Proposal for a Modified Jaw Opening Exercise for Dysphagia: A Randomized, Controlled Trial

Area of Science:

• Neurology
• Rehabilitation Medicine
• Swallowing Disorders

Background:

• Stroke often leads to dysphagia, characterized by pharyngeal residue, impacting nutritional intake and quality of life.
• Impaired hyoid movement is a key factor in post-stroke dysphagia.
• Current therapeutic exercises may not fully address the biomechanics of swallowing in this population.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of a novel modified jaw opening exercise (MJOE) in stroke survivors with pharyngeal residue.
• To assess the MJOE's impact on key swallowing biomechanics.

Main Methods:

• A double-blind, randomized controlled trial was conducted with 16 post-stroke patients experiencing dysphagia.
• Participants were assigned to either the MJOE group (80% MVC, 6s holds) or a control group (20% MVC isometric jaw closing exercise).
• Videofluoroscopic swallowing studies measured the distance between the mental spine and hyoid bone (DMH) and hyoid displacement (HD) pre- and post-intervention over six weeks.

Main Results:

• Twelve participants completed the six-week regimen without adverse events.
• The MJOE group demonstrated a significant increase in anterior hyoid displacement (HD).
• No significant changes in DMH or HD were observed in the control group.

Conclusions:

• Modified jaw opening exercise (MJOE) is a feasible and safe intervention for post-stroke patients with dysphagia.
• MJOE effectively promotes anterior hyoid displacement, a critical component for improved swallowing.
• This exercise regimen shows promise for enhancing swallowing function in stroke survivors.