Abstract
Purpose: The most crucial airway protection mechanism during swallowing is adequate laryngeal elevation. Suprahyoid muscles are responsible for laryngeal elevation. Our study aimed to compare the effects of three different exercises, Shaker, resistance chin tuck (CTAR) exercise, and chin tuck exercise with theraband, on suprahyoid muscles activity responsible for laryngeal elevation. Methods: Forty-two healthy subjects with a mean age of 27.92±5.02 years (18-40 years), of which 50% were male were included. All individuals were divided into three groups with computerized randomization. Surface Electromyography (EMG) evaluation was performed to determine electrical activity of the suprahyoid muscles (geniohyoid, mylohyoid, anterior belly of digastric, thyrohyoid, stylohyoid muscles) during maximal voluntary isometric contraction and during performing CTAR, Shaker exercise and chin tuck with theraband. Normalized suprahyoid muscle activations were calculated as the recorded maximum electrical activity during exercise (mV)/recorded maximum electrical activity during maximum isometric contraction (mV). Results: A statistically significant difference was found between three groups regarding normalized suprahyoid muscle activation (p<0.001). The difference between the three groups was caused by the difference between CTAR and Shaker (p<0.001) and between CTAR and theraband (p=0.040) in favor of CTAR. No difference was found between Shaker and theraband (p=0.104). Conclusion: Primarily CTAR exercise should be included in rehabilitation to increase the suprahyoid muscle activation. In addition, chin tuck exercise with theraband can also be considered as an alternative to CTAR.
Highlights
Swallowing is a series of sequential functions starting with oral intake of food and transferring to the pharynx, esophagus, and stomach, respectively [1]
It was found that the difference among three groups was caused by the differences between Chin-Tuck Against Resistance (CTAR) and Shaker (p
No statistically significant difference was found between Shaker and Chin Tuck exercise with theraband (p=0.107)
Summary
Swallowing is a series of sequential functions starting with oral intake of food and transferring to the pharynx, esophagus, and stomach, respectively [1]. Any problem during these sequential functions is defined as swallowing impairment (dysphagia). When swallowing reflex is triggered, hyolaryngeal complex move up and forward to provide airway protection with the tilt of epiglottis. The upward movement of the laryngeal complex allows relaxation of the upper esophageal sphincter, and thereby bolus enters into the esophagus with the squeezing effect of pharyngeal constrictor muscles. The most critical airway protection mechanism during swallowing function is adequate laryngeal elevation. Main structures responsible for laryngeal elevation are suprahyoid muscles [2,3]
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