Bridge Swallowing Exercise for Stroke Patients with Gastroesophageal Reflux Disease Symptoms: A Case Series

BACKGROUND: We previously reported that swallowing in the bridge position (bridge swallowing) strengthened esophageal contractions and increased the lower esophageal sphincter pressure against gravity. Furthermore, bridge swallowing exercise improved the symptoms of gastroesophageal reflux disease (GERD) in subjects with GERD. Bridge swallowing may have the potential to strengthen esophageal peristalsis and improve GERD. In this case series, we evaluated the effect of bridge swallowing on GERD symptoms and esophageal residue observed by videofluoroscopic examination of swallowing (VF) in patients with dysphagia after stroke. CASES: We reviewed the cases of five patients hospitalized with stroke and concurrent GERD symptoms. Dry swallowing exercises in the bridge (hip lift) position were performed ten times per day for 4 weeks. Frequency Scale for Symptoms of GERD (FSSG) questionnaire scores and esophageal residue on VF were compared before and after exercise. All patients completed the bridge swallowing exercise without adverse events and all showed improved FSSG scores after the exercise. Three patients showed improvements in esophageal residue on VF after exercise. DISCUSSION: Our findings indicated that the bridge swallowing exercise can improve FSSG scores. Some patients showed improved esophageal residue on VF. This exercise was performed easily and safely without adverse events. Further studies are needed to validate the effectiveness of the bridge swallowing exercise in improving GERD.