一项舌部阻力训练计划可改善轻度认知障碍体弱老年人的力量、耐力和吞咽功能：一项双盲随机对照试验。
A tongue resistance training program improves strength, endurance, and swallowing in frail older adults with mild cognitive impairment: a double-blind randomized controlled trial.
作者信息
Kao Shu-Hua, Chen Ruey, Su Pi-Yu, Banda Kondwani Joseph, Sung Chien-Mei, Wang Chia-Hui, Chiang Kai-Jo, Fajarini Melati, Chou Kuei-Ru
机构信息
School of Nursing, College of Nursing, Taipei Medical University, No.250, Wu-Hsing Street, Taipei, 110, Taiwan, R.O.C.
Department of Nursing Management, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
出版信息
Geroscience. 2025 May 29. doi: 10.1007/s11357-025-01715-5.
BACKGROUND
Age-associated decline in swallowing and tongue function is associated with mild cognitive impairment (MCI) and frailty. However, evidence regarding effectiveness of tongue resistance exercises in frail older adults with MCI is limited with methodological variations and lack of follow-up.
OBJECTIVE
To determine the effectiveness of a tongue resistance training program (TRTP) in improving tongue strength (anterior tongue strength [ATS] and posterior tongue strength [PTS]), tongue endurance (anterior tongue endurance [ATE] and posterior tongue endurance [PTE]), and swallowing pressure (saliva swallowing pressure [SSP] and effortful swallowing pressure [ESP]) in frail older adults with MCI.
METHODS
A prospective, double-blind, randomized controlled trial design. Participants were randomly assigned to TRTP (n = 23) or cheek-bulging exercises (n = 23). Generalized estimating equation model involving intention-to-treat approach was used for data analysis.
RESULTS
A total of 46 frail older adults with MCI were recruited (women: 80.0%; mean age: 75.7 ± 6.7 years). TRTP significantly improved ATS (β = 6.4; p = 0.016, 95%CI = 1.2-11.5), SSP (β = 12.5; p < 0.001, 95%CI = 9.2-15.9), and ESP (β = 14.2; p < 0.001, 95%CI = 9.3-19.0) at immediate posttest. However, no significant improvements were observed for PTS (β = 4.0; p = 0.231, 95%CI = - 2.6-10.6), ATE (β = - 4.5; p = 0.173, 95%CI = - 10.9-2.0), and PTE (β = 2.4; p = 0.489, 95%CI = - 4.5-9.4). At 12-week follow-up, sustained improvements were observed for SSP (β = 6.1; p < 0.001, 95%CI = 2.6-9.7) and ESP (β = 7.9; p < 0.001, 95%CI = 3.9-11.9). No significant short-term effects on ATS, PTS, ATE, and PTE (p > 0.05).
CONCLUSION
TRTP effectively improved ATS, SSP, and ESP in frail older adults with MCI. Future research should integrate progressive resistance exercises sustained isometric and isokinetic exercises, and task-specific training. Trial Registration Clincialtrials.gov: NCT06766487(2024.12.02).
背景
与年龄相关的吞咽和舌功能下降与轻度认知障碍（MCI）和衰弱有关。然而，关于舌抗阻训练对患有MCI的体弱老年人有效性的证据有限，存在方法学差异且缺乏随访。
目的
确定舌抗阻训练计划（TRTP）对改善患有MCI的体弱老年人的舌力量（前舌力量[ATS]和后舌力量[PTS]）、舌耐力（前舌耐力[ATE]和后舌耐力[PTE]）以及吞咽压力（唾液吞咽压力[SSP]和用力吞咽压力[ESP]）的有效性。
方法
采用前瞻性、双盲、随机对照试验设计。参与者被随机分配到TRTP组（n = 23）或鼓腮训练组（n = 23）。数据分析采用意向性分析的广义估计方程模型。
结果
共招募了46名患有MCI的体弱老年人（女性：80.0%；平均年龄：75.7±6.7岁）。TRTP在即时测试后显著改善了ATS（β = 6.4；p = 0.016，95%CI = 1.2 - 11.5）、SSP（β = 12.5；p < 0.001，95%CI = 9.2 - 15.9）和ESP（β = 14.2；p < 0.001，95%CI = 9.3 - 19.0）。然而，PTS（β = 4.0；p = 0.231，95%CI = - 2.6 - 10.6）、ATE（β = - 4.5；p = 0.173，95%CI = - 10.9 - 2.0）和PTE（β = 2.4；p = 0.489，95%CI = - 4.5 - 9.4）没有显著改善。在12周随访时，观察到SSP（β = 6.1；p < 0.001，95%CI = 2.6 - 9.7）和ESP（β = 7.9；p < 0.001，95%CI = 3.9 - 11.9）持续改善。对ATS、PTS、ATE和PTE没有显著短期影响（p > 0.05）。
结论
TRTP有效改善了患有MCI的体弱老年人的ATS、SSP和ESP。未来的研究应整合渐进性抗阻训练、持续等长和等速训练以及特定任务训练。试验注册Clinicaltrials.gov：NCT06766487（2024.12.02）。
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