Effects of resistive jaw opening exercise in stroke patients with dysphagia: A double- blind, randomized controlled study

Park, Jisu; An, Duk-Hyun; Kam, Kyung-Yoon; Yoon, Taehyung; Kim, Tae-Hoon; Chang, Moonyoung

doi:10.3233/bmr-181477

Cited by 18 publications

(32 citation statements)

References 17 publications

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“…Tongue resistance training improves tongue pressure and swallowing function in stroke patients (66,68). Other effective treatment options include jaw opening exercise (69), self-exercise of oral function (70), and Shaker exercise (71,72), which are reported to improve swallowing function and reduce aspiration pneumonia.…”

Section: Intervention For Oral Problemsmentioning

confidence: 99%

Oral Management in Rehabilitation Medicine: Oral Frailty, Oral Sarcopenia, and Hospital-Associated Oral Problems

Shiraishi¹,

Wakabayashi

Yoshimura³

2020

The Journal of nutrition, health and aging

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Oral health is a crucial but often neglected aspect of rehabilitation medicine. Approximately 71% of hospitalized rehabilitation patients and 91% of hospitalized acute care patients have impaired oral health. Poor oral condition in hospitalized patients can be attributed to factors such as age, physical dependency, cognitive decline, malnutrition, low skeletal muscle mass and strength, and multimorbidity. Another major factor is a lack of knowledge and interest in oral problems among health care workers. Recently, new concepts have been proposed, such as oral frailty, oral sarcopenia, and hospital-associated oral problems. Oral frailty, the accumulation of a slightly poor status of oral conditions and function, strongly predicts physical frailty, dysphagia, malnutrition, need for long-term care, and mortality in community-dwelling older adults. Oral sarcopenia refers to sarcopenia associated with oral conditions and function, although its definition has not yet been fully discussed. Hospital-associated oral problems are caused by disease, disease treatment, surgery, endotracheal intubation, poor self-care abilities, lack of care by medical staff, drugs, and iatrogenic factors during hospitalization. Furthermore, oral problems have negative impacts on rehabilitation outcomes, which include functional recovery, length of hospital stay, discharge home, and in-hospital mortality. Oral health management provided by dental hygienists improves not only oral status and function, swallowing function, and nutritional status but also activities of daily living, discharge home, and in-hospital mortality in post-acute rehabilitation. Oral rehabilitation, promotion, education, and medical-dental collaboration can be effective interventions for oral problems and therefore are necessary to improve rehabilitation outcomes.

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Section: Intervention For Oral Problemsmentioning

confidence: 99%

Oral Management in Rehabilitation Medicine: Oral Frailty, Oral Sarcopenia, and Hospital-Associated Oral Problems

Shiraishi¹,

Wakabayashi

Yoshimura³

2020

The Journal of nutrition, health and aging

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“…Exercise-based dysphagia rehabilitation (EBDR) has been commonly used in clinical practice for the past three decades by multidisciplinary approach of specialized professionals including rehabilitation physicians, speech-language therapists, and occupational therapists [18,19]. In the past few years, many researchers have reported various methods of EBDR, such as shaker exercise (head lift exercise) [4,20], tongue strengthening exercise [12,21,22], expiratory muscle strengthening training [23,24], effortful swallowing [25,26], chin tuck against resistance exercise [27,28], forehead against resistance [29], chin-to-chest exercise [28,30], Mendelsohn [31,32], jaw opening exercise [33,34], proprioceptive neuromuscular facilitation technique [35], head extension swallowing exercise [36,37], swallowing against laryngeal restriction [38,39], and swallow exercise aid exercise [40,41] to improve swallowing function. These methods are known to induce high activation of muscles by providing loading to the oropharyngeal muscles, and consequently, contributing to the improvement of oropharyngeal swallowing function, increased hyoid bone movement and myophysiological changes.…”

Section: Introductionmentioning

confidence: 99%

Effect of Dysphagia Rehabilitation Using Kinesiology Taping on Oropharyngeal Muscle Hypertrophy in Post-Stroke Patients: A Double Blind Randomized Placebo-Controlled Trial

et al. 2020

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Background: It has recently been shown that suprahyoid muscle exercise using kinesiology taping (KT) increases the activation of the suprahyoid muscle in healthy adults, suggesting a potential therapeutic clinical exercise for dysphagia rehabilitation. This study investigated the effect of dysphagia rehabilitation using KT in stroke patients with dysphagia. Methods: Thirty subjects in South Korea were enrolled in this prospective placebo-controlled double-blind study. Participants were randomly assigned to the experimental and sham groups. In the experimental group, the tape was attached to the hyolaryngeal complex, pulled downward with approximately 70% tension, and then attached to the sternum and the clavicle bilaterally. In the sham group, the tape was applied similarly but without the tension. Both groups performed voluntary swallowing 50 times (10 times swallowing per set, times 5 sets) a day for 4 weeks with KT applied. Outcome measures were assessed using portable ultrasound equipment. The parameter measured was the change in thickness of the tongue muscle, mylohyoid muscle, and the anterior belly of the digastric muscle. Results: The experimental group showed statistically significant changes in the thickness of the tongue muscle, mylohyoid muscle, and anterior belly of the digastric muscle than the sham group (p = 0.007, 0.002, and 0.001). Conclusion: Dysphagia rehabilitation using KT is a technique that may promote oropharyngeal muscle thickness in patients with dysphagia after stroke.

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“…Wada et al [9] contemplated this mechanism and proposed JOE as one way to strengthen the suprahyoid muscles. JOE has been applied in various ways, ranging from maximal lower jaw opening without external resistance to providing external resistance using the hand or special tools [5,[8][9][10][11][12]. Wada et al [9] conducted JOE for 4 weeks without external resistance in chronic dysphagia patients with a UES-opening disorder.…”

Section: Introductionmentioning

confidence: 99%

“…Park et al [10] conducted JOE for 4 weeks using an ISO CTAR TM device (Alternative Speech and Swallowing Solutions, Orlando, FL, USA) in patients with dysphagia due to stroke. The experimental group performed exercises using a 5-mm-thick device, while the control group performed exercises using a 1-mm-thick device.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have provided no resistance when performing JOE or else used the hand or commercially available plastic devices to provide external resistance. In cases using plastic devices, it is impossible to provide quantitative and systemic resistance [10], or an individual must remodel the device to use it as an external resistance during performing JOE [12], which is inconvenient. Therefore, there are practical difficulties to applying JOE with systematic external resistance to strengthen the suprahyoid muscle [13].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Resistive Jaw-Opening Exercise with Elastic Resistance Bands on Suprahyoid Muscle Activation and Tongue Strength in the Elderly: A Pilot Study

2020

Folia Phoniatr Logop

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Background: The jaw-opening exercise (JOE) is designed to strengthen the suprahyoid muscles. However, it is difficult to apply this strength-training exercise to subjects in a systematic fashion. Objective: This study examined the effect of resistive JOE on suprahyoid muscle activity and tongue strength in the elderly through the use of an elastic band. Methods: Eight elderly people aged ≥65 years participated in this study. Participants wore an elastic loop around their head and mandible. The strength of the elastic loop used was adjusted based on the participant’s sex, and the same strength loop was used for 8 weeks. Participants were required to open their jaw maximally, maintain the position for 10 s, and then rest for 10 s. This process was repeated for 10 min. There was then a rest period of 2 min before subjects began another 10-min exercise set. All participants performed the exercise twice weekly for 8 weeks. All subjects were tested for suprahyoid muscle activation during typical/effortful swallowing as well as isometric tongue pressures and endurances at baseline and at 9 weeks. Results: After 8 weeks of exercise, the isometric maximum tongue-base pressure and tongue endurance were significantly improved. However, the swallowing tongue pressure and suprahyoid muscle activation levels had not changed significantly. Conclusion: This study confirmed that consistent resistance, which provides the same resistance throughout a resistive JOE exercise, is inadequate to reliably improve the muscle strength of swallowing-related muscles. Subsequent research should consider this and plan more efficient exercise programs.

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Effects of resistive jaw opening exercise in stroke patients with dysphagia: A double- blind, randomized controlled study

Cited by 18 publications

References 17 publications

Oral Management in Rehabilitation Medicine: Oral Frailty, Oral Sarcopenia, and Hospital-Associated Oral Problems

Oral Management in Rehabilitation Medicine: Oral Frailty, Oral Sarcopenia, and Hospital-Associated Oral Problems

Effect of Dysphagia Rehabilitation Using Kinesiology Taping on Oropharyngeal Muscle Hypertrophy in Post-Stroke Patients: A Double Blind Randomized Placebo-Controlled Trial

Effects of Resistive Jaw-Opening Exercise with Elastic Resistance Bands on Suprahyoid Muscle Activation and Tongue Strength in the Elderly: A Pilot Study

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