Jaw-Opening Exercise for Insufficient Opening of Upper Esophageal Sphincter

Wada S, Tohara H, Iida T, Inoue M, Sato M, Ueda K. Jaw-opening exercise for insufficient opening of upper esophageal sphincter. Objective To investigate the effects of the jaw-opening exercise on decreased upper esophageal sphincter (UES) opening while swallowing. Design Intervention study: before-after trial with 4-week follow-up evaluation. Setting A university school of dentistry dental hospital. Participants Patients with dysphagia (N=8; 7 men, 1 woman; average age ± SD, 70.5±11.3y; age range, 54–86y). Interventions All patients performed a jaw-opening exercise to strengthen the suprahyoid muscles. The exercise involved opening the jaw to its maximum and maintaining this position for 10 seconds. Each exercise set consisted of 5 repetitions, and 2 sets were carried out daily for 4 weeks. The effectiveness of the exercise was evaluated by a videofluorographic swallowing study (VFSS). Main Outcome Measures Hyoid elevation, UES opening, pharynx passage time, and pharyngeal residue after swallowing at preexercise and postexercise were compared by VFSS. Results Compared with before starting the exercise, significant improvements were observed in the extent of upward movement of the hyoid bone (P<.05), the amount of UES opening (P<.05), and the time for pharynx passage (P<.05) 4 weeks after initiating the exercise. Pharyngeal residue decreased in some subjects, and no increases were noted in any subjects. Conclusions The jaw-opening exercise is an effective treatment for dysphagia caused by dysfunction of hyoid elevation and UES opening.