High elevation training mask as a respiratory muscle strength training tool for dysphagia

Shih Chieh Shen, Yuval Nachalon*, Derrick R. Randall, Nogah Nativ-Zeltzer, Peter C. Belafsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Expiratory muscle strength training (EMST) is a treatment for swallowing dysfunction due to its activation of the suprahyoid muscles. Current EMST devices have numerous limitations. Objective: The purpose was to evaluate the utility of elevation training mask as an alternative respiratory muscle strength training (RMST) device. Methods: A closed system, simulating expiration was designed. Air was delivered through a pressure gauge with a measurement range of 0–15 psi. The EMST150TM and the Elevation Training Mask 2.0® (ETM) maximal resistance levels were measured and compared. Results: EMST150 produced increasing expiratory resistance pressures of 0.3, 0.6, 1.2, 1.9 and 2.1 psi, which correspond to its indicator of 30, 60, 90, 120 and 150 cmH2O. The ETM resistance pressure produced expiratory resistance pressures of 0.1 and 0.2 psi at simulated altitudes of 3000 and 6000 feet, respectively. A stable expiratory resistance pressure of 0.25 psi was measured at simulated altitudes of 9000, 12,000, 15,000 and 18,000 feet. Conclusion: ETM provides adjustable expiratory muscle strength resistance pressures. Further investigation is necessary to evaluate safety, compliance and clinical efficacy in patients with swallowing dysfunction. Significance: ETM can serve as an effective treatment modality for pulmonary dysfunction and swallowing disorders through RMST.

Original languageEnglish
Pages (from-to)536-540
Number of pages5
JournalActa Oto-Laryngologica
Issue number6
StatePublished - 3 Jun 2019
Externally publishedYes


  • EMST 150
  • Expiratory muscle strength training
  • RMST
  • altitude training mask
  • dysphagia
  • rehabilitation
  • respiratory muscle strength training
  • respiratory trainer
  • swallowing dysfunction


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