Effect of orofacial myofunctional exercise on the improvement of dysphagia patients’ orofacial muscle strength and diadochokinetic rate

Abstract

[Purpose] Measurement of the diadochokinetic rate can provide useful information on swallowing rehabilitation in the oral phase by elucidating the speed and regularity of movement of muscles related to the lips, tongue, and chin. This study investigated the effect of a three-week period of orofacial myofunctional exercise on the improvement of cheek, tongue, and lip muscle strength and diadochokinetic rate in dysphagia patients. [Subjects and Methods] This study employed a pretest-posttest control group design. Both orofacial myofunctional exercise and the temperature-tactile stimulation technique were applied to the experimental group (n=23), while only the temperature-tactile stimulation technique was applied to the control group (n=25). [Results] Tongue elevation, tongue protrusion, cheek compression, lip compression, and alternating motion rate were more significantly improved in the experimental group than in the control group. [Conclusion] Orofacial myofunctional exercise is effective in the rehabilitation of swallowing function in the oral phase in dysphagia patients by improving orofacial muscle strength and response rate.

A Practical Method for Assessing Lip Compression Strengthening in Healthy Adults

“…For example, Clark and Solomon [4] measured lip compression strength in 68 young (25 men and 43 women), 41 middle-aged (28 men and 13 women) and 38 older adults (26 men and 12 women), and found the wide ranges of variation in lip strength in all age groups (range between 12 and 73 kPa in young adults, between 13 and 74 kPa in middle-age adults and between 15 and 62 kPa in older adults). Other studies also reported a similar phenomenon [5,11,12]. In healthy individuals, it is unclear whether the difference in lip compression strength affects various functions such as mastication, swallowing, and speech.…”

Effects of Age, Sex, Disease, and Exercise Training on Lip Muscle Strength

“…Similarly, when using electrical stimulation to the lip muscles (30 min/day, 5 days/week for 4 weeks), patients with dysphagia after stroke had an improvement in lip muscle strength measured by the IOPI (5.9 to 20.5 kPa) [27]. The change in lip muscle training in patients with stroke resulted in increased lip strength and function [11,13,16,27].…”

“…Thus, unlike the Lip trainers, this device can prescribe a set intensity for lip strength training. This instrument has been used in research for lip strengthening protocols and evaluations [13,16]. The IOPI measures force using a tongue bulb.…”

“…Lip strength training for patients with stroke has been studied with interventions spanning from three [16] to five weeks [4,11,13] (Table 2). Training with an acrylic Oral Screen placed directly behind closed lips that is horizontally pulled for sets of 5-10 seconds have resulted in increased lip force [11].…”

“…Hägg and Anniko [4] followed up with a review article to understand the potential influence of lip function on swallowing capacity in patients with stroke, stroke with initial facial palsy, stroke without initial facial palsy, and healthy individuals and concluded that the changes in lip muscle function in patients with stroke were also able to improve the swallowing capacity in each population. Patients with stroke and dysphagia have demonstrated an increase in lip compression strength measured by the IOPI (10.5 to 12.8 kPa) following 3 weeks of orofacial myofunctional training [16]. After lip muscle training with the IOPI, the lip muscle strength showed a significant increase from 20.5 to 25.3 kPa [13].…”