Reconsidering Rehabilitation for Neurogenic Dysphagia: Strengthening Skill in Swallowing

Purpose of Review: Rehabilitation for oropharyngeal dysphagia aims to improve impaired swallowing biomechanics. However, adverse effects have been reported with strengthening exercises, such as effortful swallowing. Current research is highlighting improvements based on skill, rather than strength, training. Thus, the goal of this review is to determine what evidence exists for skill-based rehabilitation in dysphagia. Recent Findings: Skill training may be defined as functional repetition and refinement of movement patterns. Skill-based rehabilitation paradigms have been reported for rehabilitation interventions such as lingual accuracy tasks, respiratory-swallowing coordination, and using biofeedback to improve the efficiency of oropharyngeal swallowing. The ultimate goal is to acquire skill in execution of specific swallowing biomechanics at a central level. Summary: The studies reviewed provide favourable proof-of-concept and positive indicators that skill-based intervention may circumvent some limitations with existing strength-based intervention modalities. Skill-based training in dysphagia may be a promising area for future research. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.