Deep Inhalation Exercise: Improves diaphragmatic breathing and subglottic pressure to address speech intelligibility and respiratory-swallow coordination

Goal: “Patient will sustain inspiratory volume duration of 5 seconds via breathing therapy biofeedback exercise for 20/20 trials to improve subglottic pressure for voicing in 2 wks.”

Forced Expiration Exercise: Improves forced expiratory volume needed to address airway clearance (coughing, airway protection during swallow) and vocal intensity for voicing

Goal: “Patient will execute forced expiratory volume breathing biofeedback exercise for 9/10 trials with moderate level of difficulty to improve vocal intensity in order to make
needs and wants known to caregiver in 2 wks.”

Controlled Expiration Exercise: Assists in expelling carbon dioxide and reducing dyspnea to improve speech intelligibility (at the phrase/sentence level) and sustain phonation

Goal: “Patient will sustain exhalation via breathing biofeedback exercise to increase maximum phonation time to 15 seconds to improve speech intelligibility at the conversation level in 2wks.”

Rhythmical Breathing Exercise: Focuses on coordination of inspiratory and expiratory breathing to improve speech intelligibility at the sentence/conversation level and improve
respiratory-swallow coordination

Goal: “Patient will work on rhythmical breathing biofeedback exercise to help normalize respiratory-swallow coordination exhibited by an improved score of ≤ 3 from a score of 12 on the EAT-10, indicating decreased difficulty swallowing in 2 wks.”

Active Cycle of Breathing Technique (ACBT)/Huff Technique Exercise: Addresses proper breath control, thoracic expansion, and huff technique to mobilize secretions to improve productive cough for airway clearance and airway protection during swallow

Goal: “Patient will execute huff technique with use of breathing biofeedback exercise to perform productive cough x 3 per session to clear airway during PO trials, in order to increase nutrition/hydration in 2 wks.”