改善身体机能可通过增强急性心力衰竭患者的舌肌力量来减少吞咽困难：两波交叉滞后中介模型分析。

Improving physical performance reduces dysphagia via improvement of tongue strength in patients with acute heart failure: a two-wave cross-lagged mediation model analysis.

机构信息

Division of Comprehensive Rehabilitation Sciences, Hirosaki University Graduate School of Health Sciences, 66-1, Hon-Cho, Hirosaki, Aomori, 036-8564, Japan.

Department of Clinical Research, National Hospital Organization Sendai Medical Center, Sendai, Japan.

出版信息

Aging Clin Exp Res. 2023 Oct;35(10):2237-2246. doi: 10.1007/s40520-023-02485-w. Epub 2023 Jul 18.

DOI:10.1007/s40520-023-02485-w

PMID:37462898

Abstract

BACKGROUND

Physical performance improvement through whole-body exercise may have a positive impact on dysphagia via improvement of maximum tongue pressure (MTP).

AIMS

The present study aimed to quantitatively analyze whether improvement in physical performance reduces dysphagia by improving MTP in patients with acute heart failure (AHF).

METHODS

A total of 146 patients with AHF and dysphagia were included. Dysphagia was defined as a functional oral intake scale (FOIS) score < 6. The short physical performance battery (SPPB) indexed physical performance. A two-wave cross-lagged mediation model was used to examine whether an improvement in SPPB results improves the FOIS score via an improvement in MTP. The SPPB, MTP, and FOIS scores (T1: baseline, T2: hospital discharge) were included in the model.

RESULTS

A total of 146 patients were included in the final analysis. The SPPB result at T1 positively affected MTP (β = 0.150, P = 0.030) and the FOIS score (β = 0.249, P = 0.002) at T2. MTP at T1 also positively affected the FOIS score at T2 (β = 0.189, P = 0.026). Furthermore, the SPPB result indirectly affected the FOIS score by affecting the MTP (indirect effect = 0.028; 95% CI = 0.010, 0.078).

DISCUSSION

This study contributes to the knowledge base regarding the potential of exercise therapy as a new treatment strategy for dysphagia in patients with AHF.

CONCLUSION

An improvement in SPPB results improved the FOIS score by improving the MTP in patients with AHF.

摘要

背景

全身运动改善身体机能可能会通过提高最大舌压（MTP）对吞咽困难产生积极影响。

目的

本研究旨在通过分析急性心力衰竭（AHF）患者的身体机能改善是否通过提高 MTP 来降低吞咽困难，从而定量分析这一问题。

方法

共纳入 146 例 AHF 合并吞咽困难患者。吞咽困难定义为功能性口腔摄入量表（FOIS）评分＜6。短体适能测试（SPPB）评估身体机能。采用两波交叉滞后中介模型，检验 SPPB 结果的改善是否通过 MTP 的改善来提高 FOIS 评分。模型纳入 SPPB、MTP 和 FOIS 评分（T1：基线，T2：出院时）。

结果

共纳入 146 例患者进行最终分析。T1 的 SPPB 结果对 T2 的 MTP（β=0.150，P=0.030）和 FOIS 评分（β=0.249，P=0.002）具有正向影响。T1 的 MTP 也对 T2 的 FOIS 评分具有正向影响（β=0.189，P=0.026）。此外，SPPB 结果通过影响 MTP 对 FOIS 评分产生间接影响（间接效应=0.028；95%CI=0.010，0.078）。