Comparison of three different types of exercises for selective contractions of supra- and infrahyoid muscles

Abstract

Several exercise methods, such as the Shaker exercise, tongue press exercise, chin tuck against resistance (CTAR) exercise, and submandibular push exercise, have been introduced to strengthen the muscles involved in swallowing. In this study, we compared the effectiveness of the CTAR, submandibular push, and Shaker exercises for the induction of selective supra- and infrahyoid muscle contractions using surface electromyography (EMG). This study is a prospective non-randomized controlled study. Twenty-five healthy subjects and 20 patients experiencing swallowing difficulty were enrolled. During the three different types of exercises, the root mean square (RMS) values of the sternocleidomastoid (SCM), suprahyoid (anterior belly of the digastric and mylohyoid muscles), and infrahyoid (sternothyroid and thyrohyoid muscles) muscles were analyzed using surface EMG. Differences in the activity of swallowing muscles among the three different exercises were analyzed using one-way repeated measured analysis of variance. In terms of both the maximum and mean RMS values of the suprahyoid muscle, the submandibular push exercise showed a larger RMS value than the CTAR and Shaker exercises in healthy subjects (p < 0.05). In terms of both the maximum and mean RMS values of the suprahyoid muscle, the Shaker exercise and submandibular push exercise showed a larger RMS value than the CTAR exercise in patients with swallowing difficulty (p < 0.05). The submandibular push exercise may be effective as a swallowing muscle exercise owing to its superiority in inducing selective contractions of the supra- and infrahyoid muscles. The CTAR and Shaker exercises are also effective in this regard.

Predictors of Step Length from Surface Electromyography and Body Impedance Analysis Parameters

“…The amplitude, time, and frequency domains of the sEMG signals are affected by the timing and intensity of the muscle contraction [ 38 ]. The RMS value, calculated from the average power of these signals, is used as a validated parameter from sEMG data in many types of research [ 39 , 40 , 41 ]. Although the RMS value at maximal knee flexion strength tended to positively correlate with measured strength, it did not show a very high correlation in our study (R 2 = 0.1549, p < 0.001, Figure S4 ).…”

Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis

“…People can choose the appropriate resistance according to their physical condition. Several studies have been conducted to validate the biomechanics effects of CTAR exercise and compared with Shaker exercise using surface electromyography (sEMG), which demonstrate CTAR is effective in stimulating the SHM but there are inconsistent conclusions in the comparison of CTAR and Shaker exercise ( 20 , 21 ). To our knowledge, a previous systematic review ( 22 ) summarized the applications of CTAR exercise, in which both healthy participants and patients with dysphagia were included.…”

Therapeutic Effect and Optimal Electrode Placement of Transcutaneous Neuromuscular Electrical Stimulation in Patients with Post-Stroke Dysphagia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…TNMES carries electrical impulses to stimulate muscular contraction, improving or restoring the function of stimulated muscles [ 10 ]. The supra and infrahyoid muscles have been widely described as contributing to swallowing function [ 11 ]. Depending upon electrode placements in the submental or laryngeal regions, TNMES activates suprahyoid muscles, which cause the hyoid bone to move anterosuperiorly, whereas stimulating infrahyoid muscles depresses the hyoid bone and the hyolaryngeal complex.…”