1
|
Oh JC. Effect of Visual Biofeedback Obtained Using the Iowa Oral Performance Instrument on the Suprahyoid Muscle Activation Level During Effortful Swallowing Maneuver. Dysphagia 2024; 39:433-443. [PMID: 37936019 DOI: 10.1007/s00455-023-10627-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/08/2023] [Indexed: 11/09/2023]
Abstract
Effortful swallowing (ES) is a maneuver prescribed for patients who experience pharyngeal residues after swallowing owing to weakness of the tongue and pharyngeal constrictor muscles. ES can increase the pharyngeal contraction force by intentionally increasing the degree of effort during swallowing. However, the effect is limited as the nature of swallowing makes it difficult to maintain a constant high-effort level. The aim of this study was to assess the effect of visual feedback, delivered by the Iowa Oral Performance Instrument (IOPI), a tongue pressure measurement device on ES maneuver effort. Overall, 34 healthy adults performed five sets of ten ES, once every 10 s. The ES maneuver was conducted under two conditions, ES with and without IOPI biofeedback in a crossover design. IOPI biofeedback was provided at 80% of the maximum posterior oral tongue pressure. The suprahyoid muscle activation level was assessed using surface electromyography during the ES maneuver. The mean suprahyoid muscle activation levels in all sets for which IOPI biofeedback was provided were significantly higher than those during ES maneuver without biofeedback (p < 0.05). IOPI biofeedback can help maintain the ES maneuver target effort, utilizing a constantly high swallowing pressure potentially promoting better pharyngeal pressures and muscle strength.
Collapse
Affiliation(s)
- Jong-Chi Oh
- Department of Occupational Therapy, Cheongju University, 298 Daesung-ro, Cheongwon-gu, Cheongju, Chungcheongbuk-do, 28503, Republic of Korea.
| |
Collapse
|
2
|
Yaşaroğlu ÖF, Serel Arslan S, Cengiz E, Alıcı R, Demir N, Oğuz B, Düger T. Swallowing kinematics and submental muscles activation during a newly designed maneuver called Mouth Open Swallowing Maneuver: A comparative study. PLoS One 2024; 19:e0299845. [PMID: 38527058 PMCID: PMC10962842 DOI: 10.1371/journal.pone.0299845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/18/2024] [Indexed: 03/27/2024] Open
Abstract
The aim of this study was to design a new maneuver called the Mouth Open Swallowing Maneuver (MOSM), and to compare swallowing kinematics and submental muscles activation (SMA) between MOSM and two current approaches used in dysphagia rehabilitation. Fifty healthy volunteers were asked to perform three repetitions of dry swallowing (DS) (control task), the MOSM, the Mendelsohn Maneuver (MM), and the Tongue-Hold Maneuver (THM) during videofluoroscopic swallowing study accompanied with simultaneous SMA recording. Swallowing kinematics were measured by frame-by-frame analysis on hyolaryngeal movement using ImageJ. Swallowing with maximum hyolaryngeal movement and SMA during these tasks was used for comparative analysis. Vertical movement of the hyoid during the MOSM was significantly greater than those observed during the DS and the THM (p<0.001, p<0.001). Horizontal movement of the hyoid during DS and the THM was significantly greater than that observed during the MM (p = 0.001, p = 0.001). Vertical movement of the larynx during the MOSM was significantly greater than those observed during DS, MM, and THM (p<0.001). There was no significant difference between tasks in horizontal movement of the larynx (p = 0.785). SMA during the THM was significantly greater than that observed during MOSM (p = 0.002). No significant difference was found between other tasks in terms of SMA (p>0.05). The MOSM as a newly designed maneuver was significantly superior to other maneuvers in increasing vertical hyolaryngeal movement. The THM has as much effect on hyolaryngeal movement as the MM. In this study, the MOSM was shown to be effective in increasing hyolaryngeal movement. ClinicalTrials.gov Protocol Registration and Results System (PRS); the clinical trial registration number (NCT05579041).
Collapse
Affiliation(s)
- Ömer Faruk Yaşaroğlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Selen Serel Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Emre Cengiz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Rabia Alıcı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Numan Demir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Berna Oğuz
- Department of Radiology, Hacettepe University Hospitals, Ankara, Türkiye
| | - Tülin Düger
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| |
Collapse
|
3
|
Barikroo A, Im I, Crary M, Carnaby G. Effects of Age and Lingual-Palatal Pressure Levels on Submental Surface Electromyography Measures. Dysphagia 2023; 38:1277-1285. [PMID: 36656382 DOI: 10.1007/s00455-023-10553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023]
Abstract
Submental surface electromyography (sEMG) may provide information about the lingual-palatal pressure (LPP) during swallowing. However, the extent to which changes in age and LPP levels are reflected in different sEMG measures is unclear. This study aimed to understand the effects of age and different levels of submaximal LPPs on submental sEMG peak, average, and integrated values in healthy adults. Ninety community-dwelling healthy participants were categorized into three age groups (young: 20-39 years, middle age: 40-59 years, older: 60 ≥ years). sEMG and LPP measurements were collected concurrently. After placing the sEMG electrodes, the maximal isometric LPP was established using the Iowa oral performance instrument (IOPI) on the anterior tongue. sEMG recordings were conducted for three submaximal LPP levels, including 40%, 60%, and 80% of the maximum LPP. Two-way repeated measure ANOVAs were conducted to find the effects of age and varying LPP levels on mean sEMG peak, average, and integrated measures. A significant age by LPP level interaction was identified for sEMG peak [F (4, 172) = 4.116, p < 0.007, ηp2 = 0.087], sEMG average [F (4, 170) = 5.049, p < 0.001, ηp2 = 0.106], and sEMG integrated values [F (4, 170) = 4.179, p < 0.003, ηp2 = 0.090]. Post hoc testing demonstrated that, in general, sEMG values significantly increased with rising LPP levels, primarily for younger and middle-aged adults. Furthermore, at 80% of maximum LPP, older adults generated less sEMG average and integrated values than middle age (only significant for sEMG integrated value) and younger adults. Likewise, max LPP was lower in older adults compared with young and middle-aged groups. Submental sEMG has the potential to be incorporated into a skill-based lingual exercise paradigm to improve tongue function during swallowing. Moreover, submental sEMG can characterize some age-related subclinical changes in swallowing.
Collapse
Affiliation(s)
- Ali Barikroo
- Swallowing Physiology & Rehabilitation Research Laboratory, Speech Pathology and Audiology Program, School of Health Sciences, Kent State University, PO Box 5190, Kent, OH, 44242-0001, USA.
| | - Ikjae Im
- Department of Language and Rehabilitation, Catholic Kwandong University, Gangneung, South Korea
| | | | - Giselle Carnaby
- School of Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| |
Collapse
|
4
|
Effect of Intensive Oropharyngeal Training on Radiotherapy-Related Dysphagia in Nasopharyngeal Carcinoma Patients. Dysphagia 2022; 37:1542-1549. [PMID: 35175419 DOI: 10.1007/s00455-022-10419-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/07/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the effect of intensive oropharyngeal functional training on swallowing in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma. METHODS Fourteen patients with nasopharyngeal carcinomas and dysphagia after radiotherapy received intensive oropharyngeal training for two weeks. The Functional Oral Intake Scale (FOIS) and videofluoroscopic swallowing studies (VFSS) were used to evaluate swallowing function before and after intensive oropharyngeal training. Spatiotemporal parameters of the VFSS were analyzed using a digital image analysis system. RESULTS After training, the FOIS, Rosenbek penetration-aspiration score, DIGEST, normalized residue ratio scale, and spatiotemporal parameters of VFSS were significantly improved (P < 0.05). CONCLUSIONS This study indicated that intensive oropharyngeal training improves swallowing function after radiotherapy in patients with nasopharyngeal carcinoma.
Collapse
|
5
|
Freitas ASD, Zica GM, Freitas EQ, Silva ACAE, Dias FL, Santos IC. Residue localization and risk for aspiration in partial laryngectomy: the relevance of assertive therapeutic strategies and resources. EINSTEIN-SAO PAULO 2022; 20:eAO6262. [PMID: 35293434 PMCID: PMC8909125 DOI: 10.31744/einstein_journal/2022ao6262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/15/2021] [Indexed: 11/14/2022] Open
Abstract
Objective: To describe the correlation between the residues, their anatomical location and the presence of laryngotracheal penetration and aspiration in patients after supracricoid laryngectomy undergoing cricohyoidoepiglotopexy reconstruction. Methods: This study included 70 patients treated by supracricoid laryngectomy with cricohyoidoepiglotopexy reconstruction in a referral national cancer hospital. The patients were submitted to swallowing videofluoroscopy, and the findings were classified by the penetration and aspiration scale. The images were described observing the presence or absence of residues and their anatomical location. Results: The prevalence of penetration in this study was 68.6% and aspiration was 34.3%. An association was found between the presence of residue on the tongue (p=0.005), posterior pharyngeal wall (p=0.013), pyriform recesses (p=0.002), valecula (p=0.061), and laryngeal penetration. The residue in the upper esophageal sphincter (p=0.039) was associated with the occurrence of laryngotracheal aspiration. Conclusion: Patients undergoing supracricoid laryngectomy with cricohioidoepiglotopexy reconstruction have food residues in different anatomical regions after swallowing. Penetration was associated with the presence of residues on the base of the tongue and posterior pharyngeal wall. Aspiration was associated with the presence of residues in the upper esophageal sphincter.
Collapse
|
6
|
Possible Rehabilitation Procedures to Treat Sarcopenic Dysphagia. Nutrients 2022; 14:nu14040778. [PMID: 35215427 PMCID: PMC8878994 DOI: 10.3390/nu14040778] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/25/2022] [Accepted: 02/09/2022] [Indexed: 12/14/2022] Open
Abstract
Sarcopenic dysphagia requires the presence of both dysphagia and generalized sarcopenia. The causes of dysphagia, except for sarcopenia, are excluded. The treatment for sarcopenic dysphagia includes resistance training along with nutritional support; however, whether rehabilitation procedures are useful remains unclear. In this narrative review, we present possible rehabilitation procedures as a resistance training for managing sarcopenic dysphagia, including Shaker exercise, Mendelsohn maneuver, tongue-hold swallow exercise, jaw-opening exercise, swallow resistance exercise, lingual exercise, expiratory muscle strength training, neuromuscular electrical stimulation, and repetitive peripheral magnetic stimulation. We hope that some procedures mentioned in this article or new methods will be effective to treat sarcopenic dysphagia.
Collapse
|
7
|
Cho H, Noh JS, Park J, Park C, Park ND, Ahn JY, Park JW, Choi YH, Chun SM. Decreased Maximal Tongue Protrusion Length May Predict the Presence of Dysphagia in Stroke Patients. Ann Rehabil Med 2022; 45:440-449. [PMID: 35000369 PMCID: PMC8743842 DOI: 10.5535/arm.21126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/13/2021] [Indexed: 01/22/2023] Open
Abstract
Objective To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients. Methods Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS). Results The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%. Conclusion There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.
Collapse
Affiliation(s)
- Hyunchul Cho
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Jeong Se Noh
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Junwon Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Changwook Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - No Dam Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jun Young Ahn
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ji Woong Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Yoon-Hee Choi
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Seong-Min Chun
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| |
Collapse
|
8
|
Ferreira DBDC, Furlan RMMM, Frazão YS, Motta AR. Speech pathology in facial aesthetics: effects of two strategies for the suprahyoid muscles. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222469622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
ABSTRACT Purpose: to verify the effects of tongue pressure exercises against the incisive papilla, used both alone and in combination with functional swallowing training, on the electrical activity of the suprahyoid muscles and the self-perception of aesthetic changes in the submandibular region. Chi-square, Fisher’s exact, Mann-Whitney, Kruskal Wallis, and Wilcoxon tests were used. The significance level was set at 5%. Methods: an experimental, analytical, prospective study on 27 women, aged 30 to 78 years, divided into two treatment groups (G1 and G2), and a control group (CG). Individuals were submitted to 8 weeks of training, in which G1 performed only tongue pressure exercises against the incisive papilla, and G2 performed the same exercises in combination with swallowing training, while CG was not submitted to any intervention. The suprahyoid muscle electrical activity was obtained with surface electromyography at the beginning and end of the study when subjects also answered a self-perception questionnaire on possible aesthetic results. Pearson’s chi-square, Fisher’s exact, Mann-Whitney, Kruskal Wallis, and Wilcoxon tests were used. The significance level was set at 5%. Results: statistically significant differences were found between the initial and final electrical activity in both G1 and G2, which was not found in CG. There was no significant difference between the groups regarding their self-perception of visual or muscle improvements. Conclusion: both strategies analyzed were equally effective to increase suprahyoid muscle recruitment, though with no impact on the self-perception of aesthetic changes in the submandibular region.
Collapse
|
9
|
Ferreira DBDC, Furlan RMMM, Frazão YS, Motta AR. Fonoaudiologia em estética da face: efeito de duas estratégias para musculatura supra-hioidea. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222469622s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RESUMO Objetivo: verificar os efeitos do exercício de pressão de língua contra a papila incisiva, realizado de forma isolada e associada ao treino funcional da deglutição, na atividade elétrica da musculatura supra-hioidea e na autopercepção da mudança estética na região submandibular. Métodos: estudo experimental, analítico e prospectivo, realizado com 27 mulheres entre 30 e 78 anos, divididas em dois grupos de tratamento (G1 e G2) e um grupo controle (GC). Os indivíduos foram submetidos a oito semanas de treinamento, sendo que o G1 realizou somente o exercício pressão de língua contra a papila incisiva, o G2 realizou o mesmo exercício associado ao treino da deglutição e o GC não foi submetido a qualquer intervenção. A atividade elétrica da musculatura supra-hioidea foi obtida por meio da eletromiografia de superfície no início e ao final do estudo, quando também foi aplicado um questionário de autopercepção dos possíveis resultados estéticos obtidos. Foram utilizados os testes Qui-quadrado de Pearson, Exato de Fisher, Mann Whitney, Kruskal Wallis e Wilcoxon, com nível de significância de 5%. Resultados: foram encontradas diferenças estatisticamente significativas na atividade elétrica entre os valores inicial e final tanto no G1 quanto no G2, fato não observado no GC. Não houve diferença significativa entre os grupos em relação à autopercepção da melhora visual e da melhora muscular. Conclusão: as duas estratégias analisadas mostraram-se igualmente eficazes para promover o maior recrutamento da musculatura supra-hioidea, porém, sem impacto na autopercepção da mudança estética na região submandibular.
Collapse
|
10
|
Félix-Lusterman CC, Joseph ME, Daniels SK. Update on Exercise-Based Rehabilitation Approaches for Neurogenic Dysphagia. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00333-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
11
|
Izumi M, Akifusa S. Tongue cleaning in the elderly and its role in the respiratory and swallowing functions: Benefits and medical perspectives. J Oral Rehabil 2021; 48:1395-1403. [PMID: 34612518 DOI: 10.1111/joor.13266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
Abstract
Oral dysfunction, including oral uncleanness and decline in tongue motor function, tongue pressure and swallowing function, precedes frailty. The tongue's dorsum is a reservoir of oral microbiota, desquamated epithelial mucosa and leukocytes due to the multi-papillate anatomy, and leads to tongue coating. The tongue coating is frequently found in older adults because of hyposalivation, immunity's hypoactivity, diminished motor function and compromised tongue's pressure with age. Anaerobe-driven volatile sulphur compounds in tongue coating are a major cause of intra-oral malodor. Dysbiosis of the tongue-coating microbiome rather than the amount of microorganisms is associated with a risk of aspiration pneumonia. Daily tongue cleaning with a brush or scraper is an easy way to control tongue coating deposits and quality. Using mouth wash or rinse-containing germicides is also a way to control the microbiota of tongue coating. The tongue function is closely related to swallowing. Tongue and suprahyoid muscles are linked with respiratory muscles through the endothoracic fascia. The mechanical stimulation during the cleaning of the tongue may stimulate the respiratory muscles. An intervention trial revealed that tongue cleaning by mucosal brush improves tongue pressure, swallowing and respiratory function in old residents of nursing homes, suggesting a rehabilitative effect of tongue cleaning on the swallowing and respiratory functions, preventing aspiration pneumonia. This narrative review assesses the tongue-cleaning benefits for respiratory and swallowing functions and the possibility of preventing aspiration pneumonia.
Collapse
Affiliation(s)
- Maya Izumi
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | - Sumio Akifusa
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| |
Collapse
|
12
|
Aihara K, Inamoto Y, Kanamori D, González-Fernández M, Shibata S, Kagaya H, Hirano S, Kobayashi H, Fujii N, Saitoh E. Effect of tongue-hold swallow on posterior pharyngeal wall using dynamic area detector computed tomography. J Oral Rehabil 2021; 48:1235-1242. [PMID: 34407238 PMCID: PMC9291453 DOI: 10.1111/joor.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/15/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
Purpose The purpose of this study was to elucidate the effects of the tongue‐hold swallow (THS) on the pharyngeal wall by quantifying posterior pharyngeal wall (PPW) anterior bulge during the THS. In addition, the effect of tongue protrusion length on the extent of pharyngeal wall anterior bulge was analysed. Methods Thirteen healthy subjects (6 males and 7 females, 23–43 years) underwent 320‐row area detector CT during saliva swallow (SS) and THS at two tongue protrusion lengths (THS1 protrude the tongue as much as 1/3 of premeasured maximum tongue protrusion length (MTP‐L) and THS2 protrude the tongue as much as 2/3 of MTP‐L). To acquire images of the pharynx at rest, single‐phase volume scanning was performed three times during usual breathing with no tongue protrusion (rest), protrusion of the tongue at 1/3 of MTP‐L (rTHS1) and protrusion of the tongue at 2/3 of MTP‐L (rTHS2). Length from cervical spine to PPW (PPW‐AP) and the volume of pharyngeal cavity was measured and was compared between rest, rTHS1 and rTHS2 and between SS, THS1 and THS2. Correlation between MTP‐L and PPW‐AP was calculated in three conditions, SS, THS1 and THS2. Results PPW‐AP at rest, rTHS1 and rTHS2 was 2.9 ± 0.6 mm, 3.0 ± 0.5 mm and 3.0 ± 0.5 mm, respectively, showing no significant differences across swallows. PPW‐AP at the maximum pharyngeal constriction was 8.1 ± 2.0 mm, 9.1 ± 2.4 mm and 8.7 ± 2.0 mm in SS, THS1 and THS2, respectively. Compared to SS, PPW‐AP in THS1 was significantly larger (p = 0.04) and PPW‐AP in THS2 was not significantly different (p = 0.09). Pharyngeal volume at rest, rTHS1 and rTHS2 was 16.4 ± 5.2 mm3, 18.4 ± 4.5 mm3 and 21.3 ± 6.2 mm3, respectively. It was significantly larger during rTHS2 compared with rest or rTHS1 (rTHS2‐rest p = 0.007, rTHS2‐rTHS1 p = 0.007). Pharyngeal volume was completely obliterated (zero volume) at maximum pharyngeal contraction in all except one subject. There was no correlation between MTP‐L and PPW‐AP in any of the three conditions (SS, THS1 and THS2). Discussion This study demonstrated that the expanded pharyngeal cavity due to the tongue protrusion was completely obliterated by the increase in anterior motion of pharyngeal wall during THS. It also became clear that the degree of tongue protrusion did not linearly correlate with the movement of PPW during THS. There was no relationship between PPW motion and the MTP‐L, suggesting that the effect of tongue protrusion is better determined in each subject by analysing the motion of PPW using imaging tools.
Collapse
Affiliation(s)
- Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Daisuke Kanamori
- Department of Density and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Marlís González-Fernández
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hiroko Kobayashi
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Naoko Fujii
- Department of Radiology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
13
|
Fujiwara S, Hori K, Shitara S, Okawa J, Kodama S, Murakami K, Ono T. Effect of hard gummy candy chewing on masticatory function. J Oral Rehabil 2021; 48:909-915. [PMID: 34028839 DOI: 10.1111/joor.13208] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/23/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although various training methods have been reported for improving oral function such as occlusal force, there are few reports that show the training effect of eating hard food on the oral functions. OBJECTIVE To examine the training effects of habitually ating hard gummy candies on oral functions. METHODS Participants of this cohort study were recruited into a training (six women, eight men; mean age 27.6 ± 3.5 years) and control group (two women, seven men; mean age 28.3 ± 4.9 years). The training group ate nine custom-developed hard gummy candies three times per week for 3 months. Training effects were evaluated by measuring the maximal occlusal force, masticatory performance, maximal tongue pressure, number of chewing cycles until swallowing the candy, duration of chewing and cycle time before training, after 1, 2 and 3 months of training, and 1 month after stopping training. The iEMG/force, which evaluates masseter muscle hypertrophy with electromyograms (EMG), was calculated. RESULTS Masticatory performance after 1 month (p = 0.01), maximal occlusal force after 2 months (p < 0.01) and maximal tongue pressure after 3 months of training were significantly increased (p = 0.02), and the cycle time after 2 months of training (p = 0.02) was significantly decreased compared to before the intervention. Except for masticatory performance, the other effects were maintained for 1 month after stopping training. Changes in iEMG/force were not significant, but a tendency for muscle hypertrophy was observed in the training group. CONCLUSION Habitual eating of hard gummy candies is a task-specific training that can improve overall masticatory function, including tongue pressure.
Collapse
Affiliation(s)
- Shigehiro Fujiwara
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoko Shitara
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Jumpei Okawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Shohei Kodama
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazuhiro Murakami
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| |
Collapse
|
14
|
Izumi M, Sonoki K, Ohta Y, Fukuhara M, Nagata M, Akifusa S. Tongue cleaning maintains respiratory function in older individuals: A 1-year randomised controlled trial. J Oral Rehabil 2021; 48:730-737. [PMID: 33687734 DOI: 10.1111/joor.13165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this 1-year longitudinal randomised controlled trial was to evaluate the effectiveness of tongue cleaning on the maintenance of respiratory function in older adults requiring care. METHODS The participants included 24 residents of two nursing homes in Kitakyushu, Japan. The participants were randomised to receive tongue cleaning with routine oral care (intervention group, n = 12), or routine oral care alone (control group, n = 12). Among the participants, three in the intervention group and four in the control group had cerebrovascular disease history, four in the intervention group and four in the control group had a history of cardiac disease, and five in the intervention group and four in the control group were without medical history. Respiratory function was assessed on the basis of the peak expiratory flow rate (PEFR). Tongue pressure, swallowing function, oral health status, activities of daily living and nutritional status were also measured at baseline and at the end of the 1-year follow-up period. RESULTS The number of analysed participants in each group was 12. In the control group, the PEFR (1.6 [0.4-4.2] L s-1 vs 1.4 [0.4-3.2] L s-1 , P = .034) and tongue pressure (16.4 [1.7-35.2] kPa vs 8.0 [1.4-38.6] kPa, P = .032) significantly declined after 1-year. However, the PEFR (1.5 [0.8-2.9] L s-1 vs 1.6 [0.7-4.2] L s-1 , P = .366) and tongue pressure (18.1 [4.2-37.1] kPa vs 16.1 [5.2-41] kPa, P = .307) were maintained in the intervention group. The change in the PEFR was significantly greater in the intervention group compared with the control group (0.130 [-0.45-1.70] L s-1 vs -1.70 [-10.00-10.00] L s-1 , P = .028). CONCLUSION Our findings suggest that tongue cleaning may help maintain tongue and respiratory function in older adults requiring care.
Collapse
Affiliation(s)
- Maya Izumi
- Faculty of Dentistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Kazuo Sonoki
- Faculty of Dentistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Yuko Ohta
- Division of Comprehensive Internal Medicine, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | - Masayo Fukuhara
- Division of Comprehensive Internal Medicine, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | | | - Sumio Akifusa
- Faculty of Dentistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| |
Collapse
|
15
|
Aoyagi Y, Ohashi M, Ando S, Inamoto Y, Aihara K, Matsuura Y, Imaeda S, Saitoh E. Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals. Dysphagia 2021; 36:936-943. [PMID: 33386483 PMCID: PMC8464565 DOI: 10.1007/s00455-020-10217-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/17/2020] [Indexed: 01/19/2023]
Abstract
Tongue-hold swallow (THS) is a swallow exercise in which an individual swallows saliva while holding the anterior portion of the tongue between the front teeth. The effect of THS on pharyngeal contractile vigor is still unclear. The purpose of this study was to quantify THS using high-resolution manometry with a contractile integral analysis. Twenty-two healthy participants performed three different saliva swallow tasks: normal swallow, weak THS (in which the tongue was protruded 1 cm outside the upper incisors), and strong THS (in which the tongue was protruded 2 cm outside the upper incisors). The participants repeated each task twice randomly. Pharyngeal and upper esophageal sphincter metrics, including the pharyngeal contractile integral, were analyzed. Both weak and strong THS enhanced the velopharyngeal contractile integral and peak pressure compared with normal swallow (P < 0.01). THS also prolonged mesopharyngeal contraction (P < 0.01). Holding the tongue anteriorly during swallow requires significant biomechanical changes to pharyngeal contractile properties at the superior and middle pharyngeal constrictor levels; thus, it may serve as a resistance exercise for the muscles that are involved in bolus propulsion.
Collapse
Affiliation(s)
- Yoichiro Aoyagi
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Miho Ohashi
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Shiori Ando
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Keiko Aihara
- Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Yoko Matsuura
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Sayuri Imaeda
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| |
Collapse
|