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我们是否了解最常用的传统吞咽动作对颏下肌肉的长期影响?

Do We Know the Long-Term Effects of the Most Popular Traditional Swallow Maneuvers on the Submental Muscles?

作者信息

Söyler Ayşe Kübra, Kıylıoğlu Nefati, Serel Arslan Selen, Demir Numan, Gök Mustafa, Ertekin Ersen, Düger Tülin

机构信息

Faculty of Health Science, Physiotherapy and Rehabilitation, Aydın Adnan Menderes University, Aydın, Turkey.

Department of Neurology, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkey.

出版信息

J Oral Rehabil. 2025 Apr;52(4):412-419. doi: 10.1111/joor.13862. Epub 2024 Sep 30.

DOI:10.1111/joor.13862
PMID:39344429
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11934837/
Abstract

BACKGROUND

Various trainings focus on the submental muscles (SMs) for dysphagia rehabilitation because of their importance for swallowing safety and efficiency. According to the current literature, swallow-specific tasks may be optimal exercises for dysphagia. The effortful swallow (ES) and the Masako maneuver (MM) are the most commonly used swallow-specific tasks in the clinical settings for dysphagia for years, but long-term effects for these trainings is insufficient.

OBJECTIVES

This study aims to investigate and compare the effects of ES and MM on SM activity, strength and thickness.

METHODS

Thirty-seven healthy adults were randomised to ES, MM and control groups, and ES and MM groups completed 6 weeks of swallowing training. Participants in both training groups performed a total of 120 swallows in each session, while control group did not participate in any swallowing training. Surface electromyography was used to evaluate SM activity, digital dynamometer for SM strength and ultrasonography for SM thickness.

RESULTS

Both trainings did not change SM activity (p > 0.05), but increased SM strength (p < 0.05). MM increased the thickness of all SM (p < 0.05), and ES increased the thickness of mylohyoid (right, left) and digastric muscle (right) (p < 0.05), and there was no change in all evaluation parameters in the control group (p > 0.05). Also, trainings were not superior to each other in any parameter (p > 0.05).

CONCLUSION

The results of this study provided new evidence to the literature to show that ES and MM trainings are effective for improving SM strength and thickness. Considering that SM is important in terms of swallowing safety and effectiveness, it is thought that both trainings may be promising by increasing the strength and mass of SM, especially in individuals with reduced SM strength and mass.

摘要

背景

由于颏下肌(SMs)对吞咽安全和效率的重要性,各种训练都将重点放在颏下肌上以进行吞咽功能康复。根据当前文献,特定吞咽任务可能是吞咽功能障碍的最佳锻炼方式。多年来,用力吞咽(ES)和马萨科手法(MM)是临床吞咽功能障碍治疗中最常用的特定吞咽任务,但这些训练的长期效果并不充分。

目的

本研究旨在调查和比较ES和MM对颏下肌活动、力量和厚度的影响。

方法

37名健康成年人被随机分为ES组、MM组和对照组,ES组和MM组完成6周的吞咽训练。两个训练组的参与者每次训练共进行120次吞咽,而对照组不参与任何吞咽训练。使用表面肌电图评估颏下肌活动,用数字测力计评估颏下肌力量,用超声评估颏下肌厚度。

结果

两种训练均未改变颏下肌活动(p>0.05),但增加了颏下肌力量(p<0.05)。MM增加了所有颏下肌的厚度(p<0.05),ES增加了下颌舌骨肌(右侧、左侧)和二腹肌(右侧)的厚度(p<0.05),对照组所有评估参数均无变化(p>0.05)。此外,两种训练在任何参数上都没有优于对方(p>0.05)。

结论

本研究结果为文献提供了新的证据,表明ES和MM训练对提高颏下肌力量和厚度有效。考虑到颏下肌在吞咽安全和有效性方面的重要性,认为这两种训练通过增加颏下肌的力量和质量可能具有前景,尤其是在颏下肌力量和质量降低的个体中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79d7/11934837/10a1537d5e41/JOOR-52-412-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79d7/11934837/10a1537d5e41/JOOR-52-412-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79d7/11934837/10a1537d5e41/JOOR-52-412-g001.jpg

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本文引用的文献

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Surface electromyographic activity of submental muscles during different types of swallow-specific tasks: A comparative study.颏下肌在不同吞咽特定任务中的表面肌电活动:一项比较研究。
J Oral Rehabil. 2023 Jul;50(7):580-586. doi: 10.1111/joor.13448. Epub 2023 Mar 29.
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Functional Role of Suprahyoid Muscles in Bolus Formation During Mastication.咀嚼过程中舌骨上肌群在食团形成中的功能作用
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Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals.健康个体中舌抵吞咽对咽部收缩性能的影响。
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Systematic Effortful Swallowing Exercise Without External Resistance Does Not Increase Swallowing-Related Muscle Strength in the Elderly.系统用力吞咽训练不增加老年人吞咽相关肌肉力量,无需外部阻力。
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A Systematic Review of the Physiological Effects of the Effortful Swallow Maneuver in Adults With Normal and Disordered Swallowing.努力吞咽动作对正常和异常吞咽成人的生理影响的系统评价。
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