Immediate Effects of the Forehead Exercise for Suprahyoid Muscles: A Case Series

Area of Science:

• Gerontology
• Neurology
• Speech-Language Pathology

Background:

• Dysphagia is prevalent in older adults and neurological patients, increasing risks of aspiration pneumonia and decreased quality of life.
• The Forehead Exercise for Suprahyoid Muscles (FESM) is a non-invasive method to strengthen suprahyoid muscles.
• The immediate impact of FESM on swallowing function, particularly penetration and aspiration, remains unclear.

Purpose of the Study:

• To evaluate the immediate effect of a single FESM session on reducing penetration and aspiration risks during swallowing.
• To assess changes in the Penetration-Aspiration Scale (PAS) score following FESM in patients undergoing videofluoroscopic swallowing studies (VFSS).

Main Methods:

• A retrospective case series of 12 patients (mean age 76.6 years) with baseline PAS score ≥2 undergoing VFSS.
• Patients performed at least five repetitions of FESM (isometric chin-tuck) immediately before a post-intervention swallow.
• PAS scores were compared pre- and post-FESM using the Wilcoxon signed-rank test.

Main Results:

• The median PAS score significantly decreased from 3.5 to 1.0 after FESM (p=0.025).
• Ten out of 12 patients demonstrated improvement in their PAS scores.
• One patient showed no change, and one patient experienced a worsening of their condition.

Conclusions:

• A single FESM session can immediately reduce penetration and aspiration events during swallowing.
• FESM shows potential as a practical, low-effort preparatory exercise to mitigate airway invasion risk.
• Further controlled trials are necessary to validate these findings and explore long-term benefits.