The Breather provides our patients with concrete feedback and motivation as they advance through the Breather's numbers. Patients may struggle with breath control or strategies; but, they understand and are able to successfully use the Breather. We have experienced more rapid and complete recovery in patients with voice disorders, dysarthria, and dysphagia resulting from traumatic brain injury, a variety of neurological disorders, and degenerative diseases. If only the hospitals would throw out the incentive spirometers; the Breather is so much more effective and simple to use!
- Cally R. Stone, MS, CCC-SLP, The Talk Shoppe, Meridian, ID
We were not seeing progress with typical therapy strategies in this 5 year old child with very poor volume and breathy voice quality in addition to hypernasality and nasal air emission during connected speech. We began using the Breather with the lowest resistance level for both inhalation and exhalation, gradually increasing to the highest resistance levels over five weeks. Voicing volume improved and nasal air emissions have decreased in connected speech. She enjoys using her special "Blue Blower." The family practiced with the Breather one to two times a day, in addition to more typical speech carry over activities.
- Debra Beckman, MS, CCC-SLP, Beckman & Associates, Winter Park, FL
I'm seeing immediate results when I use the Breather in terms of relaxation of the vocal chords. There is a lowering of pitch of the voice when the vocal chords relax. The concept is similar to that of guitar strings, looser strings make a decrease in pitch. When the vocal chords are strained and trying to approximate, there is an increased pitch and strained voice. So relaxation helps to promote a lower pitch which has an immediate effect with my patients inteligibility.
- Caroline Smallwood, MACC-SLP, Moultrie Creek Rehab, St. Augustine, FL
Three of my current patients have been instructed in conventional speech therapy along with RBT. They didn't regularly practice their conventional speech therapy but they never missed using the Breather. They appeared to like a tangible, biofeedback type of device. I also believe in the need for improved respiratory function to help support the use of the Passy-Muir Speaking Valve. (The Passy-Muir Speaking Valve fits the standard 15mm hub of most adult tracheostomy tubes, and when in place, re-directs airflow on exhalation through the oral/nasal cavities, hence restoring a closed physiologic system permitting oral speech, improved swallowing, expectoration, improved smell and taste, and reduced risk of aspiration and/or aspiration pneumonia.)
- Mary Spremulli, Speech pathologist, Punta Gorda, FL
After over thirty years of clinical work, what a find! As speech pathologists, we work on improving respiratory support for phonation, speech articulation, and safer swallowing. The protocol is simple to follow. Functionally, changes are typically seen in areas such as: stronger, more productive cough in dysphagia patients and safer swallow; more audible voice in Parkinson's patients with improved articulation of many consonants; stronger voicing, safer swallow, clearer articulation in patients with a variety of neuromuscular disorders; faster recovery of voice in patients who had been recently extubated; general improvement in all dimensions of voice in patients with dysphonias related to poor respiratory support due to shallow breathing.
- Sena Hawes, Ph.D., CCC-SLP, Diamondhead, MS
An excellent oral/motor muscle trainer. My patients practice 3 sets of 5, twice a day. The results have been amazing. All that have used the Breather have made remarkable progress, especially my dysphagia patients. They were able to swallow more safely, and their diets were upgraded.
- Bonnie Sins, CCC-SLP
A respiratory therapist I work closely with introduced me to "the Breather" during joint therapy sessions with severely dysphagic and respiratory compromised patients. As a speech-language pathologist, I saw great results in improved cough effort and breath support when resistive breathing training (RBT) was incorporated into my speech and swallowing sessions. I recently worked with a heart transplant/dysphagic patient who reported "feeling a difference" in the strength of his cough and swallow once RBT was added to his exercise program. Patients with short phonation have also made measurable increases after including the Breather in their speech therapy program. I've continued to incorporate RBT to improve exercise fitness and to help overcome speech and swallowing disorders in my speech therapy programs.
- Pam Parker, MS, CCC-SLP, Portland, OR
I noticed that patients held air in their cheeks and firmly held their lips together when they had to make a seal with their mouths while practicing with the Breather. I feel this increased their buccal or cheek tone and labial (lip) strength or tone. This strength is necessary for eating and speaking. I also noticed slurred speech was improved with one of my CVA (stroke) patients using RBT.
- Speech pathologist in Bradenton, FL
I have my patients sit in front of a mirror whenever possible and begin exercise program with RBT for approximately 10 breaths before resting, especially in the beginning so as not to let the patient get dizzy. One CVA patient could only phonate 3 to 4 seconds and is now completely normal - up to 15 seconds.
- Speech pathologist in MO
Note to Speech Pathologists: How many of you have seen speech therapy called in after a patient is extubated? It can be quite difficult to initially detect if a patient is experiencing difficulty in swallowing, however, if the patient has a whispery voice or difficulty in speaking, then there is trauma to vocal folds and the patient is at risk for aspiration pneumonia.
Swallowing Disorders In Patients With Prolonged Orotracheal Intubation Or Tracheostomy Tubes; Critical Care Medicine, Dec.1990. Discussed that swallowing disorders (dysfunction) may persist after the tracheostomy tube is removed. And the defects may be more analogous to disuse muscle atrophy, with weakness and discoordination of the swallow response. And in conclusion, prolonged intubation (mean average of time for patients in this study was 19.9 days) is associated with swallowing disorders and may predispose the patient to aspiration. The defects might be secondary to muscle atrophy, discoordination or diminished senses to nerve endings rather than motor nerve injury. The disorder appears reversible, and therapy might help shorten the course. And as pointed out, the presence of a gag reflex does not confer protection against aspiration, but appropriate therapy may decrease risk for aspiration and/or aspiration pneumonia. Note: Article did not suggest what type of speech therapy should be initiated.
RBT appears to not only increase the strength of the respiratory muscles, but may strengthen and improve the muscles to improve swallowing and to facilitate adequate breath and muscle tone for improved speech. In conclusion, more observation needs to be done by speech pathologists and you as to whether RBT can strengthen the muscles of swallowing and speech, however, since respiratory control is the foundation of good phonation, breathing exercise and RBT should be a significant part of speech therapy.
Please contact us with your experiences or questions using Resistive Breathing Training (RBT) in order to benefit other professionals.