SWEEP AND TAP

Myofunktional Exercise  Collection

Application:

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This exercise is applied for defects of the surface sensitivity of the tongue to gain a physiological sensitivity (under hand mirror control). (Anatomy: IIB, Page 19).

Contents:

Carried out under self control (if requested) with visual support (hand mirror) in self manipulation as a mechanical surface stimulation of the tongue for its sensitation and triggering of local muscular reflexes.

Materials:

Spatula, cotton carrier, soft toothbrush (to be used with both the front and back end), plush flannel.

Procedure:

- Previous exercises: In the early stage of application generally posture exercises are appropriate.

-Starting position: Recommendable PAUSE-POSITION.

- Step-by-step-description:

-1 The mouth opens wide, the tongue shows up staying lissom.

-2 SWEEP: The instrument (plush, cotton carrier, brush) are laid on as far back as possible on one side of the tongue margin and moved rostrally towards the tip in a stroking manner. The movements are repeated and counted.

-3 TAP: The other instrument (spatula, toothbrush handle) now is dabbed or tapped on to the middle (one possibility, see “Discussion”) of the tongue from above (cranial), softly but distinctly.

-4 Change to the other side.

The actions are repeated and counted.

-Timing: Generally this exercise has its place very early in the total planning, especially one run makes one sequence which may be occupied by different frequencies. The action SWEEP should be repeated five times, the TAP ten times. As a series the sequence repetition of five will be practical.

Characteristics:

Instruction, motivation, sensitation, local reflexes, (see also DIAGNOSTIC EXERCISES respectively the special exercise in the book’s part Diagnostic Exercises).

Remarks:

Commonly rather a hyposensitivity will be given as with the tongue pressing or biting (frontal or lateral) respectively with a hypermotility. Asensitivties mostly appear restricted to certain areas or single sided (neural lesions). With the latter we are confronted with the difficult task of the stimulus triggered restitution of  nerve pathways. Here it may be recommendable to, after having diagnostically demarcated the asensitive areas, to start from the demarcation line with setting stimuli – eventually under hand mirror control by the patient. In these cases the exercises GUESS-THE-TAP

will be recommendable.

Discussion:

Through the monitoring of the measures by the Patient with a hand mirror during the instruction besides the learning effect the skill is created to be able to, later on, carry out the exercise in self manipulation. In the starting phase the hand mirror is a quite useful visual aid in respect to the coordination of stimulus setting and perception. The stimuli are relatively gross and unspecific and lead to rather regional reflectory muscle contractions which are not controlled by fine motor skills by and do not hold a stereognostic background. They represent early steps to the regeneration of sensitivity. The manipulation is generally performed by the therapist, planned for about three sessions and then substituted by more differentiated exercises as described under SENSITIVITY EXERCISES. Here, then, will be found the refined methods for stereognosis as they can be produced rather laboriously with the exercise discussed here.

In resistant cases an assistant person should be instructed for the at-home training.

If a sufficient acceptance and cooperation of the patient can be noticed he may take over the part by himself. The two described ways of a sensory stimulation are mostly described in literature as two different exercises. So the SWEEP may be varied or done fore or backward. The TAPping may be set in aimed for one of the three tongue thirds each and then, too, for each tongue half plus changing in the localisation. In half-side defunctionalisation the stimulus should “steal in” slowly from the sensitive part towards the deficitary field to enlarge the sensitive zone by and by. As an aimed measure we find that in the exercise DIMPLE (local reflex reaction) and  GUESS-THE-TAP (stereognostic surface sensitivity).

Instructions:

The tongue will learn to feel – and to react upon it.

It reacts for one part to the touch with the feeling you sense and on the other hand with automatic motions of its surface.

And, there are to kinds of a touch.

You may stroke along one side of the tongue margin with something hairy like the toothbrush (SWEEP) and you can TAP on the surface of the tongue with the brush handle.

Do carry it out as we set it in our training session.

Remember there being quite different ways to do it. The simplest way might be to set the brush on the tongue surface at its rim quite far back at the end and draw it forward. Do it five times. Afterwards you go over to the other side and do the SWEEP once more.

New you turn the brush upside down and do the TAP ten times with the end of the brush handle vertically on the tongue surface directly in the middle or, maybe, changing from side to side.

All will be repeated as often as fixed.

If we found out that a certain area of the tongue needs surplus attention we will have to concentrate on this site – but for this we will argue about special advice in the next session.