Device-Assisted Therapy for Lingual Function Rehabilitation: A “How To” Guide for Clinicians

Lingual function rehabilitation is a frequently targeted area of exercise-based dysphagia treatment. This tutorial aims to provide a detailed guideline for clinicians on how to apply currently available evidence for implementation of lingual rehabilitation exercises both with and without device-assisted modalities. We provide a detailed review of existing definitions of lingual function parameters (e.g., strength and endurance) with currently available normative values for clinical reference. Guidelines are also provided on how to use available lingual manometry (Iowa Oral Performance Instrument and Tongueometer) to aid in both assessment and treatment. With respect to determining exercise targets based on the lingual function assessment, we review the importance of leveraging principles of exercise physiology into the rehabilitation planning. Strategies for incorporating exercise physiology principles into strength and endurance training are provided along with a case example illustrating these concepts. This tutorial serves as a framework for clinical implementation of comprehensive lingual function assessment and rehabilitation. Considerations regarding barriers in access to equipment and clinical advocacy are also discussed.