Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA.
College of Health Sciences Physical Therapy, Marquette University Milwaukee, Milwaukee, WI, USA.
Neurogastroenterol Motil. 2018 Oct;30(10):e13382. doi: 10.1111/nmo.13382. Epub 2018 Jun 29.
Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty- and age-related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly.
A total of 28 volunteers (75 + 7 years; 17 females) with no complaint of dysphagia were studied using video fluoroscopy before and after 6 weeks of the swallow strength training exercise. Eighteen of these volunteers also underwent high-resolution pharyngeal manometry non-concurrent with fluoroscopy. Ten additional volunteers (81 + 6 years; 9 females) were studied by videofluoroscopy before and after 6 weeks of a sham exercise.
Swallow resistance exercise but not the sham exercise resulted in a significant increase in maximum upper esophageal sphincter opening (P < .01), superior and anterior laryngeal excursion (P < .01) as well as posterior pharyngeal wall thickness (P < .01). Resistance exercise but not sham exercise also resulted in a significant increase in deglutitive pharyngeal contractile integral (P < .01).
CONCLUSIONS & INFERENCES: Strength training of muscles involved in the pharyngeal phase of swallowing using the swallowing against laryngeal restriction technique is feasible and significantly improves key physiologic features of the pharyngeal phase of swallowing. These findings provide the basis for consideration of developing an exercise-based swallow health maintenance program for the elderly swallow health maintenance program for the elderly.
最近的研究表明,与虚弱和年龄相关的肌肉无力相关的口咽吞咽困难患病率很高。力量训练运动已被提倡用于老年人的运动健康维护,并显示出积极的结果。由于参与口咽吞咽阶段的肌肉也包括横纹肌,因此本研究的目的是确定一种新型阻力训练计划,即吞咽对抗喉限制(SALR),对口咽吞咽阶段吞咽的生物力学影响。
共 28 名志愿者(75+7 岁;17 名女性)在接受 6 周吞咽力量训练前后使用视频荧光透视进行了研究,他们没有吞咽困难的抱怨。其中 18 名志愿者还接受了与荧光透视非同期的高分辨率咽测压。另外 10 名志愿者(81+6 岁;9 名女性)在接受 6 周假运动前后通过荧光透视进行了研究。
吞咽阻力运动而不是假运动导致最大食管上括约肌开口显著增加(P<0.01)、喉上和前运动(P<0.01)以及后咽壁厚度(P<0.01)。吞咽阻力运动而不是假运动也导致吞咽时咽收缩积分显著增加(P<0.01)。
使用吞咽对抗喉限制技术对参与吞咽口咽阶段的肌肉进行力量训练是可行的,并且显著改善了口咽吞咽阶段的关键生理特征。这些发现为开发针对老年人吞咽健康维护的基于运动的吞咽健康维护计划提供了依据。