Neuromuscular Treatments for Speech and Swallowing A Tutorial Tutorial
Tutorial  |   November 01, 2003
Neuromuscular Treatments for Speech and Swallowing
 
Author Affiliations & Notes
  • Heather M. Clark, PhD
    Appalachian State University, Boone, NC
  • Contact author: Heather M. Clark, PhD, Department of Language, Reading, and Exceptionalities, Appalachian State University, Boone, NC 28608.
    Contact author: Heather M. Clark, PhD, Department of Language, Reading, and Exceptionalities, Appalachian State University, Boone, NC 28608.×
  • Corresponding author: E-mail: clarkhm@appstate.edu
Article Information
Swallowing, Dysphagia & Feeding Disorders / Tutorial
Tutorial   |   November 01, 2003
Neuromuscular Treatments for Speech and Swallowing
American Journal of Speech-Language Pathology, November 2003, Vol. 12, 400-415. doi:10.1044/1058-0360(2003/086)
History: Received September 11, 2002 , Accepted April 4, 2003
 
American Journal of Speech-Language Pathology, November 2003, Vol. 12, 400-415. doi:10.1044/1058-0360(2003/086)
History: Received September 11, 2002; Accepted April 4, 2003
Web of Science® Times Cited: 76

Despite the proliferation of oral motor therapies, much controversy exists regarding the application and benefit of neuromuscular treatments (NMTs) such as strength training for alleviating dysarthria and/or dysphagia. Not only is limited empirical support available to validate the use of NMTs, but clinicians may also lack the foundational information needed to judge the theoretical soundness of unstudied treatment strategies. This tutorial reviews the theoretical foundations for several NMTs, including active exercises, passive exercises, and physical modalities. It highlights how these techniques have been used to address neuromuscular impairments in the limb musculature and explores potential applications to the speech and swallowing musculature. Key issues discussed in relation to active exercise are the selection of treatment targets (e.g., strength, endurance, power, range of motion), specificity of training, progression, and recovery. Factors influencing the potential effectiveness of passive exercises and physical modalities are presented, along with discussion of additional issues contributing to the controversy surrounding oral motor therapies.

Acknowledgments
This tutorial has benefited from the contributions of several individuals. Nancy Pearl Solomon provided clarification of issues related to the physiology of the speech and swallowing systems. I am indebted to Travis Threats, Brenda Kennell, Joe Duffy, and Gary Weismer for their invaluable suggestions for strengthening earlier versions of the manuscript. I also wish to thank Kristie Cothren, who accessed many of the documents cited in this tutorial.
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