title: Adoption into clinical practice of two therapies to manage swallowing disorders: exercise-based swallowing rehabilitation and electrical stimulation.
abstract: OBJECTIVE
  To review recent literature depicting a shift in dysphagia rehabilitation in adults. Distinguishing rehabilitation from compensation in dysphagia management, a review of basic exercise principles is followed by description of recent publications depicting exercise-based therapies. Subsequently, transcutaneous electrical stimulation (TES) is reviewed as it may contribute to exercise-based dysphagia rehabilitation in adults.
  
  
  RESULTS
  Surveys have documented extensive variability in the clinical application of dysphagia therapy techniques. Despite this variability, two trends are emerging in dysphagia rehabilitation research: documentation of physiologic and functional changes within the swallowing mechanism subsequent to therapy; and prophylactic exercise-based therapies. In addition, extensive efforts have emerged describing the potential application of TES in dysphagia rehabilitation. Though results of these efforts are conflicted, TES may serve a useful role as an adjunct to well developed exercise-based rehabilitation for dysphagia.
  
  
  CONCLUSIONS
  The focus of dysphagia rehabilitation in adults is changing. Current efforts indicate that exercise-based therapies should incorporate multiple principles of exercise physiology and document physiologic change within the impaired swallowing mechanism. TES may function as an adjunctive modality; however, current practices should be evaluated to develop additional parameters of stimulation that are focused toward specific dysphagia impairments.
authors.affiliation: aSwallowing Research Laboratory, Department of Speech, Language, and Hearing Sciences bSwallowing Research Laboratory, Department of Behavioral Science and Community Health, University of Florida, Gainesville, Florida, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Crary
authors.forename: Giselle D
authors.initials: GD
authors.lastname: Carnaby
mesh_terms: D000328:Adult; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy; D006801:Humans; D004561:Transcutaneous Electric Nerve Stimulation