Therapeutic Exercise and Velopharyngeal Gap

Abstract

The physiological characteristics of velopharyngeal function during blowing, sucking, and swallowing exercises have been described by sev— eral authors, as well as the possibilities for using these exercises to in— crease velopharyngeal function during speech. Although the reports are generally descriptive in nature, the information provided from such investigations may be useful in understanding the possible results which may be expected from therapeutic exercises which involve these activities. Findings by M011 (4) and Bloomer (1) indicate that there is less sphincteric action of the velopharyngeal mechanism in speech than in swallowing. In addition, McWilliams and Bradley (3) suggest that speech demands velar—pharyngeal behavior which is physiologically different from that required for blowing. Shelton (6) maintained that velopharyngeal movement is greater during deglutition than during speech and that this difference becomes significant when fitting an obturator to facilitate velopharyngeal clo— sure. He further noted that the obturator might help to enhance greater movement of the palatopharyngeal muscles. Several authors (9, 5, '7) have suggested that the activities of swallowing , blowing, and sucking may be used as therapeutic devices to facili— tate velopharyngeal closure during speech sound production. West, Ans-berry, and Carr ('7) cite two objectives for using therapy devices such as blowing exercises: to effect a closure of the nasopharyngeal port in order to increase the intraoral pressure needed for consonants, and to obtain resonance control for the production of vowels and semi-vowels. Morley (5) indicated that blowing exercises may be useful in adjusting the position of the tongue in order to obtain least resistance to the air stream coming through the vocal tract. She also stated that blowing exercises may facilitate compensatory movements of the posterior and lateral pharyngeal walls and the soft palate and may increase mobility.