TheraSIP Swallowing Trainer is a resistive exerciser involving pressured sucking of thin liquid through micro-sized straws and then using the small sips to practice traditional swallowing exercises such as the tongue hold, the effortful swallow, or the Mendelsohn maneuver. Repetition is key to this tool in that the amount sucked is equivalent to the saliva in the mouth, allowing safe repetitive hard dry swallow drills. The resistance straws come in three sizes and are not for functional drinking. The patient is required to suck as hard as possible, and the amount drawn can be measured and monitored by the clinician. The exercise of pressured sucking involves lip seal, velo-pharyngeal seal, laryngeal seal, and activation of the suprahyoid muscles, particularly the mylohyoid and the digastric muscle (Ratovsky et al., 2012). The act of sucking ensures the exercise has specificity and the three straws of different sizes allows the exercise to be increased in difficulty. Normative information (Clark et.al. 2014) regarding the amounts typically drawn by adults are provided.
Included in the kit is:
- a 50ml graduated cylinder,
- a measuring cup,
- a set of three resistance straws
- and a complementary set of TheraSTRAW Assessment Straws
The complimentary TheraSTRAW Assessment is a set of reusable functional drinking straws of various interior diameters which telescope into each other to keep the exterior size of the straw consistent. These may be shortened by cutting with scissors or bent by putting in microwave.
The TheraSTRAW Assessment straws are designed for assessing thin liquids at bedside and during instrumental studies to determine if the swallowing of small boluses can be performed safely. It is important to ensure the patient’s mouth is not dry or false results may happen. Use of SwallowMist or DirectMist work well to lubricate the mouth before taking sips with straws. Observation of cough or other signs of difficulty at bedside will provide helpful information for the instrumental study. The safest TheraSTRAW can then be prescribed for free water protocols.