Effects of neuromuscular electrical stimulation combined with effortful swallowing on post‐stroke oropharyngeal dysphagia: a randomised controlled trial

J of Oral Rehabilitation

Hwang

Kim

et al. 2019

The lingual muscle is a component of the stomatognathic system that comprises fixed (mandible, maxilla, dental arches, temporomandibular joints and the hyoid bone) and dynamic structures (masticatory, supra-and infrahyoid muscles and the oro-facial muscle such as lingual, lips and cheek muscles) that act synergistically to perform stomatognathic functions including mastication, swallowing and speech. [1][2][3] Neurological disorders such as stroke cause weakening of the skeletal muscles. The lingual muscle also contains skeletal muscles and is therefore affected by factors causing skeletal Abstract Background: Lingual strength training (LST) has been reported to positively affect the activation of submental muscles, as well as to increase lingual muscle strength.However, there is little evidence to support its effectiveness.Objectives: This study aimed to investigate the effect of LST on the strength and thickness of oropharyngeal muscles in healthy adults. Methods:The study included 30 subjects who were assigned to the experimental (n = 15) and the control groups (n = 15). The experimental group performed LST based on tongue-to-palate resistance exercise method. LST was categorised as isometric and isotonic exercise. The intervention was performed five times a week for 6 weeks. The control group did not receive any intervention. The lingual strength was measured using the Iowa Oral Performance Instrument. Changes in the thickness of the mylohyoid and the digastric muscles and the lingual were assessed ultrasonographically.Results: After the intervention, the thickness of the mylohyoid and the digastric muscles in the experimental group was significantly greater than that in the control group (P = 0.037 and 0.042). Conclusion:This study demonstrated that LST increases the thickness and the strength of oropharyngeal muscles. Therefore, LST is a useful option in patients with dysphagia or in elderly patients prone to swallowing dysfunction. K E Y W O R D S exercise, lingual, swallowing, ultrasonography | 1037 PARK et Al.

Section: Discussionmentioning

confidence: 99%

Effects of lingual strength training on oropharyngeal muscles in South Korean adults

J of Oral Rehabilitation

Hwang

Kim

et al. 2019

“…Image J program was used for movement analysis of the hyolaryngeal complex, and Penetration–Aspiration Scale (PAS) were used to quantify degree of penetration–aspiration. Hyolaryngeal movement was analysed using similar method as in a previous study .…”

Section: Methodsmentioning

confidence: 99%

“…penetration-aspiration. Hyolaryngeal movement was analysed using similar method as in a previous study (14).…”

Section: Methodsmentioning

confidence: 99%

Effect of head lift exercise on kinematic motion of the hyolaryngeal complex and aspiration in patients with dysphagic stroke

J of Oral Rehabilitation

Hwang²,

et al. 2017

The head lift exercise (HLE) is a head-raising workout performed in a supine position. This exercise facilitates activation of the submental muscles located above the hyoid bone in front of the neck. HLE is a potential method to improve the movement of the hyolaryngeal movement and swallowing functions. The purpose of this study was to investigate the effect of HLE on the hyolaryngeal movement and aspiration in patients with dysphagic stroke. A total of 27 patients with stroke were randomly assigned either into the experimental (n = 13) or the control group (n = 14). The experimental group performed HLE 5 days a week for 4 weeks (a total of 20 sessions). Both groups received the same conventional dysphagia therapy. Two-dimensional analysis of the hyolaryngeal movement was carried out using Image J program based on a videofluoroscopic swallowing study. Penetration-aspiration was assessed using Penetration-Aspiration Scale (PAS). The experimental group showed a significant increase in the only superior movements of the hyoid bone compared with the control group (P = 0·033). Aspiration in liquid also exhibited a significant decrease in the experimental group compared with the control group (P = 0·044). Findings from this study confirmed that HLE is an effective intervention to improve hyoid movement and decrease aspiration.

“…This is because reduced hyolaryngeal movement is closely related to airway aspiration, pharyngeal residue and upper oesophageal sphincter opening (Park et al . ).…”

Section: Introductionmentioning

confidence: 97%

Effect of effortful swallowing training on tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia: a double‐blind, randomized controlled trial

Intl J Lang & Comm Disor

Yoon

et al. 2019

Background Effortful swallowing training (EST) is a remedial method for the training of swallowing‐related muscles in the oropharyngeal phase. However, clinical evidence of its effectiveness is insufficient. Aims To investigate the effects of EST on tongue strength and swallowing function in patients with stroke. Methods & Procedures Stroke patients with dysphagia were randomly assigned to one of two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group underwent EST, while the control group performed saliva swallowing. Training was conducted 5 days per week for 4 weeks. Both groups underwent conventional dysphagia treatment for 30 min/day, 5 days/week for 4 weeks. Outcomes & Results Tongue strength was assessed using the Iowa Oral Performance Instrument. The Videofluoroscopic Dysphagia Scale (VDS), based on a videofluoroscopic swallowing study, was used to analyze oropharyngeal swallowing function. The experimental group showed greater improvements in anterior and posterior tongue strength compared with the control group (p = 0.046 and 0.042, respectively), and greater improvement in the oral phases of the VDS (p = 0.017). Conclusions & Implications We recommend EST as a remedial strategy for improving tongue strength and oral swallowing function in patients with stroke.