Relearning to swallow after stroke--application of maneuvers and indirect biofeedback: a case study.

A patient with medullary infarct recovered swallowing at 45 months after stroke by using a series of pharyngeal swallow maneuvers. Each maneuver effected quantifiable changes in specific elements of the pharyngeal swallow. The success of these maneuvers is the basis for the conceptualization of the pharyngeal swallow as a cluster of closely coordinated neuromuscular actions which are independently modifiable, rather than a single event.