIC EXERCISES.

Discussion:

The most version form of this exercise represents rather a pre-orientation and thus may be included into the treatment plan in an early stage. As it contains the basic mechanism of the swallowing reflex it may also be completed stepwise and by this grow with the progress of therapy.

The literature describes various contents which may be utilized for such a consistent stepwise completion. A possible developmental construction of a work-out progression is described under the paragraph UNIT-CONSTRUCTION-SYSTEM.

Under these conditions of development the stepwise procedure of step1, step2, step3 would represent:

A.1- Tongue-tip to the POINT

   2-  Molars set

   3-  swallow.

B.1-  DIMPLE to the POINT

    2- Molars set and TOUCH-THE-BUTTON

    3-  swallow.

C.1- DIMPLE to the POINT

    2- (therapy for adductor hyperactivity) solely TOUCH-THE-BUTTON

    3-  swallow.

D.1- DIMPLE to the POINT

    2- Molars set and TOUCH-THE-BUTTON

    3- ,KA’ movement and  swallow.

Of course these stepwise proceedings in changing the action course upon the framework of ,1-2-3’ may, starting with the 'ZIP', install the total swallowing mechanism.

Furthermore in these exercises there may be built in the various MEMOS as  the LIPS OPEN or feedback stimuli.

Another described variation is increasing the intricacy level and adjusts the tongue-tip additionally to the POINT: Here the tip pushes the drinking straw, gently supported by the teeth, against the POINT without squeezing it. This implementation has, through the gentle tucking of the straw, the additional effect to ease the adductor musculature of the mandible. Furthermore this variation may function as a pre-exercise for the LIQUID SWALLOW when a liquid is sucked up through the straw.

Among the exercises to be further developed we find exercises as the ,1-2-3’-EXERCIS the WORDEXERCISES or the EAT-(AND DRINK-)EXERCISE  the HOLD respectively SWALLOW exercises as the TWO-RING-EXERCISE, the THREE-RING-EXERCISE and as the number 1 in this series the here discussed as, so to say, “ONE-RING-EXERCISE”.