WATER CARRIER

Myofunktional Exercise  Collection

Application:

to enlarge click picture

Suiting the fine motor movement of the rostral region of the tongue to the initial phase of the swallowing procedure in case of a unstable swallowing pattern (see also SWALLOW-MECHANISM. (Anatomie hauptsächlich interne mehr superfizielle Zungenmuskulatur, vorderes Dritte; l, 1.2 Areal II, Seite 18.)

Contents:

Pseudomanipulated fine motor move (skill) exercise, localized  reflex link.

Materials:

Small disposable injection or micro pipette, teaspoon; some liquid, hand mirror, if necessary.

Procedure:

- Previous exercises: POINTPOSTURE, DIMPLE.

-Starting position: Not specified, desirable the BASIC-POSITION.

- Step-by-step-description:

-1 The mouth opens and the tongue shows up a bit forming the DIMPLE on its first third.

-2 The therapist, later on an assisting person or the patient himself, deposits half a teaspoon ( 5 to 7 drops) of water into the dimple.

-3 Now the filled up dimple is carried carefully and, for the start, under hand mirror observation  back and up with the tongue tip touching the POINT not spilling a drop.

-4 Molars are put upon each other, lips open and swallow.

-Timing: Taking the complete action as one sequence, increasingly five to fifteen sequences may be put in a row to a series.

Characteristics:

Surface sensitivity, stereognosis, motivation, tactile esthetical, function kinesis, coordination, fine motor, pseudo-manipulation, partial reflex.

Remarks:

The fluid load should not be chosen too big, from a soup spoon on it will become problematic. It needs not be granted the whole mass of seven drops liquid reaching demonstrably the POINT; the DIMPLE, the movement and the feeling for it are important.

Discussion:

The exercise is meant to be a pre-stage for LIQUID SWALLOW. The discussed exercise may be combined with WATER-RETAINER. While the latter is emphasizing rather the static (hold-exercise), in the here described the kinetics are dominating (movement coordination). The prescription of WATER CARRIER might be considered as pre-exercise. Under the initial monitoring with the hand-mirror the discussed exercise will effect the necessary coordination of the fine motor skills in the tongue surface. The exercise is regarded as manipulated, as within the carry-out is included the handling, material and instrumentation by a third person. Water swallowing not being nonphysiological lets the exercise appear more pseudo-manipulated. If it is desired to test the marginal sealing of the dimple the WATER-RETAINER should be arranged in an ALTERNATIVE EXERCISE with the discussed or in the following chain in form of an INCREASE-ARRANGEMENT: POINTPOSTURE– DIMPLE-  WATER CARRIER  - WATER-RETAINER – Simultaneous training of  MOUSE-SQUEAK , the ,ZIP’-EXERCISE and an adapted  ,1-2-3’-EXERCISE may be recommended.

Instructions:

The tongue knows its favourite seat.

It also knows how to form a dimple.

Now its starts practicing to handle the dimple.

Therefore its comes looking out and forming the dimple which, then, is filled with some drops of water. And from now on do not shed any of it, do not allow it to seep out; the water will, now, be carried up to the POINT, slowly and carefully. The POINT is Precisely the spot from where everything that is swallowed starts its voyage to the stomach.

Off we go! Just for once the lips stay open, the back teeth are set upon each other and – swallow!

The whole run, now, once more, as often, as we have set.