ELASTIC EXERCISES

Myofunktional Exercise  Collect ion

Application:

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

The exercises maintain an facilitate aimed feed-back stimuli for triggering desired muscle actions showing a deficit or for monitoring of their correct carry-out especially in the target area tongue.

The aim of the exercises is the controlled and conscious perceiving of proceed muscle actions.

Contents:

Application of items / foreign bodies, here the standardized elastic ring for the manipulated setting of a feed-back stimulus.

Materials:

Small orthodontic rubber ringlets with a ring diameter of about one centimetre and a rubber ring thickness of about half a millimetre.

Procedure:

- Previous exercises: Commonly the muscle action required (posture or motion, reflex circuit) will be prepared on the muscular level.

Moreover it might be desirable to focus the mucomembraneous surface (of the tongue) on the tactile sensation mostly meaning rather a sensitation then a desensitising (with this also see SENSITIVITY EXERCISES like TONGUE DABBING or TONGUE CONTACTS).

-Starting position: With this the correct positioning of the elastic will be practiced in a special training session using the hand mirror monitoring where at first the therapist, later on the patient will set the ring in position. With this precision should be observed.

- Step-by-step-description:

-1 <the patient opens his mouth slightly extending his slender formed tongue (tip) slightly. The ring is positioned on the tip with a finger and “put straight” (readjusted) as to extend the tongue border evenly and slightly (see illustration).

-2 The step sequence descriptions are exercise specific; the respective exercises are recorded in the paragraph “Discussion” under ‘List of Exercises’.

-Timing: The elastic ring is prescribed each time in the starting phase of the training of a particular muscle action and finally will have to be replaced through the natural touch sensibility (thigmaesthesia) tongue against mucosa.

Characteristics:

Sensitivity, Stereognosis, Habituation, Motivation, Information, (Tactile (kin)aesthesia, Orientation, Feed-back, Reflex-control, Rest position.

Remarks:

As with all aids and supplies, especially the nonphysiologic, - an elastic ring normally does not belong into the mouth (in contrary to the alternatives as the rice grain etc. (as described further down) and should be replaced by the physiological Tactile aesthesis after the therapeutic success.

Optimal instruction should be mediated about the positioning, location, maintenance and posture monitoring, the length of stay and the holding time and opportunity. Moreover an appropriate mediation of back-ground information with initial self control with a hand mirror is required. Accompanying measures like timetables, success and score lists are to be prescribed. The danger of aspiration will have to be taken into account. The manipulative measures are to be replaced by functional ones as soon as possible (see above).

Discussion:

The Elastic Exercises are representing the core of a training phase in multiple cases. The method serves the orientation as similarly described in the chapter REMINDER or as explained under FEEDBACK or it is established for the habituation of the desired neuro-muscular action.

Firstly the matter of discussion should be the question if the Elastic should be used principally. The view is found supported that this foreign body is unphysiologic and would hold the danger of being swallowed or aspirated. Quite a number of alternatives is being offered of which the cornflake, here called “Flake” for short, is giving several of the exercises their character as, for example in ELEVATOR, the SQUEEZE-A-FLAKE or the ,KICK’. Substitutes are offered with rice grains (boiled or unboiled) and raisin slices. As described, the carry-out of exercises by application of the elastics – for example in connection with the integration of the detail step swallow for the palatal orientation of the tongue back or furthermore with the CRUMB SWALLOW, LIQUID SWALLOW

or  EAT-(AND DRINK-)EXERCISE and the like – of great service at one hand but also controversial at the other.

MFT-exercises are called function-therapeutic. Here the meaning of function would be “matching or corresponding the physiological course of action”. This contents definition should help to only deviate from physiological conditions even in Training only in urgent exceptional cases in which “the end justifies the means “ and no alternative is at hand.

Swallow exercises with elastics are fairly unphysiologic; a foreign body tracked down in the mouth during the chewing process should interrupt the procedure to be eliminated before the swallow reflex passes off.

The retaining of chewing matter upon the tongue surface may rather occur when foodstuff particles are noticed as being not jet sufficiently chopped up. For this example the before mentioned alternative presents itself. For hold-exercises with elastics the application of these is more acceptable (RING LOCKER). For this opportunity, though, small sugar free pastilles with tasty aromas may be recommended which will melt in the mouth.

For the MFT-practitioner it is definite that the elastic has quite a motivating effect on little patients and, as known so far, never has caused allergic reactions.

LIST OF EXERCISES (using elastics):

RING LOCKER

TWO-RING-EXERCISE

THREE-RING-EXERCISE

CRUMB SWALLOW

EAT-(AND DRINK-)EXERCISE

LIQUID SWALLOW

WORDEXERCISES (in exceptional cases).

Instructions: