What Happens to Swallowing Muscles after Stroke?: A Prospective Randomized Controlled Electrophysiological Study

Umay, Ebru; Yılmaz, Volkan; Gündoğdu, İ̇̇brahim; Öztürk, Erhan Arif; Gürçay, Eda; Karaahmet, Özgür Zeliha; Saylam, Güleser; Ceylan, Tijen; Çakçı, Aytül

doi:10.4103/0028-3886.273645

Cited by 11 publications

(25 citation statements)

References 25 publications

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“…The decrease in skeletal muscle mass and function, including those for mastication and swallowing, has emerged as a medical issue in the geriatric population, leading to a rising number of comorbidities and impaired quality of life [2]. The tongue, including its intrinsic and extrinsic muscles, predominantly encompasses Nutrients 2021, 13, 1821 2 of 11 type II muscle fibers [3] and can be affected by malnourishment and various neurological disorders, such as strokes [4] and parkinsonism [5]. The age-related decline in tongue pressure has been uncovered recently, and a cross-sectional study demonstrated a negative correlation between tongue thickness and age [6].…”

Section: Introductionmentioning

confidence: 99%

Suboptimal Tongue Pressure Is Associated with Risk of Malnutrition in Community-Dwelling Older Individuals

Chang

Chen

et al. 2021

Nutrients

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The tongue plays an important role in swallowing, and its dysfunction theoretically leads to inadequate oral intake and subsequent malnutrition. This study aimed to explore how different levels of tongue pressure are related to malnutrition among community-dwelling older individuals. The target population was community-dwelling adults aged ≥ 65 years. Tongue pressure was measured using the Iowa Oral Performance Instrument, whereas the mini nutrition assessment (MNA) test was administered to determine the nutritional status. A full MNA score of less than 24 points was defined as risk of malnutrition. Multivariate logistic regression analyses were conducted to calculate the odds ratio (OR) of risk of malnutrition among different quartiles of tongue pressure. Among the 362 participants, 26 (7.1%) were classified as having risk of malnutrition. Body weight, body mass index, handgrip strength, skeletal muscle mass index, sum MNA score, and serum levels of albumin were lower in the malnutrition risk groups than in the normal nutrition status group. A positive correlation was identified between tongue pressure and the MNA score (r = 0.143, p < 0.01). Treating the subgroup of the highest quartile of tongue pressure as the reference, the crude odds ratio (OR) of having risk of malnutrition was 5.37 (95% CI, 1.14–25.28) in the subgroup at the third quartile, 3.10 (95% CI, 0.60–15.84) in the subgroup at the second quartile, and 3.95 (95% CI, 0.81–19.15) in the subgroup at the lowest quartile. After adjustment for age and sex, the subgroup in the third quartile still presented with a significantly higher risk (OR, 4.85; 95% CI, 1.02–22.99) of risk of malnutrition. Compared with the subgroup at the highest quartile of tongue pressure, the crude OR for all the subgroups in the lower three quartiles was 4.17 (95% CI, 0.96–18.04), showing borderline significance (p = 0.05). In conclusion, we found hints for an association between decreased tongue pressure and an increased risk of malnutrition in community-dwelling older individuals. Older people with suboptimal tongue pressure should undergo a thorough assessment of their nutritional status and swallowing function for the early identification of subclinical malnutrition and dysphagia.

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Section: Introductionmentioning

confidence: 99%

Suboptimal Tongue Pressure Is Associated with Risk of Malnutrition in Community-Dwelling Older Individuals

Chang

Chen

et al. 2021

Nutrients

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“…A partir da análise dos estudos, dentre os fatores associados à disfagia nos pacientes, constatou-se o comprometimento biomecânico no processo de deglutição tanto na fase oral, quanto na fase faríngea [22][23][24] , sendo tais alterações relacionadas à fatores como: fraqueza da musculatura perioral, mastigatória e intrínseca da língua 24 , risco prolongado de aspiração 22 e grau de severidade do AVC relativamente associado à gravidade da disfagia 23 .…”

Section: Discussionunclassified

“…(2019) 24 refere o impacto da redução da capacidade funcional dos músculos faciais e cervicais sob a deglutição, e inclusive sob a coordenação entre respiração e deglutição, sendo esses pacientes dispostos a possível aspiração. De forma correspondente, outros autores evidenciam a importância dos músculos periorais, intrínsecos da língua e submentais para a deglutição funcional 47 .…”

Section: Discussionunclassified

Fatores associados à disfagia em pacientes com AVC: uma revisão sistemática

et al. 2021

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Introdução. Alteração no processo de deglutição, designada disfagia, está relacionada ao desenvolvimento de complicações pós Acidente Vascular Cerebral (AVC), tais como desnutrição, desidratação e problemas pulmonares. Objetivo. Verificar os fatores associados à gravidade da disfagia de pacientes com AVC. Método. A busca de artigos foi realizada nas bases de dados Scielo, Lilacs, Pubmed, Scopus, Bireme e Web Of Science. Não houve restrição de localização e idioma, entre 2015 a 2020. Para a seleção dos estudos foi utilizada a combinação baseada no Medical Subject Heading Terms (MeSH). Foram incluídos na pesquisa 3 estudos que obtiveram ≥6 pontos segundo o protocolo para pontuação qualitativa. Resultados. Os artigos inclusos constataram correlação entre a pontuação do NIHSS e o grau de disfagia, sendo o AVC leve associado à deglutição normal e disfagia leve; enquanto o AVC grave à disfagia grave. Todos os pacientes com pontuação NIHSS≥16 apresentaram algum grau de disfagia orofaríngea e todos os pacientes em risco de aspiração tiveram AVC no território da artéria cerebral média. Lesões combinadas do opérculo frontal e córtex insular resultaram no risco prolongado de aspiração. A disfagia e a aspiração em pacientes pós AVC foi relacionada à disfunção da fase oral. Conclusão: Há evidências de que a integridade funcional dos músculos orais e cervicais representa um fator agravante para os quadros de disfagia após AVC, a aspiração é um aspecto associado a disfagia após o AVC. Contudo, não houve correlação entre a localização hemisférica da lesão do AVC e disfagia.

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“…Understanding the stomatognathic system disturbances is key to diagnosing them early and implementing rehabilitation approaches to promote functional recovery [11]. Previous studies have shown different interventions involving the stomatognathic system's structures and functions [12,13]. In addition, Shimmel et al [14] reported that orofacial symptoms seem not to improve without a specific rehabilitation approach.…”

Section: Of 19mentioning

confidence: 99%

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review

Zapata-Soria

Cabrera‐Martos

López‐López

et al. 2022

IJERPH

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Background: Understanding the stomatognathic system disturbances is key to diagnosing them early and implementing rehabilitation approaches to promote functional recovery. The objective of this study was to systematically review all published data that examined the assessment and rehabilitation strategies for the stomatognathic system disturbances in patients with stroke. Methods: Five databases (i.e., PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and PEDro), were screened for manuscripts that included the assessment and rehabilitation strategies for stomatognathic system disturbances. The methodological quality was evaluated using the Mixed Methods Appraisal Tool. Results: Sixteen articles were included in this systematic review. The most frequently reported symptoms in patients with stroke included stiffness and thickness of the masseter muscle on the affected side and suprahyoid muscles; facial muscles’ asymmetry and weakness; temporomandibular disorders; and a reduced maximum lip force, tongue pressure, and saliva flow rate. The rehabilitation strategies more frequently reported included exercises directed to the jaw, temporomandibular joint, tongue, and neck. The mean score for methodological quality was 85%. Conclusion: The stomatognathic system disturbances are frequently reported among patients with stroke, leading to dysfunction in masticatory performance or swallowing. More studies on interventions for stomatognathic system disturbances are required before conclusions may be drawn. Key Practitioner Message: This systematic review has clinical implications for rehabilitation practices, given that the results may help to develop early assessment and rehabilitation strategies for stomatognathic disturbances in patients with stroke.

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What Happens to Swallowing Muscles after Stroke?: A Prospective Randomized Controlled Electrophysiological Study

Cited by 11 publications

References 25 publications

Suboptimal Tongue Pressure Is Associated with Risk of Malnutrition in Community-Dwelling Older Individuals

Suboptimal Tongue Pressure Is Associated with Risk of Malnutrition in Community-Dwelling Older Individuals

Fatores associados à disfagia em pacientes com AVC: uma revisão sistemática

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review

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