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Pu D, Yao TJ. The use and effects of whole-body exercises on swallowing function: A scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 36759960 DOI: 10.1111/1460-6984.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Swallowing function can become impaired due to primary medical conditions or age-related presbyphagia, resulting in swallowing disorders, known as dysphagia. Specific manoeuvres that target different musculature have been innovated and researched, but whole-body exercises (WBE) that target multiple large groups of body systems and muscles have been rarely considered in dysphagia management, despite the causes of dysphagia being often systemic. AIMS To identify intervention studies that have used or incorporated WBE to target swallowing function in humans, and report on their findings. METHODS & PROCEDURES A scoping review was conducted given the paucity and novelty of this topic in research and practice. Key search terms were used to search five major databases on for all human studies published before 28 November 2022. Studies that were not interventional or used animal models were excluded. All swallowing and oromotor-related outcomes were extracted from the studies. Two researchers independently reviewed all search results following the PRISMA-ScR guideline before meeting to resolve any disagreements. MAIN CONTRIBUTION Final analysis was conducted on 11 papers that described 10 studies, with 10 papers (9 studies) reporting positive findings for swallowing or oromotor function-related outcomes. Studies ranged from randomised controlled trials to case studies in design. The study design and populations were heterogeneous, with outcome measures for swallowing and oromotor function ranging from subjective questionnaires to instrumental assessments. CONCLUSIONS & IMPLICATIONS Dysphagia rehabilitation that incorporates WBE as part of a comprehensive programme appears to be more beneficial than either WBE or swallowing-related interventions alone. This review is an initial attempt to systematically examine the evidence on this topic. There is a need for future research to study how WBE can be used, either alone or combined with traditional swallowing exercises, to influence swallowing function in different healthy and clinical populations. WHAT THIS PAPER ADDS What is already known on this subject Dysphagia rehabilitation usually focuses only on the swallowing muscles and structures of the head, neck, and respiratory system. Whole-body exercise (WBE) and fitness are associated with stronger performance of the tongue muscles, there may be transference potential of WBE to swallowing function. What this paper adds to existing knowledge This review found 10 studies conducted in the last decade that investigated the inclusion of WBE in programmes intended to improve swallowing and/or oromotor-related outcomes. The studies varied widely in design and methodology, but most reported evidence in support of the inclusion of WBE to improve or maintain swallowing and/or oromotor-related functions. What are the potential or actual clinical implications of this work? There is potential for WBE to have a synergistic effect on swallowing function when combined with traditional swallowing exercises. Future clinical research should compare different rehabilitation approaches with controls. Clinicians should enlist allied health professionals who can provide whole-body rehabilitation when managing dysphagia.
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Affiliation(s)
- Dai Pu
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia
| | - Theresa Jingyun Yao
- Department of Otolaryngology-Head and Neck Surgery, Stanford Health Care, Palo Alto, CA, USA
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Arakawa‐Kaneko I, Watarai Y, Schimmel M, Abou‐Ayash S. Relationship between tongue pressure and handgrip strength: A systematic review and meta-analysis. J Oral Rehabil 2022; 49:1087-1105. [PMID: 35972300 PMCID: PMC9804501 DOI: 10.1111/joor.13362] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/23/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Muscle strength decreases with age, causing a decline in physical and oro-facial function. However, the impact of physiological and pathophysiological factors on tongue pressure (TP) has not been clarified. The purpose of this systematic review and meta-analysis was to compare and analyse TP and handgrip strength (HGS) between individuals aged <60 and ≥60 years, gender and need for care (independent older adults (IC) and older adults receiving nursing care (NC)). Furthermore, the effect of HGS in physical function on TP was examined. METHODS Human clinical studies reporting HGS and TP were searched systematically using PubMed and Ichushi-Web published from 1969 to Nov 2021. Random-effects meta-regressions were performed to compare between subgroups and to examine the association between HGS and TP (α < .05). RESULTS Forty-four studies with a total of 10 343 subjects were included. TP and HGS values were significantly higher in people aged <60 years relative to ≥60 years and in IC relative to NC (all p < .001). Regarding gender, there was no significant difference in TP (p = .370). However, a significant gender-dependent difference in TP was observed in people aged <60 years (p < .001), but not in aged ≥60 years in IC group (p = .118) and aged ≥60 years in NC group (p = .895). There was a significant positive correlation of HGS and TP (p < .001). CONCLUSIONS Similar to decrease in HGS, age-related sarcopaenia seems to have an effect on oro-facial muscles like the tongue. Research on rehabilitation measures for oro-facial muscle strength, similar to HGS might be beneficial to improve the personally acquired oro-facial potential.
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Affiliation(s)
- Itsuka Arakawa‐Kaneko
- Department of Reconstructive Dentistry and Gerodontology, School of Dental MedicineUniversity of BernBernSwitzerland,Comprehensive Dental Care UnitThe Nippon Dental University Niigata HospitalNiigataJapan
| | - Yuko Watarai
- Department of Removable ProsthodonticsThe Nippon Dental University School of Life Dentistry at NiigataNiigataJapan
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental MedicineUniversity of BernBernSwitzerland,Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental Medicine, University of GenevaGenevaSwitzerland
| | - Samir Abou‐Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental MedicineUniversity of BernBernSwitzerland
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Tagami Y, Fujimoto K, Goto T, Suito H, Nagao K, Ichikawa T. Measurement of ultrasonic echo intensity predicts the mass and strength of the tongue muscles in the elderly. J Oral Sci 2021; 64:44-48. [PMID: 34880146 DOI: 10.2334/josnusd.21-0351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE The purpose of this study was to investigate the relationship between the echo intensity (EI) on ultrasound images of the tongue, tongue thickness, and tongue pressure to examine the effectiveness of EI measurement for assessing the tongue function. METHODS A total of 100 elderly outpatients were enrolled. Tongue thickness and EI were measured using ultrasonography. The distance from mylohyoid muscle surface to dorsal surface of the tongue was measured for tongue thickness. Subsequently, this area was vertically divided into four areas: top of tongue dorsal side (DT), bottom of tongue dorsal side (DB), top of basal tongue side (BT), and bottom of basal tongue side (BB), and the EI was measured in each area. RESULTS The mean EIs of DT and DB were lower than those of BT and BB. In the three areas apart from BB, the EI decreased with an increase in tongue thickness. In particular, a significant correlation between the EI in DB and tongue thickness was found. In all areas, the EI decreased with an increase in tongue pressure. CONCLUSION The results of this study suggested that the measurement of EI could be an important indicator for assessing the tongue function in the elderly.
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Affiliation(s)
- Yoshihiro Tagami
- Department of Prosthodontics and Oral Rehabilitation, Tokushima University, Graduate School of Biomedical Sciences
| | - Keiko Fujimoto
- Department of Prosthodontics and Oral Rehabilitation, Tokushima University, Graduate School of Biomedical Sciences
| | - Takaharu Goto
- Department of Prosthodontics and Oral Rehabilitation, Tokushima University, Graduate School of Biomedical Sciences
| | - Hideki Suito
- Department of Oral and Maxillofacial Radiology, Tokushima University, Graduate School of Biomedical Sciences
| | - Kan Nagao
- Department of Prosthodontics and Oral Rehabilitation, Tokushima University, Graduate School of Biomedical Sciences
| | - Tetsuo Ichikawa
- Department of Prosthodontics and Oral Rehabilitation, Tokushima University, Graduate School of Biomedical Sciences
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Ohara Y, Kawai H, Shirobe M, Iwasaki M, Motokawa K, Edahiro A, Kim H, Fujiwara Y, Ihara K, Watanabe Y, Obuchi S, Hirano H. Association between dry mouth and physical frailty among community-dwelling older adults in Japan: The Otassha Study. Gerodontology 2021; 39:41-48. [PMID: 34762315 DOI: 10.1111/ger.12605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/22/2021] [Accepted: 10/28/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To elucidate the relationship between physical frailty and dry mouth among community-dwelling older adults in Japan. BACKGROUND Oral hypofunction is associated with physical frailty in older adults. Dry mouth, subjectively evaluated as xerostomia and objectively measured as hyposalivation, is highly prevalent in older adults. However, few reports have used both measures of dry mouth and investigated their association with physical frailty. MATERIALS AND METHODS This cross-sectional study included 643 individuals (mean age, 73.9 years) from the Otassha Study in 2019. Xerostomia was assessed using the 5-item Summated Xerostomia Inventory (SXI). Hyposalivation was assessed by measuring the amount of resting saliva using the modified cotton roll method. Frailty phenotypes were defined by weakness, slowness, weight loss, low physical activity level and exhaustion components, and served as the outcome variable. Participants with three or more components were considered physically frail, and those with one or two components were considered pre-frail. Ordinal logistic regression analyses were performed to evaluate the associations between physical frailty and xerostomia and hyposalivation. RESULTS Among the participants, 4.5% and 49.8% had physical frailty and pre-frailty, respectively. In ordinal logistic regression analysis adjusted for demographic and health characteristics, the SXI score was associated with physical frailty status (adjusted odds ratio for a one-point increase in SXI, 1.12; 95% confidence interval, 1.06-1.19). However, no difference was observed between the amount of resting saliva and severity of physical frailty. CONCLUSION Xerostomia is associated with physical frailty among community-dwelling older adults in Japan. CLINICAL TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Kazuhige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Department of Dental and Oral Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
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Miyoshi S, Saito A, Shigeishi H, Ohta K, Sugiyama M. Relationship between oral and physical function and length of participation in long-term care prevention programs in community-dwelling older Japanese women. Eur Geriatr Med 2020; 12:387-395. [PMID: 33145741 DOI: 10.1007/s41999-020-00424-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/16/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The present study aimed to clarify the relationship between community-dwelling older women's participation period in community-based exercise programs and their oral and physical functioning. METHODS From May to September 2019, we recruited 205 older women (mean age: 77.6 ± 5.5 years) who had joined weekly long-term care prevention programs such as community-based exercise programs that included oral and physical exercises, in Hiroshima Prefecture, Japan. Physical function was evaluated using a handgrip strength test, a Timed Up & Go test, a one-leg standing test, and a 30-s chair stand test. Tongue pressure, oral diadochokinesis, and Dysphagia Risk Assessment for the Community-dwelling Elderly were measured to evaluate oral functioning. After adjusting for clinical factors (i.e., age, BMI, hypertension, diabetes, stroke, heart disease, joint disease, osteoporosis, remaining teeth, denture use, oral wetness, history of dental examinations in the last year, use of interdental brush and/or dental floss), we compared the oral and physical function parameters of participants from varying program engagement periods using propensity score matching. RESULTS A significant increase in mean handgrip strength was found in people who had been participating for ≥ 5 years compared with those who had been participating for < 5 years (p = 0.01). Furthermore, repetition of the monosyllable/ka/was significantly greater for people in the ≥ 5 years group compared with those in the < 5 years group (p = 0.03). CONCLUSION Long-term participation in an exercise program is positively associated with handgrip strength and tongue motor function in independent older women.
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Affiliation(s)
- Sanae Miyoshi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.,Takehara-Toyota Dental Hygienists' Association, Hiroshima, Japan
| | - Ayumi Saito
- Oral Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
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