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Fig. 3 | BMC Neurology

Fig. 3

From: Oral neuromuscular training in patients with dysphagia after stroke: a prospective, randomized, open-label study with blinded evaluators

Fig. 3

Orofacial sensory-vibration stimulation using an electric toothbrush. (Left) Stimulation of (1) the buccinator mechanism that activates tongue retraction; (2) the muscles of the floor (m. digastricus anterior abdomen, m. mylohyoideus and m. geniohyoideus) that will lift the hyoid bone forward and upward and activate the swallow reflex; and (3) the lips, enhancing lip closure. (Middle) Stimulation of the front of the tongue that activates and raises the root of the tongue, thus passively activating the receptors in the anterior faucial arch to perform the swallowing reflex and indirectly lift the velum. (Right) Stimulation of the tip of the tongue by downward pressure improves the force of the tongue. All the different movements in the left, middle, and right images also provide sensory stimulation (through n trigeminus, afferent pathway) and feedback as a motor response (through n facialis, efferent pathway), that describe the sensory-motor reflex arc. Illustrations: Anna Jäghagen (own illustration/image)

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BMC Neurology

ISSN: 1471-2377

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