, Volume 20, Issue 2, pp 133–138 | Cite as

Attaining and Maintaining Isometric and Isokinetic Goals of the Shaker Exercise

  • Caryn Easterling
  • Barbara Grande
  • Mark Kern
  • Karri Sears
  • Reza ShakerEmail author


Previous studies have shown that the Shaker Exercise is effective in restoring oral intake in patients with deglutitive failure due to upper esophageal sphincter (UES) dysfunction. Our aim was to determine (1) exerciser compliance among healthy older adults, (2) number of days required to attain the isometric (IM) and isokinetic (IK) exercise goals, (3) rate and reason for dropout of exercisers, and (4) complaints associated with performance of the exercise. Twenty-six nondysphagic older adults were enrolled from an independent-living community (66–93 yr) to perform the Shaker Exercise. Each participant completed a questionnaire on exercise performance and its associated difficulties three times a day for six weeks. Four randomly chosen nondysphagic participants underwent pre- and postexercise videofluoroscopic swallow studies for biomechanical measurements. Maximum anterior hyoid and laryngeal excursions, as well as maximum anteroposterior UES opening increased (p < 0.05) following exercise. Duration to attain Shaker Exercise performance goals varied among participants. IK was more easily attained than IM. Only 50% and 70% of those enrolled initially were able to complete the exercise duration and attain its IK and IM goals, respectively. However, those who stayed in the program attained the IK and IM goals (100% and 74%, respectively). Most dropouts occurred in the first two weeks of exercise. Performance of the exercise was associated with mild muscle discomfort that resolved spontaneously after a couple of weeks. We concluded that although the Shaker Exercise can be performed independently, a structured and gradually progressive program is needed to attain the exercise goals completely.


Shaker Exercise Swallowing UES opening Aspiration Deglutition Deglutition disorders 



The authors wish to thank the staff and residents of Alexian Village of Milwaukee, Wisconsin, for their patient and dedicated participation in this project.


  1. 1.
    Shaker, R, Kern, M, Bardan, E, Taylor, A, Stewart, ET, Hoffmann, RG, Arndorfer, RC, Hofmann, C, Bonevier, J 1997Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exerciseAm J Physiol272G151801522Google Scholar
  2. 2.
    Shaker, R, Easterling, C, Kern, M, Nitschke, T, Massey, B, Daniels, S, Grande, B, Kazandjian, M, Dikeman, K 2002Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES openingGastroenterology12213141321CrossRefPubMedGoogle Scholar
  3. 3.
    Harris, T 1997Muscle mass and strength: relation to function in population studiesJ Nutr1274S6SGoogle Scholar
  4. 4.
    Porter, MM, Vandervoort, AA, Lexell, J 1995Aging of human muscle: structure, function and adaptabilityScand J Med Sci Sports5124129Google Scholar
  5. 5.
    Lindle, RS, Metter, EJ, Linch, NA, Fleg, JL, Fozard, JL, Tobin, J 1997Age and gender comparisons of muscle strength in 654 women and men aged 20–93 yearsJ Appl Physiol8315811587PubMedGoogle Scholar
  6. 6.
    Moller N, Nair KS: Regulation of muscle mass and function: effects of aging and hormones. In: Food and Nutrition Board Institute of Medicine, Role of protein and amino acids in sustaining and enhancing performance. Washington, DC: National Academy Press, 1995. pp 121–36Google Scholar
  7. 7.
    Booth, F, Weeden, S, Tsong, B 1994Effect of aging on human skeletal muscle and motor functionMed Sci Sports Exer26556560Google Scholar
  8. 8.
    Saxon, KG, Schneider, CM 1995Vocal Exercise PhysiologySan Diego, CASingular Publishing Group, Inc.7785Google Scholar
  9. 9.
    Schneider, EL, Guralnik, JM 1990The aging of AmericaJAMA27323352340CrossRefGoogle Scholar
  10. 10.
    Akima, H, Takahashi, H, Kuno, SY, Masuda, K, Masuda, T, Shimojo, H, Anno, I, Itai, Y, Katsuta, S 1999Early phase adaptations of muscle use and strength to isokinetic trainingMed Sci Sports Exerc331588594CrossRefGoogle Scholar
  11. 11.
    Atha, J 1982Strengthening muscleExerc Sports Sci Rev9173Google Scholar
  12. 12.
    Heyward VH: Advanced fitness assessment and exercise prescription. In: Human Kinetics Series. Champaign, IL: University of Illinois Press, 1991, pp 67–71Google Scholar
  13. 13.
    Grove, NC, Spier, BE 1999Motivating the well elderly to exerciseJ Community Health Nurs16179189CrossRefPubMedGoogle Scholar
  14. 14.
    Resnick, B 2000A seven-step approach to starting an exercise program for older adultsPatient Educ Couns39243252CrossRefPubMedGoogle Scholar
  15. 15.
    Jurell, KC, Shaker, R, Mazur, A, Haig, A, Wertsch, JJ 1996Spectral analysis to evaluate hyoid muscle involvement in neck exerciseMuscle Nerve191224Google Scholar
  16. 16.
    Sica, RE, Sanz, OP, Columbi, A 1976The effects of ageing upon the human soleus muscle. An electrophysiological studyMedicina135768Google Scholar
  17. 17.
    Lateur, BJ 1996Therapeutic exerciseBraddom, RL eds. Physical Medicine and RehabilitationW.B. SaundersPhiladelphia401420Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Caryn Easterling
    • 1
  • Barbara Grande
    • 1
  • Mark Kern
    • 1
  • Karri Sears
    • 1
  • Reza Shaker
    • 1
    • 2
    Email author
  1. 1.MCW Dysphagia Institute, Division of Gastroenterology and HepatologyMedical College of WisconsinMilwaukeeUSA
  2. 2.Division of Gastroenterology and HepatologyMedical College of WisconsinMilwaukeeUSA

Personalised recommendations