CONTINUOUS SWALLOW

Myofunktional Exercise  Collection

Application:

no illustration

This action is helpful in case of impairments in the evenly flowing run of the swallow reflex, especially in the end phase of the training in MFT for the habituation  (Anatomy: 1. 3. 5., Page 24.)

Contents:

Continuous function movement under an attentive self-control.

Reflex training through multiple repetition of the reflex circuit.

Materials:

Cup with liquid (sugarfree!).

Procedure:

- Previous exercises: Within the context of the correction of the swallow reflex every detail step of the reflex chain should have been rehearsed (in this context see especially the exercises for TONGUE-TIP-ORIENTATION and SWALLOW-MECHANISM or SWALLOW REFLEX EXERCISES.)

-Starting position: Take up the BASIC-POSITION and set the cup to your lips – the tongue tip is at the POINT.

- Step-by-step-description::

The procedure is the physiological swallow when draining a full glass “in one go”.

For practicing it take small gulps.

In the starting position  ,L-M' the rim of the cup is placed on the lower lip. The upper lip is lifted up a bit. The tongue tip stays in position. To facilitate the continuous flow of liquid the cup and fluid level are raised above the upper rim of the lower lip. With the position WATER-RETAINER respectively DIMPLE the continuity of the oral cavity to the pharynx is sealed off.

-1 Now the tongue will release some of its pressure against the palate, its third and second third are sinking down in a well controlled manner creating a dosed vacuum within the cavum oris which sucks up a small amount of fluid.

The DIMPLE opens up like with the ,CHA', gets shaped again, fills up, searches contact to the POINT.

-2 TOUCH-THE-BUTTON – the tongue presses upwards, the swallow reflex passes off.

At first the cup is kept in position with the fluid level elevated. It will be swallowed only once, for the start,

followed by a pause.

Next swallow two times, thereafter three times and on increasing:

-3 as with step 1

-4 ditto…. and so forth, accompanied by the sensory control “what is my tongue doing”.

In this way the DIMPLE-sealing does neither let fluid get out nor a continuous stream come into the mouth. The flow gets controlled in an intermittent way.

-Timing: The procedure is regulated by the continuity of the action. The degree of complexity can be varied by the number of “gulps” per cycle (= number of swallow movements up to the pause) for example starting with 5 gulps later on increasing to ten then fifteen muscle actions.

A training sequence may be arranged clocked with a beat by, for example, breathing after ten times swallowing. This will make the first frequency tact which is followed by several similar ones. For this succession three to four eats making one sequence are advisable. A second, somewhat less demanding way of arrangement is gained by getting through the steps 1 and 2 ten times and putting this as one sequence. Followed by a short break and another sequence of the same exercise. This can be installed as one series (more about this concept see in paragraph “Discussion”).

Characteristics:

Function kinetic reflex exercise, habituation by the continuity of the action, pseudo-manipulation.

Remarks:

To go trough this exercise only makes sense, if every detail step of the swallow procedure can be mastered. A certain danger of choking should be minded. During the session the patient should repeatedly be admonished to feel “what is going on in the mouth”.

Discussion:

For the timing also see note about increase exercises in the paragraph “Discussion” of the chapter RAPID SWALLOW. While the exercises WATER CARRIER or LIQUID SWALLOW trains a single run trough a reflex chain, in the here discussed exercise the conscious control of the continuity of a frequently repeated reflex course is worked out. The process may later on be habituated by the exercise RAPID SWALLOW.

A variation or intensification is given by the CONTINUOUSSWALLOW using a drinking straw which is described in the exercise PIPELINE. In these swallow patterns it is evident, that the tooth contact –if ever- is carried out with a minimum pressure. By an accented supporting of the mandible through the tongue musculature (presumably the extrinsic) against the palate a sufficient posture stability is gained. This is essential for a decrease training of a muscle hypertonic with teethpressing and similar dysfunctions as we can, hereby, demonstrate to the patient that (excessive) tooth contact can be avoided lastingly even with swallowing (also see TEETHCLICKING).

Instructions:

Swallowing is very important. Not only, that you do not starve or get very thirsty. As we might have discussed, the muscles are forming your face, even the bones below the skin. So you should swallow correctly to keep your individual form.

If you know, with how many single steps the swallow proceeds and if you know how to carry out all the steps one after the other, then you still have to get used to it.

And that can best be achieved by repeating it very often. At first you will have to remember how to swallow with the correct method which is for safety’s sake listen up once again later on.

Then you take a cup of water to your mouth and start drinking with little swigs in succession and without a break but quite carefully as not to choke.

At the beginning 5 gulps one after the other followed by a break.

Later on ten, then 15 swigs.

Repeated as often, as we had arranged.

Tongue to the POINT with its back leaning at the palate –

The tongue back sinks down, water flows into the mouth-

the DIMPLE is formed -

the BUTTON is touched –

and SWALLOW.