Page 153 - Functional impairment and cues for rehabilitation of head and neck cancer patients -

Muscle activation during swallowing exercises
SEA exercises
The three exercises performed with the SEA are presented in Figure 2 (18, 35). The chin tuck against resistance exercise (CTAR+) is performed by repetitively pressing the chin downwards against the chin bar of the SEA, while keeping the mouth closed, until the chin bar reaches the chest bar attachment (providing tactile feedback). It was hypothesized that mainly the suprahyoid muscles will be activated during this exercise.
The jaw opening against resistance exercise (JOAR+) is performed by repetitively pressing the mandible down while opening the mouth, again compressing the chin bar onto the chest bar. It was hypothesized that both the suprahyoid and jaw opening musculature will be activated during this exercise.
The effortful swallow exercise (ES+) is performed with the chin placed on the chin bar (pressed halfway down (50%)), whereby the subject effortful swallows voluntarily as if swallowing a large bolus with the mandible down and the lips/mouth closed. This exercise was hypothesized to not only stimulate the suprahyoid and jaw muscles involved in mouth opening, but also the tongue and pharyngeal musculature.
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Figure 2 Exercises performed with the swallow exercise aid. Top left: start position; top right: chin tuck against resistance (CTAR) exercise; bottom left: jaw opening against resistance (JOAR) exercise; bottom right: effortful swallow (ES) exercise.
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