Research has been emerging recently which supports the use of the ISO-SED for dysphagia therapy. A poster session at the 21st Annual Dysphagia Research Society compared using a plastic ball for chin tuck against resistance (CTAR) to the Shaker exercise via sEMG and found no significant difference in suprahyoid muscle activity between CTAR and Shaker for isokinetic exercise (Khoon 2013). Another study found that the jaw-opening exercise improved hyoid movement, UES opening and time for pharynx passage (Wada 2012). An online article published by Watts (2013) also supports the jaw opening exercise to increase hyolaryngeal elevation.
Background: Dysphagia is a common sequela post (chemo) radiotherapy ([C]RT) for head and neck cancer (HNC) and after stroke. The Shaker maneuver is a promising rehabilitative exercise for improvement of swallowing function by means of strengthening neck musculature. This pilot study primarily aimed to evaluate the feasibility of the Shaker exercise and, secondarily, to evaluate its impact on dysphagia and health-related quality of life in patients with radiation-induced or stroke-related dysphagia.
Jeri A. Logemann; Alfred Rademaker; Barbara Roa Pauloski; Amy Kelly; Carrie Stangl-Mcbreen; Jodi Antinoja; Barbara Grande; Julie Farquharson; Mark Kern; et al. (Profiled Authors: Jerilyn A Logemann; Barbara Roa Pauloski; Alfred W Rademaker) A randomized study comparing the Shaker exercise with traditional therapy: A preliminary study. Dysphagia. 2009;24(4):403-411.
The ISO swallowing device addresses this exact exercise with their device to provide resistance. A recent article published online by Watts (2013) supports jaw opening, or chin-to-chest exercise, to promote hyolaryngeal elevation muscle activation. While this study was done with 20 young healthy subjects it provides an excellent spring board into further research into jaw-opening and jaw-opening against resistance as a viable alternative to the Shaker exercise. Additionally, there was a poster session at the 21st Annual Dysphagia Research Society that addressed CTAR (chin tuck against resistance) using an inexpensive small plastic basketball (Khoon 2013). Forty healthy adults were given four exercise tasks. CTAR (chin-tuck against resistance), isometric and isokinetic and shaker isometric and isokinetic. This was in conjunction with sEMG. There was significant difference for Isometric tasks with CTAR and no significant difference between CTAR and Shaker for isokinetic exercise in relation to suprahyoid muscle activity. Benefit was seen that CTAR may be less strenuous than Shaker and compliance and achievement of the exercise may be greater. LESS STRENUOUS AND MORE COMPLIANCE ! Keeping my eyes out for an article that further expands on the poster session.
|Figure 1: The Shaker exercise
A speech language pathologist is demonstrating how to perfo