Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise
Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise
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DOI：
10.1152/ajpgi.1997.272.6.g1518
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发表时间：
1997-06-01
影响因子：
4.5
通讯作者：
Bonnevier, J
中科院分区：
文献类型：
--
作者：
Shaker, R;Kern, M;Bonnevier, J
早期的研究表明，与健康的年轻志愿者相比，健康无症状老年人吞咽上括约肌(UES)开口的横截面积减小。这项研究的目的是确定抬头运动对老年人吞咽诱导的UES开放和下咽内压的影响。我们对31名无症状健康老年受试者进行了实操(19名)和假操(12名)前后的视频透视和测压研究。实际运动后，喉前移幅度、最大前后径和UES开口横截面积均显著增加(P<；0.05)。这些变化与12名(实际运动)和6名(假运动)受试者下咽内压显著降低有关(P<；0.05)。在假运动组中没有发现类似的效果。在正常的老年受试者中，吞咽的UES开放可以通过旨在加强UES开放肌肉的运动来增强。这种增强伴随着下咽内注压的显著降低，这表明咽部流出阻力降低。这种方法可能对一些由于吞咽UES开放障碍而导致的吞咽困难患者有帮助。
Earlier studies have shown that the cross-sectional area of the deglutitive upper esophageal sphincter (UES) opening in healthy asymptomatic elderly individuals is reduced compared with healthy young volunteers. The aim of this study was to determine the effect of a head-raising exercise on swallow-induced UES opening and hypopharyngeal intrabolus pressure in the elderly. We studied a total of 31 asymptomatic healthy elderly subjects by videofluoroscopy and manometry before and after real(19 subjects) and sham (12 subjects) exercises. A significant increase was found in the magnitude of the anterior excursion of the larynx, the maximum anteroposterior diameter, and the cross-sectional area of the UES opening after the real exercise (P < 0.05). These changes were associated with a significant decrease in the hypopharyngeal intrabolus pressure studied in 12 (real-exercise) and 6 (sham-exercise) subjects (P < 0.05). A similar effect was not found in the sham-exercise group. In normal elderly subjects, deglutitive UES opening is amenable to augmentation by exercise aimed at strengthening the UES opening muscles. This augmentation is accompanied by a significant decrease in hypopharyngeal intrabolus pressure, indicating a decrease in pharyngeal outflow resistance. This approach may be helpful in some patients with dysphagia due to disorders of deglutitive UES opening.