Abstract:

Swallowing disorder is a problem that affects both the individual and the family and/or caregivers, can cause serious complications and requires a holistic approach. Airway aspiration is one of the most serious conditions in dysphagia. One of the most important parameters involved in airway protection is ensuring adequate hyolaryngeal movement. During swallowing, the hyoid bone and larynx are pulled up with the contraction of the suprahyoid muscles, and airway protection is provided with the tilt of the epiglottis. Due to insufficiency in suprahyoid muscles, hyolaryngeal elevation decreases, pharyngeal residue increases after swallowing and can lead to aspiration during and after swallowing. Therefore, there are many exercise approaches which aim to increase suprahyoid muscle activation in swallowing rehabilitation. Most of these exercise approaches include exercises for the cervical region. The first exercise developed for the cervical area is the Shaker exercise. Due to the positive effects of the first exercise on swallowing function, many exercise approaches involving the cervical region were developed and their effectiveness in different disease groups were evaluated. The developed exercises are modified Shaker exercise, chin tuck exercise against resistance, forehead against resistance, jaw opening exercises, chin to chest, Theraband exercises, swallowing with head extension, proprioceptive neuromuscular facilitation and cervical isometric exercises. Depending on the patient's condition, exercise approaches may have advantages or disadvantages compared to each other. The important thing in rehabilitation is to create an individual exercise program. According to the findings we obtained in the evaluation of swallowing, exercise should be selected considering the patient's condition in swallowing rehabilitation. Each patient should be handled together with physical, personal and environmental factors, and individual treatment approaches should be preferred by determining their needs.

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