Purpose The aim of this study was to compare biomechanical swallowing outcomes and perceived effort as well as detraining effects of the established Head Lift Exercise (HLE) and the novel Recline Exercise (RE) in healthy older adults. Method Twenty-two healthy older adults were randomized to perform either the RE or the HLE for a period of 6 weeks. Subjects underwent videofluoroscopic swallowing studies at 3 time points (baseline, postexercise, and following a 6-week detraining period). Primary outcome measures included biomechanical measures of superior and anterior hyoid excursion and upper esophageal sphincter opening, obtained using kinematic analyses on the recorded swallows. Perceived exertion ratings during exercise, as measured by the Borg scale, were included as a secondary outcome measure. Linear mixed-effects models were utilized to compare exercise groups and evaluation time points. Results The 2 exercise groups did not differ significantly in age, body mass index, or body fat percentage at baseline. Significant postexercise increases were seen in superior hyoid excursion, F (2, 36.7) = 24.01, p ≤ .0001, and anterior hyoid excursion, F (2, 36.7) = 5.40, p = .0088, for both exercise groups. Upper esophageal sphincter opening did not increase significantly following the exercise regimens, F (2, 36.5) = 2.14, p = .1322. Both groups displayed a significant decrease in perceived exertion levels over the course of the exercises, F (5, 98) = 23.73, p ≤ .0001. On average, Borg ratings were 20% lower for the RE group than the HLE group at all time points, F (5, 20) = 7.94, p = .0106, indicating that this exercise was perceived as easier to perform. Eighteen participants were followed after detraining, and no differences in detraining effects were seen between groups. In general, gains in biomechanical measures were better maintained on larger bolus types. Conclusions In healthy older adults, the HLE and the RE produced similar gains and detraining effects in biomechanical swallow outcomes. The RE exercise, however, required significantly less effort. These findings suggest that the RE is easier to perform for healthy older adults and thus may be a valuable treatment option for individuals who have difficulty performing the HLE. Further investigation in patients with dysphagia is warranted. Supplemental Material https://doi.org/10.23641/asha.7742897

Purpose The aim of this study was to investigate secondary voice outcomes and detraining effects of 2 head and neck strengthening exercises, which have been used in swallowing rehabilitation, that is, the head-lift exercise (HLE) and the recline exercise (RE), in healthy older adults. Method Twenty-seven healthy older adults (between 60 and 85 years of age) were randomized to perform either the RE or the HLE for a 6-week period. Isometric and isokinetic portions of the exercise were performed 3 times daily. Patients were evaluated at baseline, postexercise, and following a 6-week detraining period. Acoustic outcome measures included the highest and lowest frequencies of vocal range on pitch glides (measured in hertz) and cepstral peak prominence on sustained vowels and connected speech. Self-perceptual measures included perceived phonatory effort. Results Twenty-two individuals completed their assigned exercise regimen. No significant differences between exercise groups were observed at baseline for age, body mass index, or body fat percentage. A significant postexercise increase was seen in the highest frequency of vocal range on pitch glide, t (2, 56.79) = −10.28, p ≤ .0001, for both groups. This increase was not fully maintained following the 6-week detraining period; however, data remained significantly above baseline at this time point, t (2, 57.01) = −4.70, p ≤ .0001. Seventeen of the individuals who made postexercise gains were followed postdetraining. On average, these 17 individuals maintained 51% of their postexercise gains in the highest frequency of vocal range. No differences were observed between exercise groups. In addition, no significant changes in the lowest frequency of vocal range, cepstral peak prominence on sustained vowels or connected speech, or perceived phonatory effort were observed following the exercise regimens. Conclusions Both the HLE and the RE produced gains in the highest frequency of vocal range in healthy older adults. This finding is promising; however, further research is required to understand how suprahyoid muscle strengthening influences upper pitch range and whether this relationship has potential clinical implications for patients with dysphonia.