Lingual Muscle Training in Late-Onset Pompe Disease (LOPD)

Inclusion criteria: * Age ≥ 12 years * Lingual weakness as measured by quantitative muscle testing (≤ 5% lower limit of normal for stratified age) * Confirmed diagnosis of LOPD * On enzyme replacement therapy for ≥ 26 weeks at pretest * Able to follow directions for study participation * Able to complete a home-based LMT regimen * Access to reliable internet connection * Access to use of electronic device that allows for FaceTime, Jabber, or WebEx use Exclusion Criteria: * Neurodegenerative conditions (e.g. stroke, dementia) or other serious neurologic condition that would prevent meaningful study participation as determined at the discretion of the principle investigator * Any current or past history of seizures. * Head and neck cancer or radiation treatment to head/neck * Inability to tolerate IOPI device tongue bulb * Inability to give legally effective consent * Inability to read and understand English