The New Jaw Opening Exercise

                                 Jaw Opening Exercise

This exercise has been studied for years and has finally been published.  The authors described the Jaw opening exercise in the paper as active "jaw lowering.

 The jaw-opening exercise was carried out as follows. First, subjects opened their jaws to the maximum extent and maintained this position for 10 seconds. During the exercise, each

patient was made aware that the suprahyoid muscles were strongly contracted.  Your patient should feel the stretch right above the level of the vocal folds. This open-and-hold exercise was repeated 4 more times after 10 seconds of rest, which constituted 1 set.

Subjects were instructed to perform 2 sets of the exercise daily." (Wada et al., 2012)

Wada et al, 2012 states that the most widely used exercise for UES is thought to put strain on the sternocleidomastoid muscles rather than the targeted hyoid muscle group.  The jaw Opening Exercise is able to implement a less straining exercise targeting intended muscle groups i.e., mylohyoid, digastric muscles, and the geniohyoid muscle.  When these muscles are innervated, they act together to move the hyoid in an upward and forward fashion.  In turn, opening the UES.


Not very fancy but these exercises focus the effort solely on mandibular elevators without the need to lie down or do any other acrobatics. If you are interested in exercise as a means to strengthen muscles, some of the other citations below explain the rationale behind strengthening exercise which is very different from "oral motor exercise".

***Attached below is my version of a patient handout for this exercise.  
 
References 

Hara, K., Tohara, H., Wada, S., Iida, T., Ueda, K., & Ansai, T. (2014). Jaw-opening force test to screen for Dysphagia: preliminary results. Arch Phys Med Rehabil, 95(5), 867-874. doi: 10.1016/j.apmr.2013.09.005

Robbins, J. A., Gangnon, R. E., Theis, S. M., Kays, S. A., Hewitt, A. L., & Hind, J. A. (2005)The effects of lingual exercise on swallowing in older adults. Journal of the American Geriatrics Society, 53(9), 1483-1489.

Robbins, J. A., Kays, S. A., Gangnon, R. E., Hind, J. A., Hewitt, A. L., Gentry, L. R., & Taylor, A. J. (2007). The effects of lingual exercise in stroke patients with dysphagia. Archives of Physical Medicine and Rehabilitation, 88(2), 150-158. YOU SHOULD BE ABLE TO GET IT HERE: http://www.archives-pmr.org/article/S0003-9993(06)01457-2/pdf

Wada, S., Tohara, H., Iida, T., Inoue, M., Sato, M., & Ueda, K. (2012). Jaw-opening exercise for insufficient opening of upper esophageal sphincter. Arch Phys Med Rehabil, 93(11), 1995-1999. doi: 10.1016/j.apmr.2012.04.025 YOU SHOULD BE ABLE TO GET IT HERE:http://www.archives-pmr.org/article/S0003-9993(12)00322-X/pdf

Yoshida, M., Groher, M. E., Crary, M. A., Mann, G. C., & Akagawa, Y. (2007). Comparison of surface electromyographic (sEMG) activity of submental muscles between the head lift and tongue press exercises as a therapeutic exercise for pharyngeal dysphagia. Gerodontology, 24(2), 111-116.

Other good stuff to read on exercise:

Kent-Braun, J. A., Ng, A. V., Doyle, J. W., & Towse, T. F. (2002). Human skeletal muscle responses vary with age and gender during fatigue due to incremental isometric exercise. Journal of Applied Physiology, 93(5), 1813-1823.

Portero, P., Bigard, A. X., Gamet, D., Flageat, J. R., & Guezennec, C. Y. (2001). Effects of resistance training in humans on neck muscle performance, and electromyogram power spectrum changes. European Journal of Applied Physiology, 84(6), 540-546.

Thompson, D. J., Throckmorton, G. S., & Buschang, P. H. (2001). The effects of isometric exercise on maximum voluntary bite forces and jaw muscle strength and endurance. Journal of Oral Rehabilitation, 28(10), 909-917.

Yeates, E. M., Molfenter, S. M., & Steele, C. M. (2008). Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: three case reports. Clinical Interventions In Aging, 3(4), 735-747. 

---