Effect of Modified Shaker Exercise on the Amplitude and Duration of Swallowing Sounds: Evidence from Cervical Auscultation

Abstract

Objective Anecdotal evidence shows that the Shaker exercise and its modifications improve pharyngeal muscle contraction. However, there is no experimental evidence for the same. Thus, the present study examined the effect of modified Shaker exercise on the amplitude and duration of pharyngeal muscle contraction using cervical auscultation. Design The study follows a cross-sectional study design, where 50 healthy individuals (23 males and 27 females) performed modified Shaker exercise and noneffortful swallow during 10 ml water swallowing. Swallow sound characteristics were analyzed with and without modified Shaker exercise using cervical auscultation. Results The results of mixed ANOVA revealed significant differences for the amplitude of swallow sound with modified Shaker exercise (mean = 47.24, SD = 20.64) when compared to noneffortful swallow (mean = 28.19, SD = 10.26) at p < 0.05. However, no significant difference was obtained for the swallow sound duration with (mean = 0.19, SD = 0.07) and without (mean = 0.18, SD = 0.07) modified Shaker exercise at p > 0.05. No significant difference across the genders was also noted at p > 0.05. Conclusion The outcomes of the study suggest that modified Shaker exercise improves the amplitude of pharyngeal muscle contraction. Further studies are needed to confirm this finding using gold standard tools like videofluoroscopy.

Effect of Shaker Exercises on Swallowing Disturbance among Patients with Hyperthyroidism at a Selected University Hospital

“…A similar study supported the current finding; which have been performed by Suman, Manzoor, Azmat, Ibrahim and Tahir (2015) [32] on patients with dysphagia with different causes that have been interfered against swallowing function by narrowing esophagus sphincter through compression; those patients had been trained on the swallowing exercise by the end of their study; they revealed that there was improvement in clearing food out of mouth after receiving the exercise as 95% reported that swallowing exercises worked for improvement; 85% reported wet/gurgly voice quality improved as well after exercise and no voice change after swallowing while coughing/choking decreased to be 90% had no complain. Also another recent study by Babu, Balasubramaniam and Varghese (2017) [13] found result which congruent with the recent study as their study's results revealed significant differences of swallows sound with modified Shaker Exercise when they compared to non effortful swallow.…”

“…Shaker Exercises is a series of sustained and repetitive head lifting exercises to enhance the strength of suprahyoidandinfrahyoid muscular activity, reduces pyriform sinus residue and backflow aspiration and also improves swallowing functions (Babu, Balasubramaniam & Varghese, 2017) [13]. Shaker exercise includes isometric and isotonic exercises.…”

The effects of neuromuscular joint facilitation treatment using neck patterns on the acoustic analysis of swallowing sounds in healthy adults

“…In the NJF-NFRP condition, the swallowing sound was recorded during resistance in the isometric contraction of the middle limb. In the Shaker-type exercise condition, the swallowing sound was recorded during isometric neck flexion 6) . In the control condition, the swallowing sound was recorded during relaxed sitting in a chair.…”

“…The Shaker exercise, a series of sustained and repetitive head lifting with isometric and isotonic tasks, is frequently used in rehabilitation for swallowing disorders to enhance suprahyoid and infrahyoid muscle strength 1,2) , resulting in improved superior-anterior movement of the hyoid and a wider upper esophageal sphincter (UES) opening [2][3][4] . Furthermore, strengthening the pharyngeal muscle activity can decrease the amount of residue in the piriform sinus and prevent aspiration 5,6) . In the Shaker exercise, the isometric tasks were performed by three repetitions of raising the head for 1 minute followed by a 1-min rest, and the isotonic tasks were performed by 30 repetitions of alternate up-and-down movement of the head.…”

“…Despite the above-mentioned benefits, the Shaker exercise has been considered physically challenging, especially for the elderly and those with motor dysfunction 7,8) , affecting compliance. Therefore, modifications, such as the modified Shaker exercise by Babu et al, chin tuck posture against resistance (CTAR) by Yoon et al, and recline and head-lift exercises by Fujiki et al have been proposed 6,9,10) . These Shaker-type neck flexion exercises are known to effectively strengthen the suprahyoid and infrahyoid muscles.…”