Dysphagia Therapy Exercises

After a stroke, many stroke survivors experience issues with eating and drinking. These problems may include trouble swallowing, choking on food or saliva, and trouble chewing food.

Dysphagia is the medical term used to describe this type of swallowing impairment. After a stroke, muscle weakness, coordination problems and loss of sensation of the face, tongue, mouth or throat may contribute to dysphagia.

Often, after a stroke, one side of your face, tongue or throat is weaker than the other side, leading to an imbalance of strength between the two sides.

Dysphagia is a serious problem because stroke survivors who suffer from dysphagia may choke while eating, may develop a complication called aspiration pneumonia and may become malnourished as eating becomes more difficult.

Rehabilitation after a stroke typically includes a number of physical exercises as well as a swallowing evaluation. If a swallowing problem is detected, speech and swallow therapy is recommended to manage and overcome your swallowing problems after a stroke.

Dysphagia Therapy

Dysphagia therapy is primarily focused on learning how to swallow safely and how to rebuild the muscle and coordination skills necessary to improve swallowing. The overall approach to dysphagia therapy follows a comprehensive plan of care that includes modifying the type of food that you eat and practicing different types of exercises that have been shown to improve swallowing function.

For instance, if you are having difficulty directing the movement of food in your mouth due to tongue weakness, you may learn how to use maneuvers such as tilting your head or changing your body position while you to swallow.

As you participate in dysphagia therapy, you might also meet with a dietician or a nutritionist.

You will likely receive some dietary instructions to prevent choking. Changing the types of food you eat may be necessary for your safety.  For example, eating and drinking food that is thicker can help prevent choking, because thicker foods take longer to be transferred from the front to the back of the mouth.

Swallowing exercises target the muscles involved in swallowing.

Tongue Exercises

Tongue exercises are among the most effective ways to improve your swallowing ability after a stroke. Your speech and swallow therapist can show you the methods that you should use to regularly practice tongue exercises at home so that you can regain the tongue strength and control necessary to direct the food in your mouth. Strengthening your tongue and improving your coordination can make eating and drinking safer and easier after your stroke.

Lip Exercises

The muscles of your lips are used to move food around your mouth. The lips create a tight seal which prevents food and liquids from leaking out of the mouth as you begin swallowing.

Coordination of both sides of your face and lip muscles allows you to eat using both sides of your mouth without drooling. If you lose sensation of one side of your face after a stroke, it can be more difficult to control your lip muscles. Lip exercises can help you better control your lip and face movements even if your sensation is partially lost as a result of your stroke.

Jaw Exercises

A stroke can affect the areas of the brain that control the muscles needed for chewing. This makes it difficult to make your food soft enough and small enough to swallow. As a result, large chunks of food may become trapped in your throat. This is why jaw exercises can improve your ability to swallow after a stroke.

When you do not chew your food effectively, you may also be at risk of aspiration pneumonia. This is why 'pre-chewing' before swallowing is so important and why it is a real health hazard after a stroke.

Swallowing Exercises

If you have dysphagia, one of the best ways to regain swallowing ability is by performing swallowing exercises. Swallowing requires coordination, sensation and muscle strength. As with many effects of a stroke, one side may be more affected than the other side. Learning to coordinate movements of both sides of the swallowing muscles helps prevent choking and aspiration. Your speech and swallow therapist, who is a member of your stroke team, will evaluate your swallowing abilities and design a rehabilitation plan to help you rebuild your swallowing ability after a stroke.

 

Edited by Heidi Moawad MD

Source:

Rehabilitation of Swallowing and Cough Functions Following Stroke: An Expiratory Muscle Strength Training Trial, Hegland KW, Davenport PW, Brandimore AE, Singletary FF, Troche MS, Arch Phys Med Rehabil. 2016 Aug;97(8):1345-51

Continue Reading