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Rehabilitation Practice and Science

Translated Title

吞嚥運動強化及增進舌骨上肌群以改善中風患者吞嚥障礙及上食道括約肌功能異常：系統性文獻回顧

Abstract

Dysphagia often occurs in stroke patients, who may present oral, pharynx, and upper esophageal sphincter dysfunction, including insufficient chewing and stirring bolus ability, poor pharyngeal contraction, pharynx to upper esophageal sphincter incoordination, and relaxation of the upper esophageal sphincter. Insufficient opening of the upper esophageal sphincter is an obstacle for moving a bolus from the pharynx to the esophagus. In addition to provide swallowing training, most of the treatments for upper esophageal sphincter dysfunction are invasive. However, several non-invasive swallowing exercises have been published with the aim of treating upper esophageal sphincter dysfunction. The purpose of this article is to systematically reviewarticle the relevant literature on swallowing exercises that would be helpful for stroke patients with dysphagia in addition to strengthening or enhancing the function of suprahyoid muscles to improve dysphagia and upper esophageal sphincter dysfunction. Searching were conducted in databases including PubMed, Embase, Medline, Web of Science, and The Cochrane Library. Keywords were used included ＂Swallow interventions＂, ＂Insufficient opening＂, ＂Upper esophageal sphincter (UES)＂, ＂Suprahyoid muscle＂, ＂Swallowing exercises＂, ＂Dysphagia＂, ＂Deglutition disorders＂, ＂Swallowing training＂, ＂Speech therapy＂ and ＂Submental muscles＂. The search period extended from January 2008 to December 2020, and articles that met the inclusion criteria were selected for analysis and extract. A total of 27 articles were selected for analysis and extraction. Four major types of swallowing exercises were summarized; each type of swallowing exercise produces other similar swallowing exercises. Regardless of whether the subject is a healthy adult or stroke patient with dysphagia, after completing a period of training, swallowing exercises help increase the strength of the suprahyoid muscles, superior laryngeal movement, tongue strength, and cause an increase in the width of opening of the upper esophageal sphincter in addition to reducing residue after swallowing. The modern swallowing exercise provides another training option for therapists and patients with dysphagia. Conducting Shaker exercises and chin tuck against resistance or jaw opening exercises, could effectively enhance and strengthen suprahyoid muscles, laryngeal muscles, and other swallowing-related physiological manifestations, in addition to improving dysphagia or upper esophageal sphincter dysfunction in stroke patients with dysphagia. However, different swallowing exercises have their own advantages, disadvantages, and limitations. Swallowing assessment conducted by a speech therapist who chooses appropriate swallowing exercises for a patient and then modifies the exercises according to a patient's condition is necessary for those patients with dysphagia in order to help improve the symptoms of swallowing disorders.

Language

Traditional Chinese

First Page

17

Last Page

37

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