01/04/2017
Video Testimonial Contest - SLPs and Dysphagia Patients
$100 Prize or a Free ISO-CTAR Device (winner's choice)!
We know a lot of SLPs and dysphagia patients have used the ISO-CTAR Swallowing and Voice Exercise Device with wonderful results. We want to hear your stories and share your stories so that people who could benefit can hear about this device.
We're offering a $100 cash prize or a Free ISO-CTAR Device ($109.99 value plus free shipping) to the winner of the drawing on 1/30/17. Your video can be recorded on your phone, computer, or camera and should tell about your experiences with the device or about why you would like to win one. Submit videos by email to alternativespeech@yahoo.com.
By submitting your video, you are giving us permission to use it for promotional purposes, whether or not you win the prize. You will be helping us get the word out about something that can truly change someone's life. I've personally had many patients who had tried other types of dysphagia therapy without success, and then had great success using this device. I know there must be a lot of great stories out there. Please share your story!
The ISO-CTAR Swallowing and Voice Exercise Device was designed as a more convenient, less strenuous alternative to the Shaker exercise for dysphagia. Like the Shaker exercise, it targets the suprahyoid muscles (Geniohyoid, Mylohyoid, Stylohyoid, and the Digastric). It can also be used for vocal cord adduction exercises, using the tension of the CTAR hold position, instead of the push/pull technique.
The suprahyoid muscles primarily assist in elevating the hyolaryngeal complex and opening the upper esophageal sphincter (UES) during the swallow. The Mylohyoid also functions to elevate the tongue and the floor of the oral cavity.
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Website: swallowingexercises.com
Below I have listed many research studies which offer evidenced based support to these exercises. We sell these devices to hospitals, rehabs, clinicians, and patients worldwide. We've had many hospitals buy one, and then purchase several more after trying it. We are offering a 60 day money back guarantee so that you can try it risk free. We can do purchase orders for companies. We have instructional videos on our website: swallowingexercises.com.
In a study conducted in April of 2016 (Sze, Yoon, Escoffier, Rickard Liow), researchers evaluated the efficacy of the Chin Tuck Against Resistance (CTAR) and the Shaker exercise. The results indicated that the Chin Tuck Against Resistance (CTAR) exercise was more specific in targeting the suprahyoid muscles than the Shaker exercise and that the sternocleidomastoid muscles were significantly less activated and fatigued during the CTAR exercise than the Shaker exercise. (14)
In 2012, Feng et al conducted a study of the relationship between atrophy of the Geniohyoid muscle, which is one of the suprahyoid muscles, and the occurrence of aspiration in older adults. The study authors concluded, "In summary, using head and neck CT scans, we found that decreased CSA (cross-sectional area) of GH (Geniohyoid) muscle was associated with aging and was greater in aspirators compared with nonaspirators in older men.... These findings may indicate an association between GH muscle atrophy and decreased swallowing safety and aspiration in older adults and warrants further investigation." (13).
In 2015 Kraaijenga conducted a study using a Swallowing Exercise Aid device in connection with three exercises: Chin Tuck Against Resistance (CTAR), Jaw Opening Against Resistance (JOAR) and effortful swallow with resistance. They measured outcomes with a dynamometer (IOPI), MRI and VFSS, for the following: maximum chin tuck and jaw opening strength, maximum tongue strength and endurance, suprahyoid mass, and hyoid bone displacement. They concluded, "Outcomes measured following 6 weeks of exercise indicated a significant increase in all of the above along with increased mouth opening and no pain." (1).
In a study conducted in the year 2002, by Dr. Shaker, 27 out of 27 patients who were tube-fed before the study and performed the Shaker exercise three times a day for six weeks, were able to tolerate a soft p.o. diet by the end of the six weeks of treatment (11).
In 2009, seven institutions participated in a clinical trial to compare the Shaker exercise with traditional therapy. Each patient received a modified barium swallow study pre- and post-therapy. The authors concluded that although there were several improvements in the traditional therapy group, there was significantly less aspiration post-therapy in patients in the Shaker group (12).
In the year 2000 a study was conducted to evaluate surface EMG activities in the suprahyoid, infrahyoid, and sternocleidomastoid muscles groups during the Shaker exercise. The findings suggested that all three muscle groups were fatigued during the Shaker exercise (9). A similar study in 2008 indicated that the Shaker exercise fatigued all three muscle groups (10).
In 2013 Watts used surface EMG to compare the Shaker exercise to a jaw opening exercise. He measured the activation of the geniohyoid, mylohyoid, and anterior digastric muscles. He concluded that activation in these muscles was significantly greater when participants performed the jaw opening exercise than when participants performed the head-lift (Shaker) exercise (7).
A study conducted in 2012 by Satoko Wada investigated the effects of the jaw opening exercise. Significant improvements were observedin the upward movement of the hyoid bone, the amount of upper esophageal opening, and the time of pharyngx passage. (8).
In a 2013 study by Wai Lam Yoon, the surface EMG activity of the suprahyoid muscles was compared between the Chin Tuck Against Resistance (CTAR) exercise and the Shaker exercise. The results showed significantly greater maximum SEMG values during the Chin Tuck Against Resistance isokinetic and isometric exercises than during the equivalent Shaker exercises. The authors concluded that Chin Tuck Against Resistance exercises appear to be effective in exercising the suprahyoid muscles and therapeutic effects could be comparable to those of the Shaker exercise (5).
References:
1. Kraaijenga, SAC, et al. Effects of Strengthening Exercises on Swallowing Musculature and Function in Senior Healthy Subjects: A Prospective Effectiveness and Feasibility Study. Dysphagia (2015) DOI: 10.1007/s00455-015-9611-8.
2. Logemann JA. Evaluation and treatment of swallowing disorders. 2nd ed. Pro-Ed; Austin, TX: 1998.
3. Hind JA, Nicosia MA, Roecker EB, et al. Comparison of effortful and noneffortful swallows in healthy middle-aged and older adults. Arch Phys Med Rehabil. 2001;82(12):1661–5. [PubMed]
4. Hiss SG, Huckabee ML. Timing of pharyngeal and upper esophageal sphincter pressures as a function of normal and effortful swallowing in young healthy adults. Dysphagia. 2005;20(2):149–56. [PubMed]
5. Yoon, W. L., Khoo, J. K. P., Rickard Liow, S. J. (2014). Chin Tuck Against Resistance (CTAR): New method for enhancing suprahyoid muscle activity using a Shaker-type Exercise. Dysphagia, 29(2), 243-248. doi: 10.1007/s00455-013-9502-9
6. Yoshida M, Groher ME, Crary MA, Mann GC, Akagawa Y. 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. 2007;24:111-116.
7. Watts, CR. Archives of Physical Medicine and Rehabilitation. 2013 Dec;94(12):2542-8.
8. Satoko Wada, Haruka Tohara, Takatoshi Iida, Motoharu Inoue, Mitsuyasu Sato, Koichiro Ueda, Jaw-Opening Exercise for Insufficient Opening of Upper Esophageal Sphincter, Archives of Physical Medicine and Rehabilitation, Available online 10 May 2012, ISSN 0003-9993, 10.1016/j.apmr.2012.04.025.
9. Mohammed Ferdjallah, PHD; Jacqueline J. Wertsch, MD; Reza Shaker, MD. Spectral analysis of surface electromyography (EMG) of upper esophageal sphincter-opening muscles during head lift exercise. Journal of Rehabilitative Research & Development. 2000; 37(3): May/June.
10. Kevin T. White, Caryn Easterling, Niles Roberts, Jacqueline Wertsch, Reza Shaker. Fatigue Analysis Before and After Shaker Exercise: Physiologic Tool for Exercise Design. Dysphagia. 2008; 23: 385-391
11. Shaker, R., Easterling, C., Kern, M., Nitschke, T., Massey, B., Daniels, S., Grand, B., Kazandjiam, M., Dikeman, K.. Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology. 2002 May; 122(5): 1314-21
12. Jeri A. Logemann; Alfred Rademaker; Barbara Roa Pauloski; Amy Kelly; Carrie Stangl-Mcbreen; Jodi Antinoja; Barbara Grande; Julie Farquharson; Mark Kern; et al. (Profiled Authors: Jerilyn A Logemann; Barbara Roa Pauloski; Alfred W Rademaker) A randomized study comparing the Shaker exercise with traditional therapy: A preliminary study. Dysphagia. 2009;24(4):403-411.
13. Feng, X., Todd, T., Lintzenich, C.R., Ding, J., Carr, J.J., Ge, Y., Browne, J.D., Kritchevsky, S.B., Butler, S.G.. Aging-Related Geniohyoid Muscle Atrophy Is Related to Aspiration Status in Healthy Older Adults. J Gerontol A Biol Sci Med Sci. 2013 Jul; 68(7): 853–860. Published online 2012 Oct 30. doi: 10.1093/gerona/gls225. PMCID: PMC3732109.
14. Sze WP, Yoon WL, Escoffier N, Rickard Liow SJ. Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography-Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise. Dysphagia. 2016 April;31(2):195-205. doi: 10.1007/a00455-015-9678-2. Epub 2016 Feb 2
Official Rules:
No purchase necessary. If you would like to enter without submitting a video, simply pm Jolie Parker or email alternativespeech@yahoo.com and request to be entered.
Anyone 18 years old or older may enter.
Begins 1-3-17 and ends 1-30-17.
Alternative Speech and Swallowing Solutions, Inc.
607 Jessamine Blvd., #6, Daytona, FL 32118
Prize will be either the option of $100 USD check or a ISO-CTAR Device ($109.99 value plus free shipping).
Winner will be selected by Page and Jolie Parker. Winner will be notified as a comment on this post on our page https://www.facebook.com/alternativespeech/ and by pm on 1/30/17. Facebook in no way is associated with, sponsors, or endorses this contest. By submitting your video, you agree to the following: My participation in the picture/video may be edited at Alternative Speech and Swallowing Solutions, Inc.'s sole discretion. I consent to use of my name, likeness, voice, and bioligical material about me in connection with picture/video publicity and related institutional promotional purposes. I expressly release Alternative Speech and Swallowing Solutions, Inc. and agents, employees, licensees and assigns from and against any and all claims which I have or may have for invasion of privacy, defamation or any other cause of action arising out of production, distribution, broadcast, or exhibition of the picture/video.
PhagiaFlex for Dysphagia - strengthen the swallow and improve esophageal opening during the swallow.
