Tongue-pressure resistance training improves tongue and suprahyoid muscle functions simultaneously
Tongue-pressure resistance training improves tongue and suprahyoid muscle functions simultaneously
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DOI：
10.2147/cia.s194808
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发表时间：
2019-01-01
影响因子：
3.6
通讯作者：
Minakuchi, Shunsuke
中科院分区：
文献类型：
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作者：
Namiki, Chizuru;Hara, Koji;Minakuchi, Shunsuke
目的：通过将舌头推靠在上腭上来产生舌压（TP）包括通过舌骨上肌收缩来提升舌头肌肉和提升口底。虽然研究表明，舌压阻力训练（TPRT）可以提高舌头的功能，但没有人关注舌骨上肌功能的增强。我们的研究旨在验证是否TPRT改善舌功能和舌骨运动在swallowing.Materials和方法：18例（平均年龄：76.8 +/- 6.2岁），老年性吞咽障碍的症状，如咳嗽和窒息。所有患者均能独立进行日常生活活动。没有参与者患有引起吞咽困难的疾病或先前的口腔或咽部手术。参与者被要求尽可能用力地将舌头推到上颚上，嘴巴闭合10秒钟，然后休息10秒钟。一组包括五个连续的运动和休息期;每天两组进行一个月。TP和口头diadochokinetic率（ODKR），测量音节/ta/和/ka/的重复，评估舌功能。根据视频透视数据评估前舌骨和上级舌骨运动的程度以及与吞咽相关的参数，包括穿透抽吸量表（PAS）和梨状窦（NRRSp）和谷（NRRSv）中的标准化残留物比率量表（NRRS）。随访时前（P=0.031）和上级舌骨移动（P=0.012）、TP（P=0.002）、ODKR/ta/（P=0.034）、ODKR/ka/（P=0.009）和食管上括约肌宽度（P=0.001）均大于基线。NRRSp（P=0.022）、PAS（P=0.016）和咽部通过时间（P=0.004）在随访时均小于基线值。结论：TPRT改善了舌的强度、灵活性、舌骨前、上级抬高和吞咽功能。因此，TPRT可以同时改善舌功能和舌骨上肌功能，有助于预防肌肉减少性吞咽困难。
Purpose: Producing tongue pressure (TP) by pushing the tongue against the palate consists of lifting the tongue muscles and elevating the floor of the mouth via suprahyoid muscle contraction. Though studies have shown that tongue-pressure resistance training (TPRT) increases tongue function, none have focused on suprahyoid muscle function enhancements. Our study aimed to verify whether TPRT improves both tongue function and hyoid movement during swallowing.Materials and methods: Eighteen patients (mean age: 76.8 +/- 6.2 years) with presbyphagia presenting with symptoms such as coughing and choking were enrolled. All patients performed daily living activities independently. None of the participants had diseases causing dysphagia or previous oral or pharyngeal surgery. Participants were instructed to push their tongues against the palate as hard as possible with their mouths closed for 10 seconds, and then resting for 10 seconds. A set consisted of five consecutive exercise and resting periods; two sets per day were performed for a month. TP and the oral diadochokinetic rate (ODKR), measured by repetitions of the syllables /ta/and /ka/, assessed tongue function. The extent of anterior and superior hyoid movement and parameters related to swallowing, including the penetration aspiration scale (PAS) and the normalized residue ratio scale (NRRS) in the valleculae (NRRSv) and piriform sinus (NRRSp), were evaluated based on videofluoroscopic data.Results: The anterior (P=0.031) and superior hyoid movement (P=0.012), TP (P=0.002), ODKR/ta/(P=0.034), ODKR/ka/(P=0.009), and the width of the upper esophageal sphincter (P=0.001) were larger at follow-up than at baseline. NRRSp (P=0.022), PAS (P=0.016), and pharyngeal transit times (P=0.004) were smaller at follow-up than at baseline.Conclusion: TPRT improved tongue strength, dexterity, both anterior and superior hyoid elevation, and swallowing functions. Therefore, TPRT could improve tongue function and suprahyoid muscle function simultaneously and contribute to prevention of sarcopenic dysphagia.