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Purpose: This exercise facilitates increased pressure in your throat to aid movement of food and fluid through to your oesophagus (food pipe). This
also helps to decrease the leftover residue in your throat.
1. Try to squeeze very hard with your tongue and throat when you swallow.
2. “Imagine swallowing a ping-pong ball”.
3. Feel the effort in your neck while you swallow.
4. Repeat this exercise 5-10 times, three times per day..
NB. Practice with saliva only first and then try this with sips of water.


Who and how many people required?
1 person – RPC/RPW/Friends
Aim of Intervention:
To facilitate improved upper esophageal sphincter opening to maximize swallowing saftey
Head-Lift Exercise
1. Show the client the picture below and read the instructions aloud to the client / demonstrate to the client
2. Ask the client to complete the following:

I. Lie on your back; and

II. Raise you head until you can see your feet (but do not use your shoulders to do this).
III. Hold this posture for 10 seconds.
IV. Repeat Steps 1-3 x3 times.
V. Then… Repeat Steps 1 & 2. But only hold your head up briefly then relax – repeat x10 times.
VI. Do these x 3 daily.

** do not complete with food!

Record success/difficulty on the feedback form
Purpose: An indirect exercise that helps open the upper oesophageal sphincter (the muscle at the top of your food pipe). An exercise that
can be beneficial when the larynx (voice box) isn’t moving properly.

1. Lie down on a bed.

2. Slowly raise your head (only) off the bed.
3. Repeat head raises repetitively 30 times and hold each one for three seconds.
4. Do this 3 times a day.

Purpose: An exercise to increase the strength of the muscles at the back of your throat in order to improve the movement of food and fluid
to the oesophagus (food pipe).

1. Stick out your tongue and hold it between your front teeth.
2. Swallow while your tongue is held in this position.
3. Start with 7-10 repetitions and increase to 10-20 as able. Repeat three times a day.

NB. You may need to moisten your mouth to help get your swallow started.

Who and how many people required?
1 person – RPC/RPW/Friends/Family

Aim of Intervention
To improve base of tongue to posterior pharyngeal wall approximation; to improve positive pressure on the bolus; to improve
strength of pharyngeal swallow.
Massako Manoeuvre
1. Read the following instructions aloud to the client, demonstrate the instruction, then ask the client to copy you
2. Get a mirror and encourage the client to look at themselves in the mirror when completing this task.
3. Do not complete with food!
4. Put your tongue between your teeth and bite it gently.
5. Swallow
6. Do this 10 times, twice a day.
7. You should encourage the client to have a drink in between.
Record success/difficulty on the feedback form

Purpose: An exercise to improve the opening of the upper oesophageal sphincter (muscle at the top of your food pipe) to help move
food and fluid more efficiently through the pharynx (throat).

1. Swallow and feel your voice box/Adam’s apple rising up as you swallow.

Next time, during the swallow, try to hold the voice box up at it’s highest point for five seconds.
Repeat this exercise 5-10 times, three times per day.

NB. Do not use food or fluid with this exercise