Can you describe the Shaker technique that is used for dysphagia and when it is appropriate to use this treatment technique?
The Shaker technique, also called the Head Lift, is indicated for patients who exhibit reduced superior and anterior movement of the hyolaryngeal complex. That is, the hyoid and larynx are not lifting and moving forward to the extent needed in order to open the upper esophageal sphincter. This results in residue in the pyriform sinuses, placing the patient at risk to aspirate this material. Therefore, if reduced hyolaryngeal excursion is observed on videofluoroscopy, with resultant pyriform sinus residue, this technique is indicated. On a fiberoptic exam, one might conclude from viewing pyriform residue that the patient is not getting good excursion.
To perform the exercise, as described in the studies, the patient lies flat and, keeping the shoulders on the bed/mat, raises the head to look at the toes. The patient maintains this position (the goal is 60 seconds) and then repeats this 2 more times. The second part of the exercise is a repetitive movement. In the same starting position, the patient raises the head to look at the chin, lowers the head back to the bed and then repeats this 30 times. Three sets of 30 are the goal.
This Ask the Expert was taken from the course entitled: Evidence for Pharyngeal Dysphagia Treatment Techniques by Nancy Swigert, M.A., CCC-SLP, BRS-S
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Nancy B. Swigert is the director of Speech-Language Pathology and Respiratory Care at Central Baptist Hospital, an acute care facility in Lexington, KY. She is a Board recognized specialist in swallowing and swallowing disorders. She is a former President of the Kentucky Speech-Language-Hearing Association, the Council of State Association Presidents, and was President of the American Speech-Language-Hearing Association in 1998.