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Background: Tongue‐strengthening exercises may be used at home to strengthen swallowing‐related oropharyngeal muscles in community‐dwelling older adults with sarcopenic dysphagia; however, evidence of their effectiveness remains unclear. Objective: This study aimed to investigate the effects of a home‐based tongue‐strengthening exercise (hTSE) using portable tool on swallowing‐related oropharyngeal muscles in community‐dwelling older adults with sarcopenic dysphagia. Methods: Forth community‐dwelling older adults with sarcopenic dysphagia were enrolled in the study. The participants were randomly assigned to the experimental and control groups. 1‐Repetition Maximum (1‐RM) of tongue muscle was measured in the experimental group using the Iowa Oral Performance Instrument, and hTSE was performed using a portable tool with an intensity corresponding to approximately 70%–80% of the range based on the 1‐RM value (90 times/day, 5 days/week, for 8 weeks). The control group did not perform any tongue exercises. The primary outcome measures were tongue strength and thickness. The secondary outcome measure was suprahyoid muscle strength (digastric and mylohyoid muscles). Results: The experimental group showed significantly greater increases in suprahyoid muscle (mylohyoid and digastric) thickness (p =.01 and.011, d = 1.0 and.55), as well as tongue strength and thickness (p <.001 and.029, d = 2.2 and.6) than the control group. Conclusion: This study confirmed that hTSE using a portable tool is effective in increasing swallowing‐related oropharyngeal muscle activity in older adults with sarcopenic dysphagia. Therefore, hTSE is recommended as an inexpensive, safe, and easy‐to‐use therapy for sarcopenic dysphagia in older adults. [ABSTRACT FROM AUTHOR]

Recently, a therapeutic method to stimulate the suprahyoid muscle using peripheral magnetic stimulation for dysphagia rehabilitation has been reported. However, clinical evidence, application protocol, and intervention method remain unclear. Therefore, a systematic review of the published literature is needed. The objective of this study was to systematically review clinical studies of peripheral magnetic stimulation applied for rehabilitation of dysphagia. Issues to be considered in future studies are also suggested. This systematic review performed a literature search of four databases (Medline, Embase, CINAHL, and Web of Science) to identify relevant studies published on the application of repetitive peripheral magnetic stimulation (rPMS) for swallowing-related muscles between 2010 and 2022. Seven studies were reviewed. Randomized controlled trials and one-group pre–post, case study designs were included. In the included studies, rPMS was applied to strengthen the submental suprahyoid muscles. The intervention regime varied. The rPMS was applied at a frequency of 30 Hz for 2 s. Rest time ranged from 8 s to 27–28 s. The number of intervention sessions ranged from 2–3 to 30. The intensity ranged from pain-inducing minimum intensity (90% of maximum stimulus output) to non-painful intensity (70–80% of maximum intensity). The rPMS on the suprahyoid muscles had positive effects on physiological changes in the swallowing function, such as displacement of the hyoid bone, muscle strength (cervical flexor, jaw-opening force), swallowing safety, swallowing performance, and swallowing-related quality of life. Participants also reported little pain and adverse reactions during rPMS. Although rPMS is a therapeutic option that can help improve the swallowing function as a non-invasive stimulation method in the rehabilitation of dysphagia, clinical evidence is needed for the development of clear stimulation protocols and guidelines. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the effects of neuromuscular electrical stimulation (NMES) on oropharyngeal swallowing function according to 2 types of placement, acting as assistance and as resistance, in stroke patients with dysphagia. METHODS: Thirty-eight stroke patients with dysphasia were randomly assigned to the suprahyoid group (SMG), or infrahyoid muscle group (IMG); 26 patients completed the intervention and were included in the analysis. In the SMG, the electrodes were placed on the region between the jaw and the hyoid bone, whereas in the IMG, the electrodes were placed on the region below the hyoid for the targeted infrahyoid muscles. Both groups received NMES for 30 min/d, 5 d/wk, for 4 weeks and conventional dysphagia therapy. Swallowing function was measured using the Videofluoroscopic Dysphagia Scale and Penetration-Aspiration Scale based on videofluoroscopic swallowing study. Oral dietary intake was measured using the Functional Oral Intake Scale. RESULTS: Both groups showed significant improvements in oropharyngeal function and level of functional oral intake, but there was no significant difference between the two groups. However, the SMG showed a more reduced penetration-aspiration, compared with the IMG. CONCLUSIONS: Altogether, these data demonstrate that 2 types of NMES placements have a similar effect on improving swallowing function and oral diet intake in patients with dysphagia. [ABSTRACT FROM AUTHOR]

BACKGROUND: The resistive jaw opening exercise (RJOE) was suggested as a potential remedial treatment for patients with dysphagia. However, clinical evidence is insufficient. OBJECTIVE: To investigate the effect of RJOE on hyoid bone movement, aspiration, and oral intake level in stroke patients with dysphagia. METHODS: Forty stroke patients with dysphagia were randomly allocated into either the experimental group (n = 20) or placebo group (n = 20). The experimental group performed RJOE using a portable device, while the placebo group performed RJOE using a sham device with fewer loads. Intervention was conducted 5 times a week for 4 weeks. Hyoid bone movement was analyzed by two-dimensional analysis of anterior and superior motion based on a videofluoroscopic swallowing study. Aspiration was assessed using a penetration-aspiration scale (PAS), and oral intake level was assessed using the functional oral intake scale (FOIS). RESULTS: Both groups showed statistically significant differences in hyoid movement, PAS, and FOIS scale (p < 0.05). However, after the intervention, there was no significant difference between the two groups except for the liquid type of PAS. Effect sizes (Cohen's d) were 0.9 and 0.7, 0.6 and 0.6, and 1.1 for the anterior and superior movement of the hyoid bone, semisolid and liquid type of PAS, and FOIS scale respectively. CONCLUSIONS: This study suggests that RJOE helps in hyoid movement, aspiration reduction, and oral intake in patients with dysphagia after stroke. [ABSTRACT FROM AUTHOR]

Background: Chin tuck against resistance exercise was recently reported as a novel method for improving the swallowing function of patients with post‐stroke dysphagia. However, as this exercise involves holding and fixing the device using the hand, physically weak patients may find it difficult to perform it. Objectives: This study aimed to investigate the effect of modified chin tuck against resistance (mCTAR) exercise on patients with post‐stroke dysphagia. Methods: In total, 30 patients with dysphagia were recruited in this study. They were randomly assigned to either the experimental or control group. The experimental group performed mCTAR exercise and received traditional dysphagia treatment, whereas the control group received only traditional dysphagia treatment. mCTAR exercise involved isometric and isotonic exercises. Aspiration and oral diet were evaluated using penetration‐aspiration scale (PAS) and functional oral intake scale (FOIS), respectively. Moreover, the rate of nasogastric tube removal was analysed. Results: Compared with the control group, the experimental group showed statistically significant improvement in PAS and FOIS (P < 0.001, both). The rates of nasogastric tube removal were 25% and 15% in the experimental and control groups, respectively. Conclusion: This study demonstrated that mCTAR exercise can reduce aspiration and improve dietary levels in patients with post‐stroke dysphagia. Therefore, mCTAR exercise is expected to be beneficial for physically vulnerable patients with dysphagia who have limited hand strength and range of motion. [ABSTRACT FROM AUTHOR]

Background: Effortful swallowing training (EST) is a remedial method for the training of swallowing‐related muscles in the oropharyngeal phase. However, clinical evidence of its effectiveness is insufficient. Aims: To investigate the effects of EST on tongue strength and swallowing function in patients with stroke. Methods & Procedures: Stroke patients with dysphagia were randomly assigned to one of two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group underwent EST, while the control group performed saliva swallowing. Training was conducted 5 days per week for 4 weeks. Both groups underwent conventional dysphagia treatment for 30 min/day, 5 days/week for 4 weeks. Outcomes & Results: Tongue strength was assessed using the Iowa Oral Performance Instrument. The Videofluoroscopic Dysphagia Scale (VDS), based on a videofluoroscopic swallowing study, was used to analyze oropharyngeal swallowing function. The experimental group showed greater improvements in anterior and posterior tongue strength compared with the control group (p = 0.046 and 0.042, respectively), and greater improvement in the oral phases of the VDS (p = 0.017). Conclusions & Implications: We recommend EST as a remedial strategy for improving tongue strength and oral swallowing function in patients with stroke. [ABSTRACT FROM AUTHOR]

BACKGROUND: Neuromuscular electrical stimulation has been used to improve swallowing function in neurologic patients with dysphagia, but its effect on patients with dysphagia and Parkinson’s disease remains unclear. OBJECTIVES: This study aimed to identify the effect of effortful swallowing combined with neuromuscular electrical stimulation as a novel treatment approach in dysphagic patients with Parkinson’s disease. METHODS: Participants were randomly allocated to an experimental group (n = 9) or a placebo group (n = 9). The experimental group simultaneously received neuromuscular electrical stimulation with effortful swallowing, while the placebo group received sham neuromuscular electrical stimulation with effortful swallowing. All participants received the treatment for 30 min/day at five sessions per week for 4 weeks. Both groups also received the same conventional dysphagia therapy. RESULTS: The experimental group showed significant differences in horizontal movement (p = 0.038) and vertical movement (p = 0.042) compared to the placebo group, but showed no significant differences in the oral (p = 0.648) or pharyngeal phase (p = 0.329) of the Videofluoroscopic Dysphagia Scale compared to the placebo group, except for the Penetration-Aspiration Scale (p = 0.039). CONCLUSIONS: We demonstrated that neuromuscular electrical stimulation applied to the infrahyoid region combined with effortful swallowing effectively increased hyoid bone movement and reduced aspiration in dysphagic patients with Parkinson’s disease. [ABSTRACT FROM AUTHOR]

BACKGROUND: Recently, chin tuck against resistance exercise (CTAR) has been reported as a remedial treatment for pharyngeal dysphagia. However, the clinical evidence of the effect is still lacking. OBJECTIVE: This study investigated the effect of CTAR on the swallowing function in patients with dysphagia following subacute stroke. METHODS: The patients were randomly assigned to an experimental (n = 11) or a control group (n = 11). The experimental group performed CTAR using the CTAR device. The control group received only conventional dysphagia treatment. Both groups received training on five days a week, for four weeks. The swallowing function was measured using functional dysphagia scale (FDS) and penetration-aspiration scale (PAS), based on a videofluoroscopic swallowing study (VFSS). RESULTS: The experimental group showed more improvements in the oral cavity, laryngeal elevation/epiglottic closure, residue in valleculae, and residue in pyriform sinuses of FDS and PAS compared to the control group (p < 0.05, all). CONCLUSIONS: This study demonstrated that CTAR is effective in improving the pharyngeal swallowing function in patients with dysphagia after stroke. Therefore, we recommend CTAR as a new remedial training alternative to HLE. [ABSTRACT FROM AUTHOR]

Background: It has recently been shown that suprahyoid muscle exercise using kinesiology taping (KT) increases the activation of the suprahyoid muscle in healthy adults, suggesting a potential therapeutic clinical exercise for dysphagia rehabilitation. This study investigated the effect of dysphagia rehabilitation using KT in stroke patients with dysphagia. Methods: Thirty subjects in South Korea were enrolled in this prospective placebo-controlled double-blind study. Participants were randomly assigned to the experimental and sham groups. In the experimental group, the tape was attached to the hyolaryngeal complex, pulled downward with approximately 70% tension, and then attached to the sternum and the clavicle bilaterally. In the sham group, the tape was applied similarly but without the tension. Both groups performed voluntary swallowing 50 times (10 times swallowing per set, times 5 sets) a day for 4 weeks with KT applied. Outcome measures were assessed using portable ultrasound equipment. The parameter measured was the change in thickness of the tongue muscle, mylohyoid muscle, and the anterior belly of the digastric muscle. Results: The experimental group showed statistically significant changes in the thickness of the tongue muscle, mylohyoid muscle, and anterior belly of the digastric muscle than the sham group (p = 0.007, 0.002, and 0.001). Conclusion: Dysphagia rehabilitation using KT is a technique that may promote oropharyngeal muscle thickness in patients with dysphagia after stroke. [ABSTRACT FROM AUTHOR]