Proposal for a Modified Jaw Opening Exercise for Dysphagia: A Randomized, Controlled Trial.

OBJECTIVE To verify the feasibility and effectiveness of a newly developed modified jaw opening exercise (MJOE) in post-stroke patients with pharyngeal residue who completed a sixweek exercise regimen. DESIGN Double-blind, randomized, controlled trial. PARTICIPANTS 16 patients with stroke-related dysphagia. INTERVENTIONS Participants were allocated to an intervention group (MJOE: one set of five repetitions at 80% maximum voluntary contraction (MVC) for 6 seconds) or a control group (isometric jaw closing exercise: one set of five repetitions at 20% MVC for 6 seconds). Each group performed four sets a day, five times a week, for a total of six weeks. MAIN OUTCOME MEASURES A videofluorographic swallowing study was performed before and after exercise. The distance between the mental spine and the hyoid bone (DMH) and hyoid displacement (HD) were measured. RESULTS Twelve participants completed the study. No pain in the temporomandibular joint and/or anterior region of the neck occurred during the exercise period. In the intervention group (N=6), a decrease in DMH where anterior HD ended and an increase in anterior HD were seen. In the control group (N=6), no changes were seen. CONCLUSIONS MJOE is feasible without any adverse events in poststroke patients, and it promotes anterior HD during swallowing.