BACK-CENTRE-FRONT

Myofunktional Exercise  Collection

Application:

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This exercise will be used with tongue mispositioning, mobility restrictions and swallowing problems. It is managing the palatal wards version of the total tongue body accentuating the retral tongue musculature. (See Anatomy: Area II/B, Page 19).

Contents:

The tactile kinaesthetically guided exercise demands the well-directed training of muscle actions passing off in the opposed direction to the functional movement and, thus, requires some additional consciousness in coordination.

Materials:

Not required.

Procedure:

- Previous exercises: The special exercises which are directly aimed on directing the tongue up towards the palate should have been mastered (see the TONGUE EXERCISES). Furthermore it may be advisable to have the exercises for the back tongue third be carried out to reinforce tactile kinaesthetically the contact between tongue surface and palate (for example with the WORDEXERCISES 3. THIRD, the SQUEEZE-A-FLAKE or the  ,K-K-K’-EXERCISE.

-Starting position: With the, mouth wide open, at first under hand-mirror control, later on solely by feeling the retral contact of the last tongue third to the palate is sought.

- Step-by-step-description:

-1 Advancing from back to front in a slow and steady movement the tongue surface is put up against the palate like the well known “red carpet” is rolled out.

-2 The tongue remains in the end position for a moment before sinking down to the ground of the oral cavity.

-3 Beginning with step 1 again and continuing.

-Timing: One cycle represents one sequence. Time should be ample, about three to five seconds per sequence. At least ten sequences should be coupled to form a series.

To build up an ALTERNATIVE EXERCISE  the HOLD-AND-PULL will be suitable.

Characteristics:

Tactile kinaesthetic, mobility, orientation, coordination, organ stereognosis, tone increasing.

Remarks:

As with all the more complex exercises which are engaging different muscle areas in a high precision carry-out is required from trainee and trainer to avoid mistakes through inaccuracy and thereby disadvantageous effects in the work-out.

Discussion:

An increase the training effectiveness may be gained by alternation with the conduct ‘Front-Centre-Back’ as the reversed course.

Besides the primarily requested mobility of the motor skills as well, as the action guiding surface sensitivity which will raise a definite feeling of orientation the exercise is addressing strongly the concentration on the consciously moving of the single muscle areas and their continuous grouping.

This will considerably promote the organ sensation of the patient for his tongue.

In  comparison the  THREE-RING-EXERCISE         

is a static (statomotor) exercise with a manipulated heterostereognostic feed-back aid; this would make it rather useful for sedating in case of a hypermotility and hypertone.

A further advantage of the exercise discussed here lies in the easy visual monitoring of the palatum contact – starting with the tongue tip already the first phase of movement will obstruct the view on the contact touch.

As an increase of the training demands a few drops of water may be put on the retral part of the tongue with the head slightly tilted backwards while the patient holds the ‘K’-Position and breathes on through the nose. With this the exercise prompts an air stream guidance and a throat muscle training.

Besides the handling of the pipette to drip the water on bears an additional motivation.

The sensing of liquid moreover accentuates the demand to keep the tongue up to avoid a choking.

With the effort to press the water rostrally an additional feedback stimulus (functional heterostereognostic sensomotor) is triggered to let the action go on continually. Certainly the thus modified procedure requires quite a high degree of concentration and therefore will be reserved for true ‘swallow masters’.

Instructions:

For quite some time the tongue has practiced how to sit down on its favourite seat, the POINT and to lean back on the chair-back, the palate.

Now it is going to learn a new trick:

It leans its back initially on the chair-back far rear and up on the last end of the chair-back. Looking into the mouth (with a mirror) you can see that quite clearly. It hangs on the palate just at the place where the ‘K’ is formed.

Now it might get complicated.

The tongue will now be the red carpet to be rolled out for greeting some prominent people. Or, may be, some especially welcomed sweets would come to visit the mouth at the end of the training?

At any rate, the tongue will start rolling out from back there where it is touching the palate quite slowly further and further to the front along the palate till it has reached the POINT which can be felt quite clearly. For an instance the carpet will lay there then we will make it sink down.

And now the repetition: The tongue back leans against the Palate at the back and rolls out towards the front.

Ten times or as often, as we have agreed.