Proposal for a Modified Jaw Opening Exercise for Dysphagia: A Randomized, Controlled Trial

Abstract

Objective: To verify the feasibility and effectiveness of a newly developed modified jaw opening exercise (MJOE) in post-stroke patients with pharyngeal residue who completed a sixweek exercise regimen.

Design: Double-blind, randomized, controlled trial.

Participants: 16 patients with stroke-related dysphagia.

Interventions: Participants were allocated to an intervention group (MJOE: one set of five repetitions at 80% maximum voluntary contraction (MVC) for 6 seconds) or a control group (isometric jaw closing exercise: one set of five repetitions at 20% MVC for 6 seconds). Each group performed four sets a day, five times a week, for a total of six weeks.

Main outcome measures: A videofluorographic swallowing study was performed before and after exercise. The distance between the mental spine and the hyoid bone (DMH) and hyoid displacement (HD) were measured.

Results: Twelve participants completed the study. No pain in the temporomandibular joint and/or anterior region of the neck occurred during the exercise period. In the intervention group (N=6), a decrease in DMH where anterior HD ended and an increase in anterior HD were seen. In the control group (N=6), no changes were seen.

Conclusions: MJOE is feasible without any adverse events in poststroke patients, and it promotes anterior HD during swallowing.