Resistance-based devices rely on exhalation through adjusting the size of an internal diameter. EMST is implemented by hand-held devices, which are categorized as either resistance or pressure-threshold types. The effects of EMST have been shown to increase the strength of respiratory muscles for improving cough, voice and swallow functions. For the purpose of this article, EMST will be discussed along with its utility in cough function and swallow rehabilitation. As the name implies, the purpose of IMST is to strengthen the muscles of inhalation with improvement in function such as weaning from mechanical ventilation 1 and slowing the progression of respiratory deterioration in individuals with ALS 2. Expiratory muscle strength training (EMST) is one of only a few swallow exercises incorporating these important principles.ĮMST is categorized as respiratory muscle strength training (RMST), which also includes inspiratory muscle strength training (IMST). Evidence of improved swallow function with application of exercise physiology and neural plasticity principles has been shown in several therapies. I have always been amazed with the intricacy of the neural muscular underpinnings of deglutition and the power of neural plasticity through rehabilitation. Early on in my career, I was drawn to the wondrous world of swallowology.
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