Changes in Perihyoid Muscle Strength Associated with Fixed and Progressive Resistance Exercise in Healthy Adults

The supra- and infrahyoid muscles, collectively referred to as the perihyoid musculature, contribute to hyolaryngeal excursion and pharyngoesophageal segment opening during swallowing. This study investigated whether fixed- and progressive-resistance chin tuck against resistance (CTAR) protocols improve perihyoid strength, measured using open-mouth maximum isometric pressure (OM-MIP), in healthy adults. Forty-two healthy adults were randomly assigned to one of three intervention groups: traditional fixed-resistance CTAR using an inflatable ball, fixed-resistance CTAR using a novel spring-loaded device, or progressive-resistance CTAR using the same novel device. Participants completed a six-week home-based training program. Perihyoid strength was quantified at baseline and post-intervention using the OM-MIP protocol with a handheld dynamometer. Adherence was tracked using a digital home exercise platform. All groups demonstrated statistically significant within-group improvements in OM-MIP. Median paired gains were observed in the traditional fixed-resistance group (+ 3.65 kgF), novel fixed-resistance group (+ 2.25 kgF), and progressive-resistance group (+ 3.20 kgF). Between-group comparisons of change scores were not statistically significant (p = .371), indicating that no single training approach resulted in superior OM-MIP gains. Adherence did not differ significantly across groups and did not significantly predict post-intervention OM-MIP when included as a covariate. Traditional fixed-resistance, novel fixed-resistance, and novel progressive-resistance CTAR protocols were associated with improved OM-MIP in healthy adults following six weeks of home-based training. These findings support the physiologic feasibility of CTAR-based perihyoid strengthening approaches but do not establish effects on swallowing biomechanics or functional swallowing outcomes. Further research is needed to optimize resistance progression, examine dose-response relationships, and determine whether gains in OM-MIP translate to clinically meaningful swallowing outcomes in dysphagic populations.