REAR ORAL CAVITY

Myofunktional Exercise  Collection

Application:

No Illustration

This chapter gives a general description of a collective group of exercises and details which are sharing the here described facts.  

The exercises for the target area ‘retral tongue third’, Diaphragma Oris and pharyngeal space commonly are applied in the third training phase for swallowing problems or impairments of the tongue mobility – the preceding two phases are attending to the first and second tongue third.

A further emphasis lies on the practicing of the G and K sound. A special practical area are disorders in the management of the respiratory path mouth/nose which are frequently caused or continued  through the incompetency of the respective musculature (Velum, Pharynx) as with snoring or sleep-apnoea (also see paragraph “Discussion). See also PHARYNX-CLOSING-EXERCISES.

Contents:

In accordance with the disorder the exercise contents are complex, mostly function kinetically oriented.

Materials:

Exercise specific, additional means are specially needed to set feed-back stimuli.

Procedure:

- Previous exercises: Generally the exercises for the musculature of the first and second third of tongue should have been completed. In case of a defect determined  designed application  pre-exercises may be omitted.

-Starting position: Case specific.

- Step-by-step-description:

Case specific. The mostly quite complex exercises are introduced diligently as, in the beginning, the therapist is attentively monitoring the precision of the carry-out  followed by the habituation with the routine appliances. (see HABITUATION EXERCISES).

-Timing: Within the main treatment course the exercises are aligning, as already mentioned, after the Sensitation and Orientation in the final part of the respective training phase.

[ 1. phase: Regeneration of the motoric frame,

  2. phase: Establishing the neuromotoric frame,

  3. (mental) phase: Habituation.

Characteristics:

Polyvalent, mostly function-kinetic, Reflex control, Feed-back.

Remarks:

As he greater part of the problems in the back part equally will be psychically problematic and the muscle action in wide sections are passing of unconsciously special importance should be attached to cooperation of the patient. Not so rarely may be found a tendency among our patients to declare the exercises as not practicable or simply ineffective.

Practicing and carry-out should, because of the complicated visual control of the procedure, take place wit utmost diligence.

To the respiratory tract diseases equally are counted the mouth breathers. In those cases a surgical intervention for the correction of the airway will not be obligatorily requested though it may reduce the treatment time.

As with all problems in the special field of MFTherapy here as well  the neuromuscular function has shaped the (hard-) textural form – as well in the pharyngeal cavity as in the outer face. The nose which is forced to inhale will “grow”.

Discussion:

In the previous text it was pointed at the, through the position of the target area and the control through the unconscious complicated therapy situation.

An approach will be possible through sensory feed-back stimulations as well, as through mental training components. Monitoring can be realised only in parts as, for example, in  SQUEEZE-A-FLAKE

through the condition of the flake, through methods of palatography (see PALATOGRAM) or -with respective exercises under air pressure in the Cavum Oris -  using the (TONOMETER). These exercises are marked with a (T) in the following list and liked to the respective chapter.

In the follow a list is aggregated containing the topic relevant exercises:

LIST OF EXERCISES

(in a succession deriving from the translation of a similar list in the German language)

ELEVATOR

          Strengthening of the musculature for the palatal  

          version of the retral part of the tongue body by

           tactile aesthetic stimuli.

BALLOON

          Strengthening of the pharyngeal closure through

          positive air pressure in the oral cavity (T).

BLOW THE BALL         

          Pharyngeal closure against the nasal cavity

          while blowing an air stream.

THREE-RING-EXERCISE         

          Lifting of the entire tongue body as well

           retrally; tactile stimulus.

FEEDBACK-EXERCISE

          Using natural or manipulated receptor  

           stimulation for an action monitoring.         

PODGY TONGUE- SLIM TONGUE

          Dynamo -kinetic Training of the complete

          transversal musculature of the whole tongue body.

SQUEEZE-A-FLAKE

          Gross motor exercise to strengthen the palatal

          directed orientation of the tongue body.

YAWNING MAN

          Gross motor intensified keeping open of the air

           stream passage of the oral cavity.

PALATE-SLIDE

          Strong retral-caudal vert muscle traction –

           tongue and oral diaphragm muscles.

GARGLE

           Training of a reliable tracheal closure.

BLOW THE  STRAW

           Air flow exercise (T).

STRAW SUCKING

            Secure retral closure of the Cavum Oris

           together with a simultaneous volume change of

           the oral cavity.

HOLD-AND-PULL

           Gross motor  static strengthening of the

           extrinsic mouth tongue and the floor

           musculature.

BACK-CENTRE-FRONT

           Positioning and strengthening of the elevator

           muscles for the complete tongue.

CHEW AT THE BACK

           Retralisation of the chewing process.

,K-K-K’-EXERCISE

           Quick-changing opening up of the air flow

           passage mouth - nose

‚KICK’

           Feeling out the extended motion frame and

           strengthening of the muscles of  tongue base     

           mouth floor and pharynx.

L-M’-POSITION

          Fixing the tongue body at the palate and the lip

           closure in the rest stadium.

MENTAL TRAINING

          Habituation of rehearsed muscle actions and

           avoiding of unwitting dysfunctions.

MOUTHBREATHING

          Playful experiencing the own body, mostly

           combined with allo-manipulations as stretching

           and massaging.

NOSEBLOW EXERCISE

           Closure by velum to tongue base with air

           pressure loading through finger manipulated

           congestion in the nasal cavity.

,P-P-P’-EXERCISE

           Lip dosed air flow exercise with a frequent

           lifting and sinking of the Velum, here as a

           MOTILITY-EXERCISE (T).

WHISTLING KETTLE

           Air flow exercise for the S-canal.

PIPELINE

           Pseudo-manipulated functional muscle action;

           straw drinking as a continuous reflex motor

           function.

PLATELET-HOLDER

          Lip closure, manipulated hold-exercise.

PEA-SHOOTER

           Pharyngeal closure under oral cavity over-

           pressure (T).

PHARYNX-CLOSING-EXERCISES

           (see there).

RING LOCKER. Habituation of the tongue-tip position to avoid the down lapse.

DRAW-BACK

           Strengthening of the extrinsic tongue

           musculature and the Diaphragma Oris.

SWALLOW-MECHANISM

          Patient instruction.

SNORKEL,DRAWER-IN’-EXERCISE (CHIN-IN)     

           Realization of tensioning and loosening in the

           throat musculature through a sensory feed-back

           feeling.

,DRAWER-IN’-EXERCISE (CHIN-IN)         

           Physiological Mandibula position illustrated

SOAPBUBBLE

           Drinking straw exercise for the pharyngeal

           closure of the oral cavity.

TIP-PRESSURE

           Protrusion exercise for mouth floor and

           extrinsic tongue musculature.

WATER PUMP

           Drinking straw exercise for the pharyngeal

           closure

WORDEXERCISES 3. THIRD

           Acoustic monitoring of the upwards movement

           of the tongue.

Instructions: