The Recline Exercise: Comparisons with the Head Lift Exercise in Healthy Adults

Avinash Mishra, Akila Rajappa, Elizabeth Tipton, Georgia A. Malandraki*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


The aim of this investigation was to examine the comparative effectiveness of the new Recline Exercise (RE) and the traditional Head Lift Exercise (Shaker Exercise) on submental muscle activity, tongue strength, and perceived exertion in 40 healthy young adults (mean age = 24.5 years, SD 2.6 years). Both groups participated in a 6-week exercise regimen. Outcome variables evaluated pre- and post-exercise included: duration and peak amplitude of submental muscle activity during swallowing measured via surface electromyography (sEMG); anterior and posterior isometric lingual pressures measured with the Iowa Oral Performance Instrument; and perceived exertion levels measured with the Borg category-ratio scale of perceived exertion. Results indicated no significant pre-post differences within or between groups in swallow duration and peak amplitude. In addition, the RE group demonstrated significant post-treatment increases in anterior and posterior tongue strength [p = 0.009; p < 0.001]; however, these increases were of small magnitude (d = 0.132; d = 0.319). Both groups showed marked improvements in perceived exertion levels [p < 0.001]. Our findings indicate that healthy young adults who perform the RE or the HLE do not have significant swallow duration or amplitude gains, most likely due to the reduced need for such gains in the healthy head/neck musculature for submaximal tasks. Furthermore, the significant lingual strength gains seen with the RE indicate that additional musculature is being engaged during its completion. These results are encouraging; however, future research in older adults and patients with dysphagia with examination of swallowing biomechanics is needed to determine its full potential as a rehabilitative regimen.

Original languageEnglish (US)
Pages (from-to)730-737
Number of pages8
Issue number6
StatePublished - Dec 1 2015


  • Deglutition
  • Disorders
  • Exercise
  • Lingual strength
  • Recline
  • Surface electromyography

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology
  • Speech and Hearing

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