Esophageal dysphagia and reflux symptoms before and after oral IQoro<sup>R</sup>training

Objectives: Lip-seal strength, which represents the muscle strength of the lips, appears to chiefly contribute to mastication and pronunciation. However, the functional characteristics of lip-seal strength in adults are still undefined. The present study aimed to understand not only the distribution of lip-seal strength in adult men and women but also the effect of age on this strength and identify oral motor functions correlated with lip-seal strength. Materials and methods:The subjects included 339 participants (men: 170, age 39.2 ± 18.2 years; women: 169, age 43.1 ± 19.7 years). Oral motor function was evaluated for lip-seal strength, oral diadochokinesis (ODK), tongue pressure, occlusal force, and masticatory performance. Statistical analyses included the Shapiro-Wilk, Mann-Whitney U, and Jonckheere-Terpstra tests, in addition to the Spearman's correlation analysis and curvilinear regression analysis.Results: Lip-seal strength did not have a normal distribution (p < 0.001). The mean ± standard deviation and median (first quartile, third quartile) of lip-seal strength were 11.2 ± 3.4 and 10.9 (8.7, 13.2)N for the whole sample, 12.3 ± 3.4 and 11.9 (9.4, 14.4)N for men, and 10.2 ± 3.0 and 9.9 (8.0, 12.0)N for women. A significant difference was observed in lip-seal strength between men and women (p < 0.001). Oral motor functions showed a marked correlation with lip-seal strength, including tongue pressure, occlusal force, and masticatory performance and ODK (/pa/ and /ta/), tongue pressure, and masticatory ability in men and women, respectively. In women, lip-seal strength declined with increase in age.Conclusions: Lip-seal strength was non-normally distributed in both men and women, and lip-seal strength was affected by age only in women. Lip-seal strength and multiple oral motor functions were significantly correlated. Because the indicators of perioral muscle strength and performance were correlated with lip-seal strength, lip-seal strength may also partially reflect the condition of the perioral muscles.

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“…Lip muscle strength can be improved by training (Fujiwara et al, 2016;Hägg et al, 2015;Hägglund et al, 2020;Kaede et al, 2016;Oki et al, 2021)…”

Section: Discussionmentioning

confidence: 99%

Distribution of lip‐seal strength and its relation to oral motor functions

Kugimiya

Oki

Ohta

et al. 2021

Clinical & Exp Dental Res

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“…This device is designed to strengthen the facial muscles [21], the oropharyngeal muscles, and the esophageal muscles [22]. Moreover, it increases activity in all muscles, from the lips down to the diaphragm [22]. The training protocol specifies using the device actively for 30 s, three times a day, before meals.…”

Section: Methodsmentioning

confidence: 99%

Study protocol for the SOFIA project: Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial

et al. 2017

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BackgroundExtensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia).Methods/DesignThis project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality.Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT <10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups.DiscussionThe results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.Trial registrationThis trial was retrospectively registered at ClinicalTrials.gov, on July 4, 2016, identifier: NCT02825927.

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“…Neuromuscular exercise is a safe, natural and simple treatment that can be carried out by the patient his or herself, and the underlying cause of the reflux is proven to be treated in 97% [16][17][18] of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Continual pH-monitoring is also used to measure prevalence of acidic reflux but does not aim to identify its cause. Scientific studies [16][17][18] have looked at treatment of HH. When recruiting patients to these studies the researchers have always distinguished between those with the symptoms of a HH and a confirmed diagnosis; and those with the symptoms but no confirmation.…”

Section: Hiatus Hernia: the Root Cause Of Refluxmentioning

confidence: 99%

“…In all three studies [16][17][18] quoted here the patients were long-term users of PPI medication before the studies began. In a Medtech Innovation Briefing [21] produced by the UK's National Institute for Health and Care Excellence in 2019 they quoted, "all patients continued with their PPI medication as advised.…”

Section: Scientific Evidence Of the Effectiveness Of Neuromuscular Treatmentmentioning

confidence: 99%

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Introducing an Innovative Oral Neuromuscular Treatment of the Underlying Reason for Reflux Caused by Hiatus Hernia: An Aggravating Factor in Esophagitis

Hägg¹,

Franzen²

2021

Esophagitis and Gastritis - Recent Updates

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Esophagitis is a debilitating disease often leading to more serious conditions. It is aggravated by refluxed stomach acids for which the usual treatment is PPI drugs that at best treat the symptoms, not the underlying cause of reflux. Surgical interventions address the root - Hiatal muscular incompetence - but are invasive and expensive. Both treatments have proven unwanted side-effects. Neuromuscular treatment is a new and innovative alternative that addresses the root cause of reflux. The science and evidence behind this treatment is presented here. Reflux cannot happen when the diaphragm functions properly and maintains adequate pressure in the Hiatal canal, otherwise the neck of the stomach can intrude through the diaphragm into the chest cavity allowing reflux and conditions such as GERD, LPR, silent reflux, dyspepsia and more. This is especially common at night, when in bed. Training with a simple and inexpensive neuromuscular medical device takes 90 seconds per day, self-administered by the patient without medication or surgical intervention. No negative side effects are recorded for this treatment. Currently, 40 000 individuals have treated with the device. It is deployed in healthcare institutions in several countries and is recognised in the UK by NICE in a briefing to the NHS as a treatment for Hiatal hernia.

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Esophageal dysphagia and reflux symptoms before and after oral IQoro^Rtraining

Abstract: Oral IQS training can relieve/improve esophageal dysphagia and reflux symptoms in adults, likely due to improved hiatal competence.

Cited by 10 publications

References 19 publications

Distribution of lip‐seal strength and its relation to oral motor functions

Distribution of lip‐seal strength and its relation to oral motor functions

Study protocol for the SOFIA project: Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial

Introducing an Innovative Oral Neuromuscular Treatment of the Underlying Reason for Reflux Caused by Hiatus Hernia: An Aggravating Factor in Esophagitis

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Esophageal dysphagia and reflux symptoms before and after oral IQoroRtraining

Abstract: Oral IQS training can relieve/improve esophageal dysphagia and reflux symptoms in adults, likely due to improved hiatal competence.

Cited by 10 publications

References 19 publications

Distribution of lip‐seal strength and its relation to oral motor functions

Distribution of lip‐seal strength and its relation to oral motor functions

Study protocol for the SOFIA project: Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial

Introducing an Innovative Oral Neuromuscular Treatment of the Underlying Reason for Reflux Caused by Hiatus Hernia: An Aggravating Factor in Esophagitis

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Esophageal dysphagia and reflux symptoms before and after oral IQoro^Rtraining