Eccentric Chin Closure Exercise

NCT05240599 | Completed FDA Device

• 1 other identifier: ECC Exercise
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Swallowing is a set of functions that start with the acceptance of food and end with its delivery to the stomach. One of the most important problems associated with swallowing disorders is insufficient airway closure and the risk of aspiration. It is due to the inadequacy of laryngeal elevation that should occur during swallowing. Suprahyoid muscles are the most basic structures responsible for laryngeal elevation. Insufficient activation of the suprahyoid muscles causes insufficient laryngeal elevation. The suprahyoid muscles consist of a group of muscles located in the anterior region of the neck between the hyoid bone and the mandible. The muscles which forming SH muscles m. digastricus, m. stylohyoideus, m. mylohyoideus and m. geniohyoideus muscles work as a group. SH muscles play a primary role in controlling hyoid bone movement during swallowing due to their relationship with the hyoid bone. It has been reported that the muscle with the highest potential to move the hyoid anteriorly is the geniohyoid muscle, and the mylohyoid muscle has the highest potential to move the hyoid in the superior direction. In addition, in another study, it was stated that since the geniohyoid and mylohyoid muscles have greater structural potential than other SH muscles for anterior and superior displacement of the hyoid, respectively. By understanding the potential for hyoid excursion arising from the structural properties of these muscles, therapists can target specific muscles with exercises designed to promote hyolaryngeal elevation. Exercises such as Shaker exercise and resistance chin tuck in the literature either directly involve concentric training of the suprahyoid muscles or indirectly aim to gain strength by strengthening the neck flexors. In the light of the available evidence in the literature, eccentric training is also a viable method in swallowing rehabilitation. In eccentric training, the muscle is positioned by shortening its length. Eccentric training can be done by applying resistance to the jaw while the mouth is open and asking the mouth to be closed in a controlled manner against the resistance. In addition, swallowing exercise can be planned by adjusting the mouth opening and placing the SH muscles at the most appropriate angle to generate force. The aim of this study is to compare the effects of these three different exercises on suprahyoid muscle activation, muscle strength, dysphagia limit and perceived exertion level.

Conditions

Dysphagia

Keywords

Electromyography; Exercise Training; Dysphagia Limit

Outcome Measures

Primary Outcomes (2)

• Muscle Activation

  In our study, dual-channel DELSYS Trigno Duo sensors integrated into the software called DELSYS Trigno Lite System will be used. While measuring voluntary muscle activations in the superficial emg device, the values taken will be recorded in microvolts. For superficial emg recording, the high filter pass will be calculated as 20 Hz, the low filter pass as 2 kHz, and the received signal will be amplified 200 times. The signal transition interval will be set to 20 mV.

  Change from baseline muscle activation at 4 weeks and 8 weeks

• Muscle Strength

  Individuals participating in the study will be asked to sit on their backs in an upright position at 90 degrees. Participants' heads will be fixed in a neutral position to prevent possible cervical flexion movement. The head of the digital dynamometer named Jtech Medical Industries Commander Muscle Testing 7633s, which is compatible with the chin area, will be placed under the chin of the participant and the participant will be asked to open his mouth vigorously for 10 seconds against the resistance. This movement will be repeated 3 times, with a 60-second listening period in between. And the maximum and average values taken will be recorded in Newtons.

  Change from baseline muscle strength at 4 weeks and 8 weeks

Secondary Outcomes (2)

• Dysphagia Limit

  Change from baseline dysphagia limit at 4 weeks and 8 weeks

• Perceived Exertion Level

  Change from baseline perceived exertion level at 4 weeks and 8 weeks

Study Arms (3)

Shaker

EXPERIMENTAL

Shaker exercises consist of isotonic and isometric contractions of the neck flexor muscles. Participants will be asked to lie on their back with their knees straight. Participants will first wait for 60 seconds by lifting their head and looking at their feet. He will repeat the movement three times in total, resting for 60 seconds in between. Then, the participants will raise their heads again, look at the toes, and put their head back on the bed without waiting. By repeating this movement 30 times in total, the exercise program will be completed. Individuals will perform this exercise, which consists of isometric components to be repeated 3 times and isotonic components to be performed once, in 3 times per day.

Other: Exercise Training

Chin Tuck Against Resistance

EXPERIMENTAL

In this exercise, participants have to place an inflatable ball with a diameter of 12 cm between their chin and sternum. This exercise has two subcomponents, isotonic and isometric. In the isometric component, individuals must compress the ball with maximum force between their chin and sternum, hold for 60 seconds, and rest for 60 seconds. One should repeat this isometric component 3 times. In the isotonic parameter, on the other hand, the participants must slowly squeeze the ball between their chin and sternum 30 times with the maximum force they can do. Participants will perform the exercise in an upright sitting position on a back-supported chair. Individuals will perform this exercise, which consists of isometric components to be repeated 3 times and isotonic components repeated 10 times in 3 setsand 3 times per day.

Other: Exercise Training

Eccentric Chin Closure

EXPERIMENTAL

This exercise will be performed in the form of closing the chin against the manual resistance to be given from the tip of the mandible, starting from the maximum voluntary mouth opening. In this way, eccentric contraction will be created as the suprahyoid muscles will move from the shortest position to the longest position with resistance. Participants will perform the exercise by maintaining the upright posture in the upright sitting position on the back-supported chair. Volunteers will perform this exercise with 10 repetitions in 3 sets and 3 times per day.

Other: Exercise Training

Interventions

Exercise Training OTHER

Exercise training will be applied 3 times a day for 8 weeks.

Chin Tuck Against Resistance; Eccentric Chin Closure; Shaker

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Being between the ages of 18 - 35,
• Volunteering to participate in the study,
• Getting less than 3 points from the T-EAT-10 (Turkish Eating Assessment Test).

You may not qualify if:

• Having disc herniation, mechanical neck pain or any pathology in the cervical region.
• Having a temporamandibular joint problem that may affect joint biomechanics and muscle functions.
• Having any neurological or systemic disease,
• Having undergone head and neck surgery or received radiotherapy.
• Dischart Criteria
• Individuals who accepted the study and then stopped participating in the study
• Individuals who did not attend the assessments
• Individuals missing 5 days from the weekly follow-up of exercise sessions.

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Hacettepe University

Ankara, Turkey (Türkiye)

Location

Related Publications (28)

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MeSH Terms

Conditions

Deglutition Disorders

Interventions

Exercise

Condition Hierarchy (Ancestors)

Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases; Pharyngeal Diseases; Otorhinolaryngologic Diseases

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Emre CENGIZ, MSc, PhD(c)

  Hacettepe University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Assistant

Study Record Dates

• First Submitted: January 24, 2022
• First Posted: February 15, 2022
• Study Start: May 16, 2023
• Primary Completion: September 16, 2023
• Study Completion: May 1, 2024
• Last Updated: November 7, 2024

Record last verified: 2024-05

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)