The ISO-PLUS Device for Dysphagia Exercises and Voice Exercises

Many people suffer with swallowing difficulty symptoms, such as trouble swallowing food, coughing or choking while eating or drinking, and in some cases people may need to receive feedings through a PEG tube. A disorder of swallowing is called dysphagia.  

The ISO Swallowing Exercise Device (ISO-PLUS) was designed as a more convenient, less strenuous alternative to the Shaker exercise for dysphagia. Like the Shaker exercise, it targets the suprahyoid muscles under the chin (Geniohyoid, Mylohyoid, Stylohyoid, and Digastric). These muscles primarily assist in elevating the hyolaryngeal complex and opening the upper esophageal sphincter (UES) during the swallow. The Mylohyoid also helps to elevate the tongue and the floor of the oral cavity.

The ISO Swallowing Exercise Device also targets the neck flexor muscles to improve posture and jaw alignment and stabilization for improved swallowing pressure, function, and safety.

The ISO-PLUS can be used as an alternative to the Shaker exercise for dysphagia, the CTAR (Chin Tuck Against Resistance) exercise, the JOAR (Jaw Opening Against Resistance) exercise for improved chewing and swallow function, and the ESAR (Effortful Swallow Against Resistance) exercise for dysphagia treatment.  

The ISO-PLUS is a flexible, durable polycarbonate device used for dysphagia treatment to strengthen the suprahyoid muscles in the throat for people who have difficulty swallowing, called dysphagia. 

Difficulty Swallowing Causes

There are many different causes of difficulty swallowing, also called dysphagia. Most commonly dysphagia is caused by a weakness in the muscles in the mouth and/or throat involved in the swallowing process. These muscles can often be strengthened by swallowing exercises to rehabilitate the swallow function. The weakness in these muscles can originate from many different causes and can cause a variety of difficulty swallowing symptoms. 

Many patients who have survived a stroke have difficulty swallowing, which may result in a PEG tube, pureed diet, thickened liquids or mechanical soft diet being ordered due weakness in the muscles in the mouth and/or in the throat which cause dysphagia.

Diseases/conditions such as Parkinson's disease, Alzheimer's disease, Huntington's disease, Multiple Sclerosis, dementia, traumatic brain injury, and Down's Syndrome are also common causes of difficulty swallowing due to muscle weakness which may respond well to swallowing exercises such as CTAR and JOAR with the ISO-PLUS™. 

Below is an instructional Video for use of the ISO-PLUS™ in dysphagia treatment:

You can use the video below in your dysphagia treatment sessions or for home practice for guidance through the dysphagia exercises.

The ISO-PLUS has optional removable chin pad covers.

The Pediatric ISO-SED was designed for children's smaller bodies, chins, and hands.

The Pediatric ISO-SED was designed for children's smaller bodies, chins, and hands.


There are many research studies on the Shaker exercise, the Chin Tuck Against Resistance Exercise (CTAR), the Jaw Opening Against Resistance Exercise (JOAR), and the Effortful Swallow Against Resistance (ESAR) which support the use of the ISO Swallowing Exercise Device (ISO-SED) in dysphagia therapy for the treatment of swallowing disorders. For more information on research studies in this area, please see our Research page.   


The ISO-PLUS can also be used as a less strenuous way to do vocal cord adduction exercises for improved vocal cord closure which is important for vocal quality, vocal intensity (volume), and it is also important for protecting the airway during the swallow. For more information on using the ISO-SED for vocal cord adduction exercises, see our Voice page.

Dysphagia Continuing Education Course

Jolie Parker, M.S.CCC-SLP is the author of the ASHA approved CEU course for speech language pathologists: Using the ISO Swallowing Exercise Device in Dysphagia Therapy. Visit to purchase and view the CEU course.   


"I know this device is going to help many people."                                                - Steve Blackburn, M.D.

"Yep I've ordered two of these already."                                                                 - Speech Language Pathologist

"I use this and it is awesome!"                                                                                  - Speech Language Pathologist

"I am a Speech Pathologist in Australia working in adult rehabilitation. Another Speech Pathologist has mentioned your device and that she is having success using it with patients..." - Speech Language Pathologist

"...I have previously purchased several of your devices and have allowed colleagues to "borrow" them; needless to say, I never got them back :( I need to be a little more stern with the terms "borrow". Thanks again for creating this! Take care!"                                                                                     - Speech Language Pathologist

"...We highly recommend the use of the ISO device as an essential device to regain the ability to swallow properly."                                                                                                                    - Customer

"...I should also share that clinically speaking, this device has allowed two of my patients to have their PEG tubes removed!"                                                                                                        - Speech Language Pathologist

"I want to congratulate you on the ISO. It has done wonders for my wife, who had acute dysphagia problems due to radiation treatments. It has helped to greatly improve her swallowing, and her doctor is very pleased with her progress. She is also pleased, considering the fact that her first Speech Therapist wanted to put in a feeding tube... "                                                                                                          - Customer 

"I am an SLP in Palm Bch. County, FL who has a home health pt. equipped with an iso-S.  He loves exercising with it and I have felt that this tool can benefit dysphagia pts."                             - Speech Language Pathologist

"..I think that you have a great product and it has been very helpful to me."       - Customer 

"I was curious if you had a wholesale price so as to purchase ISO devices for the outpatient center where I work to resale to patients.  Often times patients after trying the device that I have on site want to be able to leave with one..."                                                                                                      - Speech Language Pathologist

"...A few months ago, we had recommended to a friend of ours in Appleton, WI, whose husband had dysphagia and she bought an ISO from you. They are very pleased with the results from using it. He is now eating after passing the swallowing test."                                                             - Customer

"I am a co-inventor of the ISO-PLUS and I am a speech language pathologist with 20 years of experience, mostly in the treatment of swallowing disorders. I have been using the ISO-PLUS™ to do swallowing exercises with my dysphagia patients since 2010. Since I started using the ISO-SED, I have consistently seen much better and faster improvements in swallowing problems than I ever saw in dysphagia patients before I started using the ISO-PLUS™. My patients love doing dysphagia exercises with it, and usually ask if they can keep it after they try it the first time because they want to use it in between sessions!"                                                                - Jolie Parker, M.S.CCC-SLP

ISO Swallowing Exercise Device Design Attributes

The ISO Swallowing Exercise Device (ISO-PLUS) is easy to hold, even with just one hand. It is held at the lower chest area, which is much less strenuous than holding the arms up at the neck level, and it is specifically designed to require as little strength and effort as possible to hold it in precisely the right position to provide the optimal resistance for the exercises. This allows patients to thoroughly fatigue the suprahyoid muscles before the arm muscles fatigue.

The ISO-SED contours to the area under the jaw, to maximize the effectiveness of the jaw opening against resistance exercise. It provides a wide range of variable resistance, depending on the strength each patient is able to exert. The more it bends as pressure is applied, the more resistance it provides. The ISO-SED allows the patient to have a full range of motion during exercises, beginning with resistance at a chin elevated position, which helps to isolate the suprahyoid muscles.

We also offer a professional package with removable chin pad covers and alcohol cleaning wipes for use with multiple patients. It all fits in a compact, professional, protective carrying case.

Patients love using the ISO-SED (ISO-PLUS). It is interesting, fun, and very motivating. High motivation, ease of use, and optimal design makes ISO-PLUS a tool no dysphagia speech language pathologist should ever be without, and every dysphagia patient should own and use daily!