"In the depth of winter, I finally learned that within me there lay an invincible summer." – Albert Camus
As the days grow shorter and the air turns crisp, winter invites us to slow down, savor cozy moments, and discover beauty in the quiet. From the sparkle of frost on a morning walk to the warmth of sharing a cup of cocoa, this season reminds us that joy often lives in life’s simplest pleasures.
At IOPI, we find joy in supporting and educating our customers every step of the way. In this quarter’s newsletter, you’ll find research-backed answers to common IOPI myths, a selection of thought-provoking articles, and—keeping patients in mind—updates on renting our Trainer devices.
Read on to find out more about our new Trainer Rental Program and to see how you can share your success stories. Also don’t forget to visit our TWO websites, https://iopicares.com/ and https://iopimedical.com/. The latter of which offers the latest news and research and gives you the opportunity to earn free CEUs with your choice of three courses. You can also interact with our IOPI staff, and Patient Advocacy tools (have you seen the Dysphagia Cost tool?!). You can also use our Get a Quote page if you need pricing information. It’s quick and easy! Visit us at https://iopimedical.com/
You can also interact with us on Instagram @iopimedical & Facebook at IOPI Medical LLC for the latest news and information.
Share the wealth! If you know someone who could benefit from our quarterly newsletter, send them this link to get signed up, www.iopimedical.com/news/.
False,IOPI is a tool, and applications reach beyond tongue strengthening. For example, IOPI can be used for biofeedback when performing effortful swallows.
2. Numerous devices have established normal values for the US population.
False, IOPI is the only device with established normal values.
3. IOPI is only for people with swallowing problems.
False, IOPI can be used with a variety of diagnoses, including motor speech disorders and obstructive sleep apnea.
Oh J. C. (2024). Effect of Visual Biofeedback Obtained Using the Iowa Oral Performance Instrument on the Suprahyoid Muscle Activation Level During Effortful Swallowing Maneuver. Dysphagia, 39(3), 433–443. https://doi.org/10.1007/s00455-023-10627-5
Oh J. C. (2022). Effects of Effortful Swallowing Exercise with Progressive Anterior Tongue Press Using Iowa Oral Performance Instrument (IOPI) on the Strength of Swallowing-Related Muscles in the Elderly: A Preliminary Study. Dysphagia, 37(1), 158–167.https://doi.org/10.1007/s00455-021-10259-7
Galek, K., Bice, E. M., & Allen, K. (2021). A Novel Protocol Designed to Treat Spastic Dysarthria Secondary to Traumatic Brain Injury: A Case Study. Perspectives of the ASHA Special Interest Groups, 6(3), 542–552. https://doi.org/doi:10.1044/2021_PERSP-20-00110
Gison, A., Ruggiero, M., Tufarelli, D., Proietti, S., Moscariello, D., & Valente, M. (2025). Intensive Speech Therapy for Hypokinetic Dysarthria in Parkinson's Disease: Targeting the Five Subsystems of Speech Production with Clinical and Instrumental Evaluation. NeuroSci, 6(1), 7. https://doi.org/10.3390/neurosci6010007
Poncin, W., Correvon, N., Tam, J., Borel, J. C., Berger, M., Liistro, G., Mwenge, B., Heinzer, R., & Contal, O. (2022). The effect of tongue elevation muscle training in patients with obstructive sleep apnea: A randomised controlled trial. Journal of oral rehabilitation, 49(11), 1049–1059. https://doi.org/10.1111/joor.13369
🌟 Share Your Success Story! 🌟 We're launching our new #ILoveMyIOPIcampaign and want to hear from YOU!
Calling all clinicians, researchers, and patients who have experienced positive outcomes with IOPI Medical products - we'd love to feature your story and help inspire others in our community.
How to participate: 📹 Create a video testimonial (3 minutes max) 💬 Share what you love about your IOPI and your genuine experience and results 📧 Submit your video to us at Info@IOPIMedical.com
What makes a great testimonial: • Authentic personal experience with our product • Specific outcomes or improvements you've seen • Clear audio and video quality • Consent for potential marketing use • Comfortable speaking pace and good lighting
Submission Guidelines: ✅ Content must be original and truthful ✅ Professional language and appropriate setting that highlights the story you are sharing ✅ Participants consent to potential use in marketing materials
Selected testimonials will be featured across our social channels, and will receive one free box of Tongue Bulbs.
Ready to inspire others with your story? We can't wait to hear from you!
Introducing the IOPI® Patient Home Rental Program. Finally, your patients can rent the IOPI® Trainer for home therapy!
Benefits for your patients…
Affordable home therapy option for patients • Rent vs. purchase—perfect for short-term needs • FREE Training & support available for clinicians new to the IOPI® Trainer • Zero administrative burden on your practice
And for your practice with enhanced patient outcomes:
Continuous therapy between clinic visits • No Administrative Load: We handle payments, shipping, and tech support • Clinical Control: You maintain oversight of therapy protocols • Flexible Rental Terms: 2–6-month rentals with easy returns
Earn ASHA CEUs with Our Three Free Courses
Many of you may already be familiar with our esteemed Clinical Consultant, Ed Bice, but did you know, you can learn from him from the comfort of your office or home?
IOPI Medical offers ASHA Continuing Education Units with our FREE courses. Choose from:
The Role of Oral Musculature in Swallowing and the Therapeutic Benefits of the IOPI, reviewing the oral musculature and its essential functions, as well as explore exercise principles and how the IOPI can be integrated into a dysphagia treatment plan.
Building a Therapy Program from the Ground Up, examining current evidence related to the assessment and treatment of dysphagia and providing practical suggestions for a path forward.
IOPI Research Updates, summarizing recent findings related to the IOPI.
Did you know we have our very own Clinical Consultant on staff? Whether you have a perplexing question or just need a bit of guidance, Ed Bice, M.Ed., CCC-SLP is always happy to help. You can schedule time with Ed by going towww.iopimedical.comand clicking on the “Schedule time with us” button. You can also reach him ated@iopimedical.com.
A great deal of information surrounds the assessment and treatment of swallowing disorders. In keeping with the theme of busting myths, Ed has selected three common ones for the current newsletter and has provided research to set the record straight.
Myth# 1: Wet vocal quality after drinking is associated with aspiration.
An investigation by Warms et al. (2000) used voice samples of 23 subjects with neurologic oropharyngeal dysphagia. Voice recordings were collected immediately after each subject swallowed during videofluoroscopy. The presence of wetness in the voice was analyzed in relation to any ingested material that remained in the larynx or trachea after each bolus was swallowed. Results showed that there was no association between the presence of a wet voice and penetration or aspiration of prandial material. The investigators concluded that the presence of wet phonation did not indicate penetration/aspiration during a clinical swallow evaluation.
Warms, T., & Richards, J. (2000). "Wet Voice" as a predictor of penetration and aspiration in oropharyngeal dysphagia. Dysphagia, 15(2), 84–88. https://doi.org/10.1007/s004550010005
Another study explored whether endoscopically confirmed material in the airway (either food/liquid residue or secretions) produces perceptible changes in voice quality.
Forty-four adults with dysphagia completed FEES with synchronized pre- and postswallow voice recordings. Expert listeners rated the voice samples to determine whether specific voice quality changes were associated with material in the airway. Overall, voice ratings did not differ when airway material was present after the swallow. However, when the researchers accounted for each person’s baseline dysphonia, listeners were more likely to notice voice abnormalities related to large volumes of secretions (rather than prandial material). The authors concluded that post-swallow voice quality is an unreliable indicator of material in the airway and should be interpreted with caution.
Welden, K., Kelchner, L., Silbert, N., & Rule, D. W. (2022). Listening for Dysphagia: Voice Quality Sequelae of Material in the Airway. Journal of speech, language, and hearing research, 65(9), 3337–3364. https://doi.org/10.1044/2022_JSLHR-22-00120
Myth 2: Thickened liquids reduce the occurrence of pneumonia.
An updated systematic review by Hansen et al. (2022) revisited the evidence behind a commonly held belief in dysphagia management: that thickening liquids reduces aspiration-related pneumonia and improves health outcomes. The researchers reviewed systematic reviews, meta-analyses, and randomized controlled trials (RCTs) published between 2015 and 2021. Only one RCT met the inclusion criteria, bringing the total to just three RCTs available to evaluate this intervention (two of which had already been reviewed in the previous 2016 guideline update). After assessing study quality using Cochrane and GRADE criteria, the authors found no basis to change the existing weak recommendation against the use of thickened liquids for pneumonia prevention.
Across all included trials, thickened liquids and modified diets did not:
Improve survival
Reduce pneumonia
Improve quality of life
Improve hydration, nutritional status, or oral intake
In short, the evidence remains clear and consistent: thickened liquids do not prevent pneumonia and may not deliver the clinical benefits often assumed in practice.
Hansen, T., Beck, A. M., Kjaersgaard, A., & Poulsen, I. (2022). Second update of a systematic review and evidence-based recommendations on texture-modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia. Clinical nutrition ESPEN, 49, 551–555. https://doi.org/10.1016/j.clnesp.2022.03.039
Myth #3: There is no harm in prescribing modified diets.
Growing evidence highlights that modified diets and thickened liquids (MD-TL) can cause significant harm. Studies document that MD-TLs are linked to dehydration, malnutrition, reduced medication absorption, decreased quality of life, social isolation, and reduced enjoyment of eating (Cichero et al., 2013). Patients frequently consume less when placed on MD-TLs, compromising their nutritional and hydration status. Thickened liquids, in particular, are associated with poor adherence, aversion, and inadequate fluid intake. The assumption that MD-TL pose no downside is inaccurate and potentially dangerous (O’Keeffe, 2018).
Recent survey research by Ward and Bowman (2025) underscores the problem: most clinicians are not fully aware of the potential negative consequences of modifying liquids and diets. In a survey, fewer than 7% of speech-language pathologists could identify known negative health outcomes associated with diet alterations, and over 20% could not identify even one. The evidence indicates modified diets are not benign. Diet modifications carry meaningful side effects.
Cichero, J. A. (2013). Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety. Nutrition Journal, 12(1), 54. https://doi.org/10.1186/1475-2891-12-54
O'Keeffe, S. T. (2018). Use of modified diets to prevent aspiration in oropharyngeal dysphagia: Is current practice justified? BMC Geriatr, 18(1), 167. https://doi.org/10.1186/s12877-018-0839-7
Ward, M., & Bowman, A. (2025). Oropharyngeal dysphagia management and informed consent: A survey of speech-language pathologists' practice patterns when recommending modified texture diets. Frontiers in Rehabilitation Sciences, 6, 1520240. https://doi.org/10.3389/fresc.2025.1520240
Don’t Forget to Use Your Resources:
To help you achieve the greatest level of success for your patients, we continue to provide you with the necessary Purchasing Advocacy tools, and clinical support.
Our Purchasing Advocacy tools can be found on our Medical Professionals page. Here you will find our IOPI Dysphagia Cost Tool as well as a ready-to-use Benefits of IOPI for Dysphagia PowerPoint. Just populate it with information specific to your patient’s needs.
You also have clinical support at your fingertips! Our clinical consultant, Ed M. Bice, M.Ed., CCC-SLP, is available to mentor through the advocacy process to assess and report the estimated cost of dysphagia to your facility. You can reach Ed for a patient consultation or clinical question by calling (844) 844-IOPI or emailing ed@iopimedical.com.
To access our IOPI Dysphagia Cost Tool, the Benefits of IOPI for Dysphagia PowerPoint, and tips on advocating for your patients, please visit our website.
How can we get better at serving our customers if we don’t know the ways in which we can improve? We have developed a very brief survey that if you can spare just a few minutes, would give us very valuable feedback. To those of you who have already completed the survey, thank you! We greatly appreciate your insight into helping us offer the best service and products possible.
