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Randomized Controlled Trial
. 2009 Mar;24(1):26-31.
doi: 10.1007/s00455-008-9167-y. Epub 2008 Aug 7.

Augmentation of deglutitive thyrohyoid muscle shortening by the Shaker Exercise

Rachel Mepani  1 , Stephen Antonik, Benson Massey, Mark Kern, Jerilyn Logemann, Barbara Pauloski, Alfred Rademaker, Caryn Easterling, Reza Shaker
Affiliations
Randomized Controlled Trial

Augmentation of deglutitive thyrohyoid muscle shortening by the Shaker Exercise

Rachel Mepani et al. Dysphagia. 2009 Mar.

Abstract

Earlier studies of the effect of 6 weeks of the Shaker Exercise have shown significant increase in UES opening and anterior excursion of larynx and hyoid during swallowing in patients with upper esophageal sphincter (UES) dysfunction, resulting in elimination of aspiration and resumption of oral intake. This effect is attributed to strengthening of the suprahyoid muscles, as evidenced by comparison of electromyographic changes in muscle fatigue before and after completion of the exercise regime. The effect of this exercise on thyrohyoid muscle shortening is unknown. Therefore the aim of this study was to determine the effect of the exercise on thyrohyoid muscle shortening. We studied 11 dysphagic patients with UES dysfunction. Six were randomized to traditional swallowing therapy and five to the Shaker Exercise. Videofluoroscopy was used to measure deglutitive thyrohyoid shortening before and after completion of assigned therapy regimen. Maximum thyrohyoid muscle shortening occurred at close temporal proximity to the time of maximal thyroid cartilage excursion. The percent change in thyrohyoid distance from initiation of deglutition to maximal anterior/superior hyoid excursion showed no statistically significant difference between the two groups prior to either therapy (p = 0.54). In contrast, after completion of therapy, the percent change in thyrohyoid distance in the Shaker Exercise group was significantly greater compared to the traditional therapy (p = 0.034). The Shaker Exercise augments the thyrohyoid muscle shortening in addition to strengthening the suprahyoid muscles. The combination of increased thyrohyoid shortening and suprahyoid strengthening contributes to the Shaker Exercise outcome of deglutitive UES opening augmentation.

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Figures

Fig. 1
Fig. 1
Videofluoroscopic analysis at initiation of deglutition and at maximal anterior-superior hyoid excursion
Fig. 2
Fig. 2
Subject dropout
Fig. 3
Fig. 3
Shaker exercise
Fig. 4
Fig. 4
Results
See this image and copyright information in PMC

References

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