Introduction:
How often have you heard that “the best exercise for swallowing is swallowing” (source unknown)? As such, individuals with dysphagia are often encouraged to practice an effortful or hard swallow to strengthen weak swallowing muscles. The effortful swallow is one of the most commonly prescribed exercises to address dysphagia resulting from muscular weakness. The original description of how to complete this exercise is attributed to Logemann (1983). To complete this exercise, individuals are instructed to squeeze all their muscles as hard as possible when swallowing. They may also be encouraged to swallow hard and fast or imagine as if they were trying to swallow a golf ball. Importantly, the effortful swallow exercise meets the principles of specificity as it is an exercise that closely matches the normal process of swallowing and overload through high effort.
The purpose of this resource is to provide a list and brief summary of the evidence available to support the use of the effortful swallow as part of a dysphagia rehabilitation plan of care. Studies have been conducted in healthy and disordered populations using a variety of outcome measures to determine the effects of the effortful swallow on safety, efficiency, and swallow kinematics. The tables below summarize a select group of studies focused on the effortful swallow.
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