A while back, I wrote a post about the ISO device.  Find the ISO post here.  I still use this device with my patients in home health as appropriate.  A few months back, Jolie sent me her 3 new models of devices to trial.  I’ll have to admit that I really like the sleek new look.

As I said there are 3 new models from which you can choose.   All 3 models can be found here.

Phagiaflex 1

The first model, pictured above is the PhagiaFlex H.  It is very similar to the original ISO, which I described below to be used with The Effortful Swallow with Resistance (ESAR), Chin Tuck Against Resistance (CTAR) and Jaw Opening Against Resistance (JOAR).   This model will cost you $169.99.

Phagiaflex 3

The next model is the PhagiaFlex HF.  This model will actually clip on to a bedside table so that the patient doesn’t have to hold the device, which is particularly good for those patients that aren’t able to hold the device.  This model will run you $229.00

Phagiaflex 2

Last but not least is the PhagiaFlex HFC.  This device actually has velcro on the bottom.  The patient can use velcro that sticks to the chest and the device will stay on that.  I was skeptical and tried this one on myself before I subjected my patients to getting flipped in the face with this device.  Remarkably, it stayed intact throughout multiple repetitions of the exercise!  This hands-free device is $149.99.  At this time, I have been unable to locate purchasing information for the chest attachment pieces for re-order.

A huge thanks to Jolie Parker for sending me an ISO device for this blog post!!


Clark, H.M. (2005).  Therapeutic exercise in dysphagia management:  Philosophies, practices and challenges.  Perspectives in Swallowing and Swallowing Disorders, 24-27.

Burkhead L.M., Sapienza C.M., Rosenbek J.C. (2007).  Strength training exercise in dysphagia rehabilitation:  Principles, procedures and directions for future research.  Dysphagia; 22:  251-265.

Clark, Heather M. “Neuromuscular Treatments for Speech and SwallowingA Tutorial.” American Journal of Speech-Language Pathology 12.4 (2003): 400-415.

Wada, Satoko, et al. “Jaw-opening exercise for insufficient opening of upper esophageal sphincter.” Archives of physical medicine and rehabilitation 93.11 (2012): 1995-1999.

Yoon, Wai Lam, Jason Kai Peng Khoo, and Susan J. Rickard Liow. “Chin tuck against resistance (CTAR): new method for enhancing suprahyoid muscle activity using a Shaker-type exercise.” Dysphagia 29.2 (2014): 243-248.

Sze WP, Yoon WL, Escoffier N, Rickard Liow SJ. Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography-Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise. Dysphagia. 2016 April;31(2):195-205. doi: 10.1007/a00455-015-9678-2. Epub 2016 Feb 2.

Satoko Wada, Haruka Tohara, Takatoshi Iida, Motoharu Inoue, Mitsuyasu Sato, Koichiro Ueda, Jaw-Opening Exercise for Insufficient Opening of Upper Esophageal Sphincter, Archives of Physical Medicine and Rehabilitation, Available online 10 May 2012, ISSN 0003-9993, 10.1016/j.apmr.2012.04.025.

3 thoughts on “PhagiaFlex

  1. Hi Tiffany, Is there any evidence as to whether the CTAR ball or the iso sed is the best choice for this exercise, as an alternative to the Shaker?


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