**Methods**

All patients received IQoro neuromuscular training 3 x 10 seconds, three times per day for a duration of 6 months.

All patients were measured before and after treatment.

#### **Outcome measurements**

Radiology or gastroscopy was used to confirm HH and to rule out oesophageal stenosis before inclusion.

An Orofacial Motor Test (OFMT) and an Orofacial Sensory Test (OST) were performed in order to exclude symptoms of any central nervous lesion. Patients with neurological diseases were excluded.

All patients were measured before and after treatment using:

• Symptom questionnaire regarding IED and GERD (reflux, heartburn, chest pain, dysphagia, globus sensation, non-productive cough, hoarseness, and misdirected swallowing) [14]


#### **Table 2.**

*Age, gender, symptom duration, and BMI in groups a, B, and C.*

• Swallowing ability (measured using Timed Water Swallow Test - TWST) [27]

◦ lower normal value for swallowing rate <sup>≥</sup> 10 ml/sec

• Pharyngeal sling force (measured using Lip Force meter) [25]

◦ lower normal value <sup>≥</sup>15 N

	- measured using Visual Analogue Scale (VAS 0–100)
