The Biber Protocol® Training

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User must attend The Biber Protocol® training and a practical session before using the BiberPLUS+ device. All participants will be rewarded with a certificate.

*Next training date will be announced. Feel free to contact us for more details.

    BiberPlus+ Training.


    • NMES

    • Swallowing training

    • facial muscle training

    • vocal training

    Training course

    This training course offers a comprehensive approach to treating dysphagia by combining traditional swallowing exercises with the principles of electrophysiology through Neuromuscular Electrical Stimulation (NMES) in order to re-educate laryngeal muscles in patients with swallowing problems or difficulties. Participants will gain an understanding of patient selection criteria, electrode placement, and the rationale for NMES parameter settings using the BiberPLUS+ device.

    Upon successful completion of the training course, clinicians will be able to:
    • Explain Neuromuscular Electrical Stimulation (NMES)
    • Describe the properties of electrical stimulation and its impact on muscle tissue
    • Describe the patient selection criteria for which NMES is indicated for the treatment of dysphagia
    • Identify the characteristics of NMES
    • Discuss the properties of Electrodes
    • Discuss and demonstrate the application of therapeutic protocol in the treatment of dysphagia
    • Describe and justify why there is a continued need for traditional swallowing exercises in conjunction with the therapeutic protocol
    • Explain why adjusting the electrical parameters of the Biber Protocol is so important
    • Demonstrate effective communication skills in patient education and allied health professionals regarding the candidacy and use of NMES for the treatment of dysphagia

    • Part I - Online

      Foundation of Dysphagia Rehabilitation

      • Fundamentals of Swallowing
      • Prevalence and Management of Dysphagia
      • Categories of Dysfunction

      Electrotherapy: History & Evidence

      • Definition
      • History
      • Current Research and Evidence Based Practice
      • Differentiation of NMES from other protocols
      • Foundational skills for interpreting the literature

      Electrotherapy in Action

      • Principles and Parameters waveforms, amplitude, frequency, pulse duration, ramp and cycle time
      • Neuroplasticity and Cortical Reorganization
    • Part II - Online / virtual

      NMES: Implementing The Biber Protocol®

      • Review of foundational principles
      • Determining Candidacy
      • Contraindications and Cautions
      • Patient Education
      • Goals of Treatment
      • Adjusting Parameters
      • Electrode Placement and Rationale
      • Electrode Care
      • Assessing for Contraction

      Facial Stimulation

      • Facial Nerve Dysfunction
      • Quantitative Evaluation
      • Electrode Placement
      • Therapeutic Protocols

      Understanding sEMG

      • History
      • Foundational Principles

      Developing a Home Program
      Case Studies

    • Part III - Virtual / in-person

      Practical 1

      Review of NMES Principles & Parameters

      • Device orientation: Introducing NMES to a Patient
      • Placing and Securing Electrodes
      • Assessing for Contraction
      • Initiating treatment

      Practical 2

      • Parameter by Parameter Singular Adjustment and Experience
      • Continued Practice with One-on-One Observation and Feedback

      Practical 3

      • Facial placements



    How does NMES works?

    Neuromuscular Electrical Stimulation (NMES) involves the use of a handheld device that transmits tiny pulses through small cloth pads placed on the skin's surface to stimulate the nerves and activate weak or paralyzed muscles. These pulses are painless and, when combined with specific targeted tasks, can result in improvements in swallowing, voicing, and facial movement.

    The Biber Protocol® is a customized NMES protocol for dysphagia, dysphonia and facial droop/paralysis, tailored to meet the specific needs of each patient.


    The Biber Protocol stands out from other dysphagia electrical therapies in numerous ways, such as electrode placement, treatment parameters, delivery method, treatment philosophy, and more.

    The Biber Protocol® is a true NMES protocol, which can be verified by numerous electrotherapy sources. While other therapies also use electrical stimulation, they do not meet the criteria for an NMES protocol, and therefore should not be referred to as NMES.


    Yes, but it is recommend that you go through the pacemaker interference protocol and consult your doctor beforehand. It is important to note that NMES should NEVER be used with a defibrillator.


    Yes. There is no scientific evidence for any risk when using NMES on a cancer patient. Indeed there is evidence that electrical stimulation can help shrink tumors and enhance radiation therapy.