Forehead against Resistance (FAR): Preliminary Findings from A Clinical Alternative to Shaker’s Type of Exercise

Abstract

Background. Reduced UES opening is a well-known risk factor for dysphagia. The Shaker exercise and the CTAR are the widely used intervention strategies to bring about effective UES opening. But there are well-known difficulties with the clinical use of these two exercise regimes. The present study proposes a clinical alternative to Shaker’s exercise and CTAR called the forehead against resistance (FAR) and its variants without altering the central principles of these two regimes. The aim of the present study was to investigate the efficacy of FAR and its variants in bringing about UES opening. Method. The study used a comparative cross-sectional study design, with the nonrandomized convenient sampling that included 27 healthy adults. MBS was carried out in the anterior-posterior and lateral views, while the participants performed FAR and its variants. The UES diameter was measured in the baseline and with the subjects performing FAR maneuver and its variants. Results. The result revealed that the participants had greater UES opening on FAR and its variant than the baseline swallow. Also, mean values of UES opening were greater for FAR with chin tuck when compared to FAR alone, although there was no significant main effect with exercise. Conclusion. FAR and its variant could be one of the options for increasing UES opening in individuals with dysphagia.

Effect of Dysphagia Rehabilitation Using Kinesiology Taping on Oropharyngeal Muscle Hypertrophy in Post-Stroke Patients: A Double Blind Randomized Placebo-Controlled Trial

“…Exercise-based dysphagia rehabilitation (EBDR) has been commonly used in clinical practice for the past three decades by multidisciplinary approach of specialized professionals including rehabilitation physicians, speech-language therapists, and occupational therapists [ 18 , 19 ]. In the past few years, many researchers have reported various methods of EBDR, such as shaker exercise (head lift exercise) [ 4 , 20 ], tongue strengthening exercise [ 12 , 21 , 22 ], expiratory muscle strengthening training [ 23 , 24 ], effortful swallowing [ 25 , 26 ], chin tuck against resistance exercise [ 27 , 28 ], forehead against resistance [ 29 ], chin-to-chest exercise [ 28 , 30 ], Mendelsohn [ 31 , 32 ], jaw opening exercise [ 33 , 34 ], proprioceptive neuromuscular facilitation technique [ 35 ], head extension swallowing exercise [ 36 , 37 ], swallowing against laryngeal restriction [ 38 , 39 ], and swallow exercise aid exercise [ 40 , 41 ] to improve swallowing function. These methods are known to induce high activation of muscles by providing loading to the oropharyngeal muscles, and consequently, contributing to the improvement of oropharyngeal swallowing function, increased hyoid bone movement and myophysiological changes.…”