Faculty Collaboration Database

Augmentation of deglutitive thyrohyoid muscle shortening by the Shaker Exercise. Dysphagia 2009 Mar;24(1):26-31

Date

08/08/2008

Pubmed ID

18685891

Pubmed Central ID

PMC2892888

DOI

10.1007/s00455-008-9167-y

Scopus ID

2-s2.0-66349096939 (requires institutional sign-in at Scopus site)   65 Citations

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.

Author List

Mepani R, Antonik S, Massey B, Kern M, Logemann J, Pauloski B, Rademaker A, Easterling C, Shaker R

Authors

Benson T. Massey MD Professor in the Medicine department at Medical College of Wisconsin
Barbara R. Pauloski PhD, CCC-SLP Associate Professor in the Communication Sciences & Disorders department at University of Wisconsin - Milwaukee
Reza Shaker MD Assoc Provost, Sr Assoc Dean, Ctr Dir, Chief, Prof in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Deglutition Disorders
Exercise Therapy
Female
Fluoroscopy
Humans
Hyoid Bone
Male
Middle Aged
Muscle Contraction
Pharyngeal Muscles
Thyroid Cartilage
Treatment Outcome