Mitchell Samantha S, Fujiki Robert Brinton, Oliver Abby J, Craig Bruce A, Malandraki Georgia A
Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN.
Department of Statistics, Purdue University, West Lafayette, IN.
J Speech Lang Hear Res. 2025 Aug 12;68(8):3759-3770. doi: 10.1044/2025_JSLHR-24-00790. Epub 2025 Jul 11.
The head lift exercise (HLE) and recline exercise (RE) are rehabilitative exercises that have been shown to elicit similar biomechanical swallowing changes in older adults. However, the neuromuscular mechanisms underlying these changes are unknown and could elucidate the physiological mechanisms these exercises target.
A randomized clinical trial with two arms-a 6-week HLE or RE regimen-was conducted. Data were collected on older adults pre- and posttreatment and at 6-week follow-up using videofluoroscopic swallow studies (VFSSs) and surface electromyography (sEMG). Results of the VFSS showing similar hyolaryngeal excursion gains post both regimens have been published. This follow-up study presents the sEMG data and includes data from 18 older adults (age range: 60-82 years; HLE = 9, RE = 9) from the pre- and posttreatment time points. sEMG activity measures (normalized mean amplitude, burst duration, and time to peak sEMG amplitude) were collected from submental muscles during standardized swallow tasks.
Normalized mean amplitude, burst duration, and time to peak amplitude during swallowing did not significantly change posttreatment for either group. Post hoc correlational analysis of percent change between outcome measures from pre- to posttreatment revealed a strong negative relationship between normalized mean amplitude and time to peak amplitude for liquids ( = -.926, = .0001) and pudding ( = -.901, = .0001), indicating that participants who required greater levels of muscular contraction to functionally swallow posttreatment may need less time to reach that contraction level and vice versa.
In combination with the Fujiki, Oliver, Malandraki, et al. (2019) results, these findings support that older adults show improvements in anterior and superior hyoid excursion post both HLE and RE without the need for greater submental musculature contraction. The inverse relationship identified post hoc between the percent change of amplitude and time to peak amplitude may indicate different neuromuscular mechanisms for biomechanical gains and needs further exploration for future personalized treatments.
抬头运动（HLE）和斜躺运动（RE）是康复运动，已被证明能在老年人中引发相似的生物力学吞咽变化。然而，这些变化背后的神经肌肉机制尚不清楚，可能会阐明这些运动所针对的生理机制。
进行了一项双臂随机临床试验，采用为期6周的HLE或RE方案。在治疗前和治疗后以及6周随访时，使用视频荧光吞咽造影研究（VFSS）和表面肌电图（sEMG）收集老年人的数据。VFSS显示两种方案后舌骨喉运动增益相似的结果已发表。这项随访研究展示了sEMG数据，并包括来自18名老年人（年龄范围：60 - 82岁；HLE组 = 9人，RE组 = 9人）治疗前和治疗后时间点的数据。在标准化吞咽任务期间，从颏下肌肉收集sEMG活动测量值（归一化平均振幅、爆发持续时间和sEMG振幅峰值时间）。
两组治疗后吞咽期间的归一化平均振幅、爆发持续时间和振幅峰值时间均无显著变化。对治疗前至治疗后结果测量值之间变化百分比的事后相关分析显示，液体（r = -.926，p = .0001）和布丁（r = -.901，p = .0001）的归一化平均振幅与振幅峰值时间之间存在强烈的负相关，表明治疗后功能性吞咽需要更高水平肌肉收缩的参与者可能需要更少的时间来达到该收缩水平，反之亦然。
结合藤木、奥利弗、马兰德拉基等人（2019年）的结果，这些发现支持老年人在HLE和RE后舌骨向前和向上运动均有改善，而无需颏下肌肉组织更大程度的收缩。事后确定的振幅变化百分比与振幅峰值时间之间的反比关系可能表明生物力学增益的不同神经肌肉机制，需要进一步探索以用于未来的个性化治疗。
