Effect of orbicularis oris muscle training on muscle strength and lip closure function in patients with stroke and swallowing disorder

Abstract

[Purpose] We aimed to investigate the effect of resistance training of the orbicularis oris muscles on lip muscle strength and closure function in patients with swallowing disorder with facial palsy after stroke. [Participants and Methods] This study recruited 10 patients with swallowing disorder and facial palsy after stroke. All the participants received orbicularis oris muscle training at an intensity of 70% of 1 repetition maximum by using an Iowa oral performance instrument. Muscle strength and lip closure function were evaluated after orbicularis oris muscle training. [Results] After the intervention, the orbicularis oris muscle strength showed a statistically significant increase from 20.5 ± 5.15 to 25.3 ± 4.2 kilopascal. Lip closure function showed a statistically significant improvement from 2.6 ± 1.5 to 1.2 ± 1.0. [Conclusion] This study recommends to train at an intensity of 70% of 1 repetition maximum for 4 weeks to increase theorbicularis oris muscle strength and improve lip closure function.

A Systematic Review of Physical Rehabilitation of Facial Palsy

“…Seven studies reported interventions aimed at remediation of facial palsy as their primary objective (6, 26-29, 31, 33), and six reported targeting lip function or movement in the context of post-stroke dysphagia therapy (13,16,23,30,32,34). Four studies reported on active intervention methods for remediation of oromotor function or facial palsy (23,(26)(27)(28); two used muscle strengthening exercises alone (26,27) and the other two used biofeedback (via mirror or device) while performing orofacial exercises (23,28). Four studies reported on passive intervention techniques such as massage, stretching or electrical stimulation for the remediation of facial muscle strength or facial palsy (13,16,29,30).…”

“…Four studies reported on active therapy methods; one RCT (23), one nRCT (28), and two case series' (26,27). All four studies reported improvements in treatment variables measured.…”

“…Both the case series' implemented protocols of lip strengthening using instrumentbased exercise. Hee-su et al (27) reported improvements in orbicularis oris muscle strength and lip closure function during swallowing; no outcomes specific to facial palsy (e.g., measures of movement or symmetry) were used. Hagg and Anniko (26) also reported improvement in raw scores of lip force from baseline measures taken using a Lip Force Meter instrument however did not specifically report on outcomes for facial palsy.…”

“…Scores on the JBI tool for case series evaluation ranged from 2 to 7 with an average of 3.8 out of 10 (see Figure 3). Four (27,29,33,34) of the six case studies were judged to be at high risk of bias; 2 of the 6 of studies failed to outline clear criteria, only 30% used valid methods for identification of the condition, >80% did not report consecutive recruitment of subjects and failed to clearly report clinical information of the participants. Two case studies were judged to have an unclear risk of bias (26,31); strengths of both these studies were found in reliable condition measurement and clear reporting of participant demographics.…”

Age Related Changes of Superior Orbicularis Oris Muscle in Terms of Tone and Viscoelastic Properties

“…13 The effectiveness of this muscle in speech, nutrition, and swallowing functions has also been reported in various studies. 14,15 Based on all this information, changes in the musculoskeletal system are inevitable with increasing age. However, studies in the literature on viscoelastic and tone properties of orbiculari oris muscle are rare.…”