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舌-腭抗阻训练可改善亚急性脑卒中吞咽困难幸存者的舌肌力量和口咽吞咽功能。

Tongue-to-palate resistance training improves tongue strength and oropharyngeal swallowing function in subacute stroke survivors with dysphagia.

作者信息

Kim H D, Choi J B, Yoo S J, Chang M Y, Lee S W, Park J S

机构信息

Department of Physical Medicine and Rehabilitation, Busan Paik Hospital of Inje University, Busan, Korea.

Department of Occupational Therapy, Kyung-hee Medical Center, Seoul, Korea.

出版信息

J Oral Rehabil. 2017 Jan;44(1):59-64. doi: 10.1111/joor.12461.

Abstract

Tongue function can affect both the oral and pharyngeal stages of the swallowing process, and proper tongue strength is vital for safe oropharyngeal swallowing. This trial investigated the effect of tongue-to-palate resistance training (TPRT) on tongue strength and oropharyngeal swallowing function in stroke with dysphagia patients. This trial was performed using a 4-week, two-group, pre-post-design. Participants were allocated to the experimental group (n = 18) or the control group (n = 17). The experimental group performed TPRT for 4 weeks (5 days per week) and traditional dysphagia therapy, whereas the control group performed traditional dysphagia therapy on the same schedule. Tongue strength was measured using the Iowa Oral Performance Instrument. Swallowing function was measured using the videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study. Experimental group showed more improved in the tongue strength (both anterior and posterior regions, P = 0·009, 0·015). In addition, the experimental group showed more improved scores on the oral and pharyngeal phase of VDS (P = 0·029, 0·007), but not on the PAS (P = 0·471), compared with the control group. This study demonstrated the effectiveness of TPRT in increasing tongue muscle strength and improving swallowing function in patients with post-stroke dysphagia. Therefore, we recommend TPRT as an easy and simple rehabilitation strategy for improving swallowing in patients with dysphagia.

摘要

舌功能会影响吞咽过程的口腔期和咽期,适当的舌肌力量对于安全的口咽吞咽至关重要。本试验研究了舌-腭阻力训练(TPRT)对吞咽困难的中风患者舌肌力量和口咽吞咽功能的影响。本试验采用为期4周的两组前后设计。参与者被分配到实验组(n = 18)或对照组(n = 17)。实验组进行4周的TPRT(每周5天)和传统吞咽困难治疗,而对照组按相同时间表进行传统吞咽困难治疗。使用爱荷华口腔功能仪器测量舌肌力量。基于视频荧光吞咽造影研究,使用视频荧光吞咽困难量表(VDS)和渗透-误吸量表(PAS)测量吞咽功能。实验组在舌肌力量方面(前后部区域均有改善,P = 0·009,0·015)改善更明显。此外,与对照组相比,实验组在VDS的口腔期和咽期得分改善更明显(P = 0·029,0·007),但在PAS上无明显改善(P = 0·471)。本研究证明了TPRT在增加中风后吞咽困难患者舌肌力量和改善吞咽功能方面的有效性。因此,我们推荐TPRT作为一种简单易行的康复策略,用于改善吞咽困难患者的吞咽功能。

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