Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama City University, Japan.
Department of Otorhinolaryngology, Tokai University, 143 Shimokasuya, Isehara 259-1193, Kanagawa, Japan.
Auris Nasus Larynx. 2021 Apr;48(2):261-264. doi: 10.1016/j.anl.2020.09.007. Epub 2020 Sep 23.
This study aimed to investigate the association among swallowing function, hand grip strength, and peak expiratory flow in elderly patients with dysphagia.
A total of 35 patients (26 men and 9 women, 80.7 ± 8.1 years) were included in the final analysis. They underwent videoendoscopy (VE) for the assessment of swallowing function, hand grip strength test, and peak expiratory flow test. We used the Hyodo score, the objective scale of VE developed by Hyodo et al. (2010), which consists of the following 4 parameters: salivary pooling degree at the vallecula and pyriform sinuses, glottal closure reflex induced by touching of the endoscope to the epiglottis or arytenoid, swallowing reflex initiation assessed by "white-out" timing, and pharyngeal clearance after blue-dyed water is swallowed.
The Hyodo score significantly correlated to hand grip strength and peak expiratory flow, and hand grip strength was significantly correlated to peak expiratory flow. Although a significant correlation was noted between the Hyodo score and hand grip strength after adjustment for peak expiratory flow, no significant correlation was found between the Hyodo score and peak expiratory flow after adjustment for hand grip strength.
This study indicated that unlike peak expiratory flow, hand grip strength is associated with swallowing function, which was evaluated by an objective scale, and can be used as an indicator for whole body muscle strength. This result may contribute to the investigation of the effect of muscle training on dysphagia.
本研究旨在探讨吞咽功能、手握力和呼气峰流速在老年吞咽困难患者中的相关性。
最终共有 35 名患者(26 名男性,9 名女性;80.7±8.1 岁)纳入最终分析。他们接受了视频内镜(VE)评估吞咽功能、手握力测试和呼气峰流速测试。我们使用了由 Hyodo 等人(2010 年)开发的 VE 客观量表——Hyodo 评分,该量表由以下 4 个参数组成:会厌谷和梨状窝的唾液积聚程度、内镜触碰到会厌或杓状软骨时引起的声门关闭反射、通过“白屏”计时评估吞咽反射起始时间,以及吞下蓝色染色水后的咽部清除率。
Hyodo 评分与手握力和呼气峰流速显著相关,且手握力与呼气峰流速显著相关。尽管在调整呼气峰流速后,Hyodo 评分与手握力之间存在显著相关性,但在调整手握力后,Hyodo 评分与呼气峰流速之间无显著相关性。
本研究表明,与呼气峰流速不同,手握力与通过客观量表评估的吞咽功能相关,可作为全身肌肉力量的指标。这一结果可能有助于研究肌肉训练对吞咽困难的影响。