This presentation explores swallowing skill training approaches and the motor learning principles (MLPs) which underpin these approaches. The session will provide a succinct overview of the research, focusing on the key objectives, methods, results and conclusions. Objectives: Dysphagia rehabilitation has traditionally focused on targeting muscle weakness as the underlying cause of dysphagia. Emerging evidence has highlighted the role of cortical motor input in swallowing. Swallowing skill training aims to increase or adapt cortical modulation to improve swallowing function. Given the recency of swallowing skill training, this scoping review addressed the following question “What are the swallowing skill training approaches used in swallowing rehabilitation and what are the motor learning principles that underpin these approaches?” Methods: Searches were conducted in five databases (CINHAL, MEDLINE, PUBMED, Emcare, and Web of Science). Two researchers independently screened studies for inclusion using Covidence, with data extraction conducted by the first author. English titles were included without time limitations. Results: 21 studies were included (15 empirical research studies and 6 opinion-based papers). From these, four primary swallowing skill training approaches were identified, including (1) Floor of Mouth surface electromyography, (2) Manometry, (3), Respiratory Swallow Coordination and (4) Iowa Oral Performance Instrument. All approaches incorporated practice and feedback related motor learning principles, however, there were variations in how these principles were applied across and within approaches. Conclusion: Swallowing skill training approaches included in this review report improved swallowing function and quality of life. However, inconsistencies in applied methods and the variability in motor learning principle implementation indicates a need for further refinement of swallowing skill training approaches. Additional research is required to refine and optimise these approaches and establish their efficacy. This research will allow for reproducibility in clinical practice and will subsequently enhance dysphagia rehabilitation to additionally address pathophysiologies which go beyond muscle weakness.

Kitago, T., & Krakauer, J. W. (2013). Motor learning principles for neurorehabilitation.Handbook of Clinical Neurology, 93–103. https://doi.org/10.1016/b978-0-444-52901-5.00008-3.

Zimmerman, E., Carnaby, G., Lazarus, C. L., & Malandraki, G. A. (2020). Motor learning,neuroplasticity, and strength and skill training: Moving from compensation to retrainingin behavioral management of Dysphagia. American Journal of Speech-LanguagePathology, 29(2S), 1065–1077. https://doi.org/10.1044/2019_ajslp-19-000

Huckabee, M.-L., & Macrae, P. (2014). Rethinking rehab: Skill-based training forswallowing impairment. Perspectives on Swallowing and Swallowing Disorders(Dysphagia), 23(1), 46–53. https://doi.org/10.1044/sasd23.1.46