Efficacy of exercises to rehabilitate dysphagia: A critique of the literature

Langmore, Susan E.; Pisegna, Jessica M.

doi:10.3109/17549507.2015.1024171

Cited by 134 publications

(100 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Especially the combination of swallow and nonswallow exercises, leading to different activation patterns encountered during various swallowing circumstances, may be more effective . Obviously, the effortful swallow exercise of the current SEA‐based exercise protocol is in concordance with the specificity principle of neural plasticity . In addition, the muscle overload principle is applicable to the SEA exercises.…”

Section: Discussionmentioning

confidence: 99%

“…Typically, repetitive exercises are used based on methods applied in sports medicine . The exercises should be built on all principles (ie, specificity, individuality, and overload) that adhere to strength or endurance training . Swallowing is considered a submaximal muscular activity.…”

Section: Introductionmentioning

confidence: 99%

“…Although these results are promising, it remains to be demonstrated whether patients with chronic dysphagia in whom the targeted, often atrophied and/or fibrosed muscle groups are trainable with such a tool, and whether increased strength indeed has an impact on swallowing function. Many studies have tested the effects of training on normal, healthy individuals, but not in patients with dysphagia . Therefore, as a next step, a prospective clinical study was conducted in a cohort of patients with head and neck cancer with chronic, therapy‐resistant dysphagia, with the primary purpose to assess the feasibility and compliance, and the secondary purpose was to establish the short‐term efficacy of this SEA‐based strength‐training protocol.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Therapeutic options directly aimed at improving the contractile function of pharyngeal peristalsis are currently limited (5,21). These options may be necessary following muscle-weakening events like stroke, radiation therapy, and surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

Effects of laryngeal restriction on pharyngeal peristalsis and biomechanics: Clinical implications

Shaker

Sanvanson

Balasubramanian

et al. 2016

American Journal of Physiology-Gastrointestinal and Liver Physi

View full text Add to dashboard Cite

To date, rehabilitative exercises aimed at strengthening the pharyngeal muscles have not been developed due to the inability to successfully overload and fatigue these muscles during their contraction, a necessary requirement for strength training. The purpose of this study was to test the hypothesis that applying resistance against anterosuperior movement of the hyolaryngeal complex will overload the pharyngeal muscles and by repetitive swallowing will result in their fatigue manifested by a reduction in pharyngeal peristaltic amplitude. Studies were done in two groups. In group 1 studies 15 healthy subjects (age: 42 ± 14 yr, 11 females) were studied to determine whether imposing resistance to swallowing using a handmade device can affect the swallow-induced hyolaryngeal excursion and related upper esophageal sphincter (UES) opening. In group 2, an additional 15 healthy subjects (age 56 ± 25 yr, 7 females) were studied to determine whether imposing resistance to the anterosuperior excursion of the hyolaryngeal complex induces fatigue manifested as reduction in pharyngeal contractile pressure during repeated swallowing. Analysis of the video recordings showed significant decrease in maximum deglutitive superior laryngeal excursion and UES opening diameter ( P < 0.01) due to resistive load. Consecutive swallows against the resistive load showed significant decrease in pharyngeal contractile integral (PhCI) values ( P < 0.01). Correlation analysis showed a significant negative correlation between PhCI and successive swallows, suggesting “fatigue” ( P < 0.001). In conclusion, repeated swallows against a resistive load induced by restricting the anterosuperior excursion of the larynx safely induces fatigue in pharyngeal peristalsis and thus has the potential to strengthen the pharyngeal contractile function.

show abstract

“…We hypothesized that post-training water swallows would have longer LVC durations than pre-training water swallows, given the focus of LVC prolongation during vLVC training. The outcome of this study is significant because it begins to address a relevant, published concern that dysphagia exercises may not lead to improvement of swallowing function (Langmore, 1995; Langmore & Pisegna, 2015). Understanding whether swallowing maneuver training can immediately transfer to natural swallowing behavior post training (generalization) is a critical first step toward improving the efficacy of dysphagia rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults

Guedes

Azola

Macrae

et al. 2017

Physiology & Behavior

View full text Add to dashboard Cite

Swallowing maneuvers are routinely trained in dysphagia rehabilitation with the assumption that practiced behaviors transfer to functional swallowing, however transfer is rarely examined in the deglutition literature. The goal of this study was to train the volitional laryngeal vestibule closure (vLVC) maneuver, which is a swallowing maneuver that targets prolonged laryngeal vestibule closure (LVC). In two different training experiments, 69 healthy adults underwent Long-hold (hold vLVC as long as possible) or Short-hold vLVC training (hold vLVC for 2 seconds). Before and after vLVC training, natural swallows (swallowing without a therapeutic technique) were completed. The outcome variables included laryngeal vestibule closure reaction time and the duration of laryngeal vestibule closure. Results indicate that during both Long-hold and Short-hold vLVC trainings, vLVC swallows had faster laryngeal vestibule closure reaction times and longer durations of laryngeal vestibule closure than in pre-training 5ml liquid swallows. However, only faster laryngeal vestibule closure reaction times transferred to post-training 5ml liquid swallows (20–24% faster), but not prolonged durations of laryngeal vestibule closure. Our findings suggest that swallowing maneuver training has the potential to induce transfer of what was practiced to functional swallowing behavior, although not all practiced behaviors may generalize. These findings are significant for bolstering the effectiveness of dysphagia management medical settings and should be tested in individuals with dysphagia.

show abstract

Efficacy of exercises to rehabilitate dysphagia: A critique of the literature

Abstract: Only a minority of exercises prescribed for patients with dysphagia have sufficient evidence for long-term improvement in swallowing.

Cited by 134 publications

References 39 publications

Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors

Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors

Effects of laryngeal restriction on pharyngeal peristalsis and biomechanics: Clinical implications

Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults

Contact Info

Product

Resources

About