title: Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography--Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise.
abstract: In this study, the efficacy of two dysphagia interventions, the Chin Tuck against Resistance (CTAR) and Shaker exercises, were evaluated based on two principles in exercise science-muscle-specificity and training intensity. Both exercises were developed to strengthen the suprahyoid muscles, whose contractions facilitate the opening of the upper esophageal sphincter, thereby improving bolus transfer. Thirty-nine healthy adults performed two trials of both exercises in counter-balanced order. Surface electromyography (sEMG) recordings were simultaneously collected from suprahyoid muscle group and sternocleidomastoid muscle during the exercises. Converging results using sEMG amplitude analyses suggested that the CTAR was more specific in targeting the suprahyoid muscles than the Shaker exercise. Fatigue analyses on sEMG signals further indicated that the suprahyoid muscle group were equally or significantly fatigued (depending on metric), when participants carried out CTAR compared to the Shaker exercise. Importantly, unlike during Shaker exercise, the sternocleidomastoid muscles were significantly less activated and fatigued during CTAR. Lowering the chin against resistance is therefore sufficiently specific and intense to fatigue the suprahyoid muscles.
authors.affiliation: Speech and Language Therapy Department, St Andrew's Community Hospital, 8 Simei Street 3, Singapore, 529895, Singapore. weipingsze@gmail.com.
authors.forename: Wei Ping
authors.initials: WP
authors.lastname: Sze
authors.affiliation: Speech and Language Pathology, Division of Graduate Medical Studies, National University of Singapore, Singapore, Singapore.
authors.forename: Wai Lam
authors.initials: WL
authors.lastname: Yoon
authors.affiliation: Asia Research Institute, National University of Singapore, Singapore, Singapore.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Escoffier
authors.affiliation: Speech and Language Pathology, Division of Graduate Medical Studies, National University of Singapore, Singapore, Singapore.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Rickard Liow
mesh_terms: D000328:Adult; D002680:Chin; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D004576:Electromyography / Q000379:methods; D049631:Esophageal Sphincter, Upper / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D018763:Muscle Fatigue / Q000502:physiology; D009334:Neck Muscles / Q000502:physiology; D055070:Resistance Training / Q000379:methods*
keywords: Deglutition disorders; Esophageal sphincter, upper; Muscle fatigue; Sternocleidomastoid muscle; Submental muscles; Swallowing intervention
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