Patent Description:
Swallowing is a complex action involving muscles and nerves within oral cavity, pharynx and esophagus, as well as a swallowing centre in the brain that is connected to the pharynx and esophagus by nerves.

Dysphagia is dysfunction of the swallowing and is in general terms described as an inability to move food, or liquid, from the mouth to the stomach. Dysphagia is a symptom of many different causes and may result from congenital abnormalities, structural damage, and/or medical conditions. For example, it may occur after head and neck cancer (HNC) treatment. Dysphagia may also occur after total laryngectomy as muscles involved in swallowing are removed or transected.

The impact on the quality of life for dysphagia patients may be substantial. For example, subjects suffering from dysphagia may be affected by chronic malnutrition, dehydration, failure to thrive, aspiration pneumonia, and exacerbation of chronic lung disease.

There are many ways to treat dysphagia and conventional therapies for dysphagia generally include dietary modification, compensatory techniques like postural alterations, indirect therapy like strengthening exercises for swallowing muscles, direct therapy like exercises during swallowing and medical therapy. The aim of the treatment is to maintain adequate nutritional and hydrational intake and to maximize airway protection. With strengthening therapy, the swallowing muscles may be exercised and the swallowing function improved. This may result in that feeding tube dependency and diet modification may be reduced. Additionally, the risk of aspiration pneumoniae and trismus may be reduced. By reducing the listed issues, a higher quality of life may be achieved.

However, there are problems associated with current strengthening therapy. There currently does not exist any exercise device, or rehabilitation device, that is suitable for persons that have undergone a total laryngectomy. Traditionally, dysphagia for these persons has mainly been treated by surgical methods, pharmacological methods and coping strategies. For this reason, existing exercise devices do not target all of the necessary muscles for persons that have undergone total laryngectomy. Additionally, as existing exercising devices are not intended for persons that have undergone total laryngectomy, these exercise devices are not suitable for a user having tracheostoma. Existing exercise devices may cover the tracheostoma and/or make breathing difficult during use of the exercise device.

Furthermore, there currently does not exist any exercise devices, or rehabilitation devices, that is possible to use for different exercises. In order to exercise different muscles, different exercise devices have to be used. Thus, a user needs to have several different rehabilitation devices for different purposes. In addition to this, existing exercise devices generally also have the drawback that the resistance used for training is unknown and that the resistance is not possible to vary. The lack of knowledge of the used resistance and the possibility to vary the resistance is also a problem for exercises that do not need an exercise device at all. These exercises usually also have the disadvantages that they often are performed in unfeasible positions, such as laying down etc..

Hence, an improved exercise device would be advantageous, and in particular, an exercise device allowing for increased user comfort, which is possible to use for different exercises and which additionally also is suitable for a person that has undergone total laryngectomy.

<CIT> and <CIT> disclose prior art exercise devices. A relevant prior art exercise device is also disclosed by <CIT>.

Accordingly, the present invention preferably seeks to mitigate, alleviate or eliminate one or more of the above-identified deficiencies and disadvantages, singly or in any combination, and solves at least the above-mentioned problems by providing an exercise device for swallowing rehabilitation. The exercise device for swallowing rehabilitation with a variable resistance of the present invention is defined by claim <NUM>.

Said exercise device comprises a curved exerciser body forming a support and holding means mounted to said exerciser body. The exercise device further comprises chin receiving means movably connected to said holding means and exercising means for creating resistance when the chin receiving means is moved towards the exerciser body. The exercising means is configured to extend between said exerciser body and said chin receiving means,.

According to an aspect, there is provided an exercise device for swallowing rehabilitation with a variable resistance, the exercise device comprising an exerciser body forming a support, chin receiving means movably connected to the exerciser body, exercising means for creating resistance when the chin receiving means is moved towards the exerciser body, and a lever arm connected to the exerciser body via a fulcrum and configured to interact with the exercising means, wherein the exercising means or the fulcrum is displaceable to provide a variable resistance against movement of the chin receiving means towards the exerciser body.

Optionally, the exerciser body comprises a chest resting plate adapted to engage with a chest of a user of the exercise device. Optionally, the at least a part of the chest resting plate is provided with a padding.

Optionally, the chin receiving means comprises a chin receiving plate for receiving a chin of a user of the exercise device. Optionally, the at least a part of the chin receiving plate is provided with a padding.

Optionally, the exercising means comprises a spring or an elastomer member. Optionally, the exercising means is slidable along the exerciser body to provide the variable resistance. Optionally, the exercising means is arranged to extend between the exerciser body and the lever arm.

Optionally, one end of the exercising means is connected to the exerciser body with an attachment device. Optionally, one end of the exercising means is connected to the lever arm with an attachment device. Optionally, the exercising means is detachably attached to the exerciser body and/or the chin receiving means with the attachment device, thereby making the exercising means replaceable. Optionally, a length of the exercising means is adjustable by the attachment device to provide the variable resistance.

Optionally, the exercise device further comprises a holding means comprising an elongated member, wherein the elongated member is secured to the exerciser body at one end and configured to receive the lever arm at the other end. Optionally, the lever arm is pivotally connected to the elongated member by the fulcrum, around which the lever arm is pivotal.

Optionally, the exercise device further comprises a handle, wherein the handle is attached to the respective ends of the exerciser body, thereby forming a closed loop with the exerciser body.

Optionally, the fulcrum is displaceable to provide the variable resistance. Optionally, the fulcrum is displaceable to adjust a lever ratio of the lever arm. Optionally, the fulcrum is displaceable between a number of pivot positions. Optionally, the number of pivot positions are defined by a rack of the lever arm.

Optionally, the exercise device further comprises a holding means secured to the exerciser body, wherein the holding means is configured to receive the lever arm. Optionally, the lever arm is coupled to the holding means via the fulcrum.

Optionally, the exercising means is disposed between the exerciser body and the adjustment lever. Optionally, the exercise device further comprises a handle disposed between the exerciser body and the adjustment lever, wherein the exercising means is disposed inside the handle.

Optionally, the lever arm comprises an elongate member having a first end and a second end, wherein the lever arm is connected to the exercising means at the first end and is configured to interact with the chin receiving means at the second end. Optionally, the chin receiving means comprises a connection member pivotal around a fulcrum/pin. Optionally, the connection member comprises a first arm configured to interact with the lever arm, and a pair of second arms configured to receive the lever arm between them when the lever arm pivots about the fulcrum. Optionally, the lever arm is configured to interact with the chin receiving means via a roller. Optionally, the lever arm is connected to the exercising means via a loading arrangement, and the loading arrangement is configured to compress the exercising means when the lever arm pivots about the fulcrum. Optionally, the loading arrangement comprises a connecting element and a stop, wherein the connecting element has a first end connected to the lever arm and a second end connected to the stop, the exercising means is disposed between the lever arm and the stop, and the stop configured to compress the exercising means when the lever arm pivots about the fulcrum by movement of the connecting element.

Also disclosed herein is an exercise device for swallowing rehabilitation with a variable resistance, the exercise device comprising an exerciser body forming a support, a chin receiving means movably connected to the exerciser body, exercising means for creating resistance when the chin receiving means is moved towards the exerciser body, and a lever arm connected to the exerciser body via a fulcrum and configured to interact with the exercising means, wherein the exercising means is displaceable to provide a variable resistance against movement of the chin receiving means towards the exerciser body.

Also disclosed herein is an exercise device for swallowing rehabilitation with a variable resistance, the exercise device comprising an exerciser body forming a support, chin receiving means movably connected to the exerciser body, exercising means for creating resistance when the chin receiving means is moved towards the exerciser body; and a lever arm connected to the exerciser body via a fulcrum and configured to interact with the exercising means, wherein the fulcrum is displaceable to provide a variable resistance against movement of the chin receiving means towards the exerciser body.

Thereby, an exercise device for adjustable swallowing rehabilitation, which is possible to use for a plurality of exercises, and with a variable resistance, is provided. The provided exercise device additionally provides an increased user comfort.

These and other aspects, features and advantages of which the invention is capable of will be apparent and elucidated from the following description of embodiments of the present invention, reference being made to the accompanying drawings, in which.

The following description focuses on an embodiment of the present invention applicable to an exercise device and in particular to an exercise device for swallowing rehabilitation. However, it may be appreciated that the exercise device is suitable also for other purposes than swallowing rehabilitation. Examples of such purposes may be voice training, general jaw training, swallowing training, and other dysphagia conditions.

<FIG> shows a side view of an exercise device <NUM> for swallowing rehabilitation according to a first embodiment of the present disclosure. Swallowing rehabilitation may include, for example, performing swallow exercises or other jaw exercises. As illustrated in <FIG>, the exercise device <NUM> comprises an exerciser body <NUM> forming a support. The exercise body <NUM> is curved and is adapted to engage with a user using said exercise device <NUM>. In some embodiments, the exercise body <NUM> may comprise a chest resting plate <NUM> adapted to engage with a chest of a user using the exercise device <NUM>. Thus, when the exerciser device <NUM> is in use, the chest resting plate <NUM> of the exerciser body <NUM> may rest against the chest of the user. At least a part of the chest resting plate <NUM> may be provided with a padding <NUM>. The padding <NUM> may be of a softer material than the exerciser body <NUM> and may thus be more comfortable to have against the chest than the rest of the exerciser body <NUM>. This may improve the user comfort. The padding <NUM> may be, for example, a foam padding.

The exercise device <NUM> further comprises holding means <NUM> mounted to the exercise body <NUM>. As seen in <FIG>, the holding means <NUM> is extending from the exercise body <NUM>. The holding means <NUM> is configured to hold a chin receiving means <NUM>. The exercise device <NUM> comprises the chin receiving means <NUM> and the chin receiving means <NUM> is movably connected to the holding means <NUM>. The holding means <NUM> secures the chin receiving means <NUM> to the exercise device <NUM> in a way such that the chin receiving means <NUM> is movable relative the exercise device <NUM>. The chin receiving means <NUM> is adapted to engage with a chin, or a jaw, of a user using the exercise device <NUM>. As illustrated in <FIG>, the chin receiving means <NUM> may comprise a chin receiving plate <NUM> for receiving a chin of a user using the exercise device <NUM>. The chin receiving means <NUM> may further comprise a connection member <NUM> for movably connecting said chin receiving plate <NUM> to said holding means <NUM>. In some embodiments, at least a part of the chin receiving plate <NUM> of the chin receiving means <NUM> may be provided with a padding <NUM>. The padding <NUM> may be of a softer material than the rest of the chin receiving means <NUM> and may thus improve the user comfort. The padding <NUM> may be, for example, a foam padding.

The holding means <NUM> may be realized in different ways and <FIG> illustrate one example embodiment. The holding means <NUM>, according to this example embodiment, comprises an elongated member. The elongated member extends in an upward direction from the exerciser body <NUM>. The elongated member is secured to the exerciser body <NUM> at one end and is configured to receive the chin receiving means <NUM> at the other end. Thus, the holding means <NUM> is firmly mounted to the exerciser body <NUM> at one end. The chin receiving means <NUM> received at the other end may be received such that it is pivotally attached to the elongated member, i.e. the chin receiving means <NUM> is movably connected to the holding means <NUM>. As illustrated in <FIG>, the chin receiving means <NUM> may be pivotally connected to said elongated member by at least one pin <NUM>, or joint. The chin receiving means <NUM> is pivotal around said at least one pin <NUM>.

The exercise device <NUM> further comprises exercising means <NUM> for creating resistance when the chin receiving means <NUM> is moved towards the exerciser body <NUM>, i.e. for creating a resistance to a user using the exercise device <NUM>. The exercising means <NUM> is arranged to extend between said exerciser body <NUM> and said chin receiving means <NUM>. According to the embodiment illustrated in <FIG>, one end of the exercising means <NUM> is fixed to the exerciser body <NUM> by an attachment device <NUM>. The other end of the exercising means <NUM> may be connected to the chin receiving means <NUM>, but without being attached with any fastening means. The chin receiving means <NUM> is adapted to rest at this other end of the exercising means <NUM>. Thus, in the embodiment illustrated in <FIG>, the exercising means <NUM> is not securely fixed to the chin receiving means <NUM>. The exercising means <NUM> and the chin receiving means <NUM> are only connected to each other by the physical contact that arises when they touch each other, but without being physically attached with any fastening means. It may thus be possible to lift the chin receiving means <NUM> in an upwards direction away from the exercising means <NUM> such that the exercising means <NUM> and the chin receiving means <NUM> are no longer connected to each other. It may be realized that according to another embodiment, the exercising means <NUM> may be securely fixed to the chin receiving means <NUM> by an attachment device, but not fixed to the exerciser body <NUM>. In still another embodiment, the exercising means <NUM> may be securely fixed at both ends, to both the exerciser body <NUM> and the chin receiving means <NUM>.

In some embodiments, the exercising means <NUM> may be detachably attached to the exerciser body and/or the chin receiving means <NUM> with the attachment device <NUM>, thereby making the exercising means <NUM> replaceable. This makes it possible to replace, or exchange, the exercising means <NUM> by another exercising means <NUM>. This may be useable in case the exercising means <NUM> breaks. This may also be used for changing the load, or the resistance, created by said exercising means <NUM>. For example, if a user finds an exercising means <NUM> with a certain stiffness or resistance too easy to exercise with, the exercising means <NUM> may be replaced by another exercising means <NUM>, which has another, higher, stiffness, or resistance. Thereby an amount of resistance created by said exercising means <NUM> may be changed. By changing the resistance, or the load, of the exercise device <NUM>, a user using the exercise device <NUM> may continue exercising at <NUM>-<NUM>% of maximum capacity. This may ensure that the user's strength will continue to increase.

In some embodiments, the exercising means <NUM> may be adjustably attached to the exerciser body and/or the chin receiving means <NUM> with the attachment device <NUM>. In such embodiments, the attachment device <NUM> may be disposed in an elongate slot <NUM>, as illustrated in <FIG>. The attachment device <NUM> is slidable along the length of the elongate slot <NUM>. As such, the position of the exercising means <NUM> relative to the holding means <NUM> and the at least one pin <NUM> is adjustable. By adjusting the position of the exercising means <NUM> relative to the holding means <NUM> and the at least one pin <NUM>, the resistance may be changed. In such embodiments, the exercising means <NUM> and the chin receiving means <NUM> are only connected to each other by the physical contact that arises when they touch each other, but without being physically attached with any fastening means. According to another embodiment, the exercising means <NUM> may be adjustably attached to the chin receiving means <NUM> by an attachment device <NUM>, with a corresponding elongate slot <NUM> present in the connection member <NUM>, but not fixed to the exerciser body <NUM>. In still another embodiment, the exercising means <NUM> may be adjustably attached at both ends, to both the exerciser body <NUM> and the chin receiving means <NUM>.

According to the previously described embodiment, the load of the exercising device <NUM> may be changed by exchanging, or replacing, the exercising means <NUM>. According to another embodiment, a length of the exercising means <NUM> for creating resistance may be adjustable by the attachment device <NUM> with which the exercising means <NUM> is attached. Thereby, an amount of resistance created by said exercising means <NUM> may be changed. The length of the exercising means <NUM> may also be adjusted in order to adjust the height of the exercise device <NUM>, such that it is more suitably adapted to the user using the exercise device <NUM>.

The exercising means <NUM> may comprise, for example, a spring. An example of such embodiment is illustrated in <FIG>. As seen in <FIG>, the spring is secured at one end to the exerciser body <NUM> with the attachment device <NUM>. The chin receiving means <NUM> is resting at the other end of the spring. As is known, different springs may have different spring constants. Different spring constants cause different stiffness and thereby causes different resistances. Thereby, by choosing a spring with a certain spring constant, i.e. stiffness, the resistance of the exercise device <NUM> may be regulated.

According to another embodiment, the exercising means <NUM> may comprise an elastomer member such as a silicone block. Depending on the size, shape, stiffness and density of the elastomer member, the resistance of the exercise device <NUM> may be regulated.

The exercise device <NUM> according to the present disclosure achieves an increased user comfort. The construction of the exercise device <NUM> makes it possible for a user to perform swallowing rehabilitation in comfortable positions, e.g. in an upright position. Thus, the user does not have to lay down in order to perform the exercises. Additionally, the provided exercise device <NUM> comprises a construction with an exerciser body <NUM>, which does not cover a tracheostoma when it is in use. This makes it easy to breathe when using the exercise device <NUM> and makes the provided exercise device <NUM> suitable for users having undergone a total laryngectomy. In some embodiments, in order to improve the user comfort for a user with a tracheostoma even further, the exercise device <NUM> may additionally comprise an opening, for example a hole or a fork in the exerciser body <NUM>. The opening makes it possible for air to freely flow through the hole of the exerciser body <NUM> in and out from the tracheostoma.

Furthermore, with the chin receiving means <NUM>, which is movable relative the exerciser body <NUM>, the user may receive tactile feedback while performing swallowing rehabilitation. By receiving direct feedback while performing swallowing rehabilitation, the user experience may be improved, which may motivate the user to continue using the exercise device <NUM>.

In some embodiments, the exercise device <NUM> may further comprise a handle <NUM>. The handle 65may be attached to the respective ends of the curved exerciser body <NUM>. By providing a handle that connects the exterior ends of the exerciser body <NUM>, the exerciser body <NUM> and the handle 65form a closed loop and thus provide a solid and secure construction of the exercise device <NUM>. With a handle 65that a user may grip during use of the exercise device <NUM>, the exercise device <NUM> may also be easier to operate and to hold in the right position during exercise.

<FIG> illustrates the exercise device <NUM> in use. In <FIG>, the user holds the exerciser device <NUM> in a start position, i.e. before any swallowing rehabilitation has begun. The exercise device <NUM> according to this embodiment comprises a handle 65that the user holds during the use. As seen in the figure, the chest resting plate <NUM> of the exerciser body <NUM> rests against the chest of the user and the user's chin is resting on the chin receiving plate <NUM> in the start position.

One of the advantages with the exercise device <NUM> presented herein is that the exercise device <NUM> may be used for a plurality of different exercises. The exercises start from the previously described start position and from this position the plurality of different exercises may be performed. Some of these exercises will now be described with reference to <FIG>.

<FIG> shows a user performing an exercise herein referred to as "chin tuck against resistance". The exercise is performed by pressing the chin downwards, towards the chest of the user, using the exercise device <NUM>. The chin rests at the chin receiving means <NUM>. When the user presses their chin downwards, the chin receiving means <NUM> pivots around the pin <NUM> and chin receiving means <NUM> is moved towards the exerciser body <NUM>. The final position, when the chest receiving means <NUM> is completely pushed towards the exerciser body <NUM>, is shown in <FIG>. The exercising means <NUM> creates a resistance so that the user has to use a force to push the chin receiving means <NUM> downwards. The purpose of this exercise is to strengthen muscles that pull the larynx and hyoid up and forward, and improve the ability to swallow. The chin tuck exercise targets the same muscles as the generally known "shaker exercises", also referred to as "head-lifting exercises". In these exercises, a user rests in a supine position and lifts the head to look at the toes. Compared to the shaker exercises, the chin tuck exercise, performed with the exercise device <NUM>, may be performed in a much more comfortable position, e.g. in an upright position. Additionally, with a replaceable or adjustable exercising means <NUM>, the load that the user is exposed to may be known and adjustable.

Another exercise, which may be performed with the exercise device <NUM>, is illustrated in <FIG> shows an exercise herein referred to as "jaw opening against resistance". The exercise is performed by pressing the lower jaw downwards, towards the exerciser body <NUM> of the exercise device <NUM>. The chin rests at the chin receiving means <NUM>. When the user opens the mouth and presses the lower jaw downwards, the chin receiving means <NUM> pivots around the pin <NUM> and chin receiving means <NUM> is moved towards the exerciser body <NUM>. The exercising means <NUM> creates a resistance so that the user has to use a force to push the chin receiving means <NUM> downwards with the lower jaw. <FIG> shows the final position of the jaw opening exercise, i.e. when the lower jaw has pushed the chin receiving means <NUM> all the way down to the exerciser body <NUM>. The jaw opening exercise targets the same muscles as the generally known "Masako exercise". The intent is to improve movement and strength of the posterior pharyngeal wall during swallowing. The exercise may also improve tongue base movement and improve the muscular pressures generated on foods and liquids during swallowing.

Still another exercise, which may be performed with the exercise device <NUM>, is illustrated in <FIG> shows an exercise, which may be referred to as "effortful swallow". The exercise increases tongue base retraction and pharyngeal pressure during the swallow for reduced residue in the valleculae. The aim of the exercise is to improve the contact and coordination between the different muscles used while swallowing. As seen in <FIG>, the exercise is performed by pressing the chin at the chin receiving means <NUM> and then swallowing.

Taken together, the three previously described exercises may target suprahyoid and infrahyoid muscles - for larynx elevation, sternocleidomastoid muscle and lateral pterygoid - mouth opening and trismus prevention-treatment. Thus, by using the provided exercise device <NUM>, the anterior tongue strength may be increased, the maximum mouth opening may be increased, and volume and strength of muscles may be increased. Thus, the provided exercise device <NUM> targets all the muscles that may be trained by a person that has undergone a total laryngectomy. Additionally, as the load of the exercising means <NUM> may be known, it is possible to choose an exercise device <NUM> with a suitable load for a certain user and potentially also increase the load as the muscles become stronger.

Another embodiment of the present disclosure will now be described with reference to <FIG>. The exercise device <NUM> according to this embodiment is embodied in a corresponding way as the ones illustrated in the previous figures, but with a different construction of the holding means <NUM>. As illustrated in <FIG>, the holding means <NUM> of the exercise device <NUM> comprises two slightly curved members. The two curved members are secured to the exerciser body <NUM> at one end. They extend in a direction away from the exerciser body <NUM>. Each of the two curved members comprises a guide track <NUM> configured to receive the chin receiving means <NUM>. <FIG> is a perspective view of the exercise device <NUM> according to this embodiment. As seen in <FIG>, the holding means <NUM> comprises two curved members firmly mounted to the exerciser body <NUM> at one end. The chin receiving means <NUM> is movably connected to the curved members, such that the chin receiving means <NUM> may move within the guide tracks <NUM>. In some embodiments, the chin receiving means <NUM> may comprise two engaging means <NUM>. The engaging means <NUM> may be radially extending from the chin receiving means <NUM> and configured to engage with the guide tracks of the holding means <NUM> such that the engaging means <NUM> is kept within the guide track during movement of the chin receiving means <NUM>.

<FIG> illustrates the previously described embodiment in use. As understood from <FIG>, when the user pushes their chin downwards, i.e. towards the chest, the chin receiving means <NUM> will slide inside the guide tracks towards the exerciser body <NUM>. While the chin receiving means <NUM> is pushed downwards, the exercising means <NUM> will create a resistance acting towards the chin receiving means <NUM>, forcing the user to push harder. As seen in <FIG>, the chin receiving means <NUM> will pivot around a center located at the neck of the user using the exercise device <NUM>. The described embodiment provides a solid and sustainable construction of the exercise device <NUM>.

<FIG> shows a cross-sectional view of an exercise device <NUM> for swallowing rehabilitation according to a third embodiment of the present disclosure. The exercise device <NUM> shown in <FIG> comprises an adjustment lever <NUM> that allows adjustment of a resistance against movement of a chin receiving means.

As illustrated in <FIG>, the exercise device <NUM> comprises an exerciser body <NUM> for supporting the device <NUM> during use. The exerciser body <NUM> may have a chest resting plate <NUM> adapted to engage with a chest of a user using the exercise device <NUM>. The chest resting plate <NUM> may have a padding (not shown), such as the padding <NUM> shown in <FIG>.

The exercise device <NUM> also comprises a chin receiving means <NUM> movably connected to the exerciser body <NUM>. The chin receiving means <NUM> comprises a chin resting plate <NUM> and padding (not shown), such as the padding <NUM> shown in <FIG>. The chin receiving means <NUM> also comprises a connection member <NUM> connected to the exerciser body <NUM>. In the embodiment of <FIG>, the chin receiving means <NUM> is connected to the exerciser body <NUM> via a holding means <NUM> (shown in <FIG>) and a pin <NUM>. The chin receiving means <NUM> is pivotable about the pin <NUM>.

The exercise device <NUM> also comprises an adjustment lever <NUM>. The adjustment lever <NUM> comprises an elongate member that is pivotable about an adjustment pin <NUM>. The adjustment lever <NUM> is connected to the exerciser body <NUM> via the holding means <NUM> and the adjustment pin <NUM>. The adjustment lever <NUM> comprises a roller <NUM> at one end that is in contact with a lower surface of the connection member <NUM> of the chin receiving means <NUM>. In operation, the chin receiving means <NUM> interacts with the roller <NUM> such that the adjustment lever <NUM> is pivoted about the adjustment pin <NUM> when the chin receiving means <NUM> is moved towards the exerciser body <NUM>.

In the embodiment of <FIG>, an exercising means <NUM> is disposed between the exerciser body <NUM> and the adjustment lever <NUM>. The exercising means <NUM> may be a compression spring, similar to those used in the previously described embodiments, or an elastomer member such as a silicone block. As shown <FIG>, in some embodiments the exercising means <NUM> is disposed inside a handle <NUM> of the exercise device <NUM>.

A loading arrangement is provided to connect the adjustment lever <NUM> to the exercising means <NUM>. The loading arrangement may comprise a connecting element <NUM>, for example a wire or cable, connected to the adjustment lever <NUM> at the opposite end of the adjustment lever <NUM> to the roller <NUM>. The loading arrangement may also comprise a stop <NUM>, for example a spring washer, connected to the other end of the connecting element <NUM>. The exercising means <NUM> is disposed between the lever arm <NUM> and the stop <NUM>. For example, the connecting element <NUM> may run through an axis of the exercising means <NUM>. The adjustment lever <NUM>, the connecting element <NUM> and the stop <NUM> are operable to compress the exercising means <NUM> during operation of the device <NUM>, as will be discussed in relation to <FIG>.

The exercise device <NUM> shown in <FIG> provides for adjustable or variable resistance against movement of the chin receiving means <NUM> towards the exerciser body <NUM>. To achieve this, the pivot position of the adjustment lever <NUM> is adjustable. As shown in <FIG>, the adjustment lever <NUM> comprises a rack <NUM> configured to receive the adjustment pin <NUM>. The rack <NUM> comprises a number of adjacent positions for receiving the adjustment pin <NUM>, which define different pivot positions for the adjustment lever <NUM>. The adjustment pin <NUM> is placed in one of the positions in the rack <NUM>, and provides a pivot for the adjustment lever <NUM> about that position. As such, the pivot position is adjustable along the length of the adjustment lever <NUM> by movement the adjustment pin <NUM> between the positions in the rack <NUM>. It will be appreciated that the pivot position of the adjustment lever <NUM> may be adjustable in any suitable way, for example by a sliding mechanism.

By adjusting the pivot position of the adjustment lever <NUM>, the resistance provided by the device <NUM> can be increased or decreased as desired. This is because adjusting the pivot position of the adjustment lever <NUM> changes the length of the adjustment lever <NUM> either side of the pivot. If the adjustment lever <NUM> has a length x and the distance from one end of the adjustment lever <NUM> to the pivot position is y, the lever ratio is defined as y/(x-y). As such, by changing the pivot position, the distance y and the lever ratio can be changed without changing the length of the adjustment lever. There is therefore no requirement for an extendible or retractable lever arm that may not always be used. This allows for a compact design that still can still provide a wide range of resistance against movement of the chin receiving means <NUM> towards the exerciser body <NUM>.

Each pivot position may increase or decrease the resistance with respect to an adjacent position by a set amount. For example, when the adjustment pin <NUM> is in a minimum resistance position closest to the exercising means <NUM>, the resistance may be of the order of 20N. Each consecutive pivot position may increase the resistance by around 20N, until a maximum resistance position furthest from the exercising means <NUM>, where the resistance may be of the order of 160N.

<FIG> shows a perspective view of the exercise device according to this embodiment. As shown in <FIG>, the holding means <NUM> connects the chin receiving means <NUM> to the exerciser body <NUM> via the pin <NUM>. The holding means <NUM> also connects the adjustment lever <NUM> to the exerciser body <NUM> via the adjustment pin <NUM>.

As also shown in <FIG>, an adjustment knob <NUM> is present which enables movement of the adjustment pin <NUM> between the positions in the rack <NUM>. The adjustment knob <NUM> can be turned to an open position to enable movement of the adjustment pin <NUM> between the pivot positions. The adjustment knob <NUM> can then be turned to a closed position to lock the adjustment pin <NUM> in place.

<FIG> also shows that the connection member <NUM> of the chin receiving means <NUM> has a forked structure at one end. That is to say, the connection member <NUM> comprises a single arm 32a that connects to the chin receiving plate <NUM> and two parallel arms 32b connected to the pin <NUM>. This structure allows one end of the adjustment lever <NUM> to pass between the arms 32b when the adjustment lever <NUM> pivots about the adjustment pin <NUM>. This will be discussed in relation to <FIG>.

<FIG> shows a cross-sectional view of the previously described embodiment in use. When the user pushes their chin downwards, i.e. towards the chest, the chin receiving means <NUM> will pivot about the pin <NUM>. This causes the roller <NUM> to move along the lower surface of the arm 32a of the connection member <NUM>, which in turn causes the adjustment lever <NUM> to pivot in an anticlockwise sense about the adjustment pin <NUM>. In turn, an end of the adjustment lever <NUM> passes upwards between the arms 32b of the chin receiving means <NUM>, and pulls the connecting element <NUM> and the stop <NUM> upwards. This causes compression of the exercising means <NUM>, which provides resistance against the user pushing their chin downwards. As such, the user can perform the exercises discussed above to exercise the relevant muscles. As discussed above, the resistance of the exercise device <NUM> can be adjusted by changing the position of the adjustment pin <NUM>.

In some examples, the exercising means <NUM> may comprise a plurality of springs, which may each be individually activated. The plurality of springs may be arranged in a magazine arrangement. Each spring may have an individual resistance, and a maximum resistance may be dependent on the number of springs used. For example, the spring magazine may comprise eight springs each having a <NUM> N resistance. Due to the individual activation of the springs, a resistance range of 20N to <NUM> N can be achieved.

<FIG> illustrates the exercise device <NUM> in use. In <FIG>, the user holds the exerciser device <NUM> in a start position, i.e. before any swallowing rehabilitation has begun. The user holds the handle <NUM> during use. As seen in <FIG>, the chest resting plate <NUM> of the exerciser body <NUM> rests against the chest of the user and the user's chin is resting on the chin receiving plate <NUM> in the start position. The exercise device <NUM> may be used for a plurality of different exercises starting from this start position.

Although the present invention has been described above with reference to specific embodiments, it is not intended to be limited to the specific form set forth herein. Rather, the invention is limited only by the accompanying claims and, other embodiments than the specific above are equally possible within the scope of these appended claims.

Claim 1:
An exercise device (<NUM>) for swallowing rehabilitation with a variable resistance, the exercise device (<NUM>) comprising:
an exerciser body (<NUM>) forming a support;
chin receiving means (<NUM>) movably connected to the exerciser body (<NUM>);
exercising means (<NUM>) for creating resistance when the chin receiving means (<NUM>) is moved towards the exerciser body (<NUM>); and
a lever arm (<NUM>, <NUM>) connected to the exerciser body (<NUM>) via a fulcrum (<NUM>, <NUM>) and configured to interact with the exercising means (<NUM>);
characterised in that the exercising means (<NUM>) or the fulcrum (<NUM>) is displaceable to provide a variable resistance against movement of the chin receiving means (<NUM>) towards the exerciser body (<NUM>),
and in that the exercising means (<NUM>) is arranged to extend between the exerciser body (<NUM>) and the lever arm (<NUM>).