School of Medicine, The University of Notre Dame, Fremantle, Western Australia 6160, Australia.
Department of Speech Pathology, Royal Perth Hospital, Perth, Western Australia, Australia.
Neuromuscul Disord. 2020 Apr;30(4):294-300. doi: 10.1016/j.nmd.2020.02.010. Epub 2020 Feb 24.
Inclusion Body Myositis (IBM) is the most common acquired myopathy in older individuals with more than two thirds of patients experiencing impaired swallowing. There are currently no standardized exercise therapies to improve or sustain swallowing despite good evidence for exercise therapy in limb muscles. Reduced upper esophageal sphincter opening is a common abnormality associated with dysphagia in IBM. This pilot study recruited IBM patients with abnormal upper esophageal sphincter function and dysphagia into an exercise program. It was hypothesized that regular practice using the Expiratory Muscle Strength Trainer (EMST) device would improve hyolaryngeal movement by strengthening suprahyoid musculature and facilitate opening of the upper esophageal sphincter thereby improving swallowing and quality of life. Overall, IBM patients who used the EMST device demonstrated no improvement in swallowing function. Consistent with that result, there was also no change in measures of quality of life. However, further studies are needed to elucidate whether it has a preventative role in the development or progression of dysphagia in IBM as there is a suggestion that patients with a shorter duration of disease may have had some benefit. This research provides pilot data and recommendations that will guide future studies on exercise therapy and swallowing in this area.
包涵体肌炎（IBM）是老年人中最常见的获得性肌病，超过三分之二的患者存在吞咽功能受损。尽管有充分的证据表明运动疗法对肢体肌肉有益，但目前仍没有标准化的运动疗法来改善或维持吞咽功能。上食管括约肌（UES）开口减少是与 IBM 相关的吞咽困难的常见异常。这项初步研究招募了上食管括约肌功能异常和吞咽困难的 IBM 患者参加运动计划。研究假设，使用呼气肌力量训练器（EMST）设备进行定期练习可以通过增强颏舌骨肌来改善舌骨和喉的运动，从而促进上食管括约肌的开放，从而改善吞咽功能和生活质量。总的来说，使用 EMST 设备的 IBM 患者的吞咽功能没有改善。与该结果一致，生活质量的衡量标准也没有变化。然而，需要进一步的研究来阐明它在 IBM 患者吞咽困难的发展或进展中是否具有预防作用，因为有迹象表明疾病持续时间较短的患者可能会从中受益。这项研究提供了初步数据和建议，将为该领域的运动疗法和吞咽研究提供指导。
