Lip muscle training in stroke patients with dysphagia

Hägg, Mary; Anniko, Matti

doi:10.1080/00016480701813814

Cited by 67 publications

(84 citation statements)

References 12 publications

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“…The PP group had an individual adjusted PP inserted in the upper jaw 3 times per day for 10-30 minutes before eating [15]. In the OS group, a standardized OS was inserted behind closed lips [17] for 5-10 s, 3 times per session before eating, 3 times daily. Verbal, practical, and written instructions about the training were given to the patients, relatives, or care assistants.…”

Section: Training Designmentioning

confidence: 99%

“…It improves the contact between tongue and palate, raises the tip of the tongue, helps the tongue to contract upward and backward, activates the levator anguli oris muscles (VII), the zygomaticus minor and major muscles, and the buccinator muscles, thus indirectly improving oropharyngeal swallowing [10,14,25]. PP was the first to be applied to sensorimotor training in dysphagia studies [14,15]; the OS device has more recently been introduced [16,17,21]. The OS training (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…The PP and OS training appliances are aimed at triggering the four different sensory cranial nerves (V, VII, IX and X) of oropharynx involved in deglutition. Through the afferent paths the signals will be sent to the swallowing *Address correspondence to this author at the Speech & Swallowing Centre, Otorhinolaryngology Department, Hudiksvall Hospital, SE 824 81 Hudiksvall, Sweden; Tel: +46 (0)650 92754; Fax: +46 (0)650 92412; E-mail: mary.hagg@lg.se center in the brainstem and further on to the efferent motor paths of the five motor cranial nerves (V, VII, IX, X and XII) in order to rehabilitate patients afflicted with dysphagia after stroke [14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

“…After one month, remaining dysphagia of around 10% is regarded to be more or less of chronic character [7,8]. In addition to so called compensatory techniques [9][10][11][12][13], dysphagia has been treated by oropharyngeal sensorimotor stimulation using oral appliances, such as a palatal plate (PP) [14] with improvement of dysphagia in 59% [15], or as an oral screen (OS) [16] with improvement in 97% and with normalization in 63% [17]. Swallowing depends on a complicated interplay of sensory and motor functions involving a large number of muscle groups that has to achieve a proper balance.…”

Section: Introductionmentioning

confidence: 99%

“…The stylohyoid muscles and the posterior part of the digastric muscles (VII) are also activated. All these activities are prerequisites of attaining a negative intraoral pressure and of initiating a swallowing reflex [14,17,20]. Fig.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Longstanding Effect and Outcome Differences of Palatal Plate and Oral Screen Training on Stroke-Related Dysphagia

Hägg¹,

Tibbling

2013

TOREHJ

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Abstract:Aim: This study aimed at evaluating (1) if the oral training effect on stroke related dysphagia differs between two different oral appliances, a palatal plate (PP) and an oral screen (OS), and (2) if the training effect remains at a late follow-up. Methods:We included patients with stroke-related dysphagia at two different time periods: the first group of 12 patients studied in 1997-2 002 had to train with a PP, the other one of 14 patients studied in [2003][2004][2005][2006][2007][2008] had to train with an OS. All patients were evaluated by a swallowing capacity test (SCT), and by a self-assessed visual analogue scale (VAS) of water swallowing capacity at entry of the study, after 13 weeks of training, and at a late follow-up.Results: At end of treatment the SCT had normalized in 33% of PP patients and in 71% of OS patients. There was a significant SCT improvement difference between the PP and OS groups in the period from baseline to late follow-up (p < 0.002) in favor of the OS group. VAS as tested at baseline and at end of treatment did not differ significantly between the two groups. Training with PP and with OS produced remaining improvement of SCT and of VAS as assessed at a late follow-up. Conclusion:The outcome of OS training on SCT in patients with stroke-related dysphagia seems to be superior to PP training. The improvement as assessed with VAS did not differ between the two groups. Training with PP or OS gives a longstanding improvement of SCT and VAS.

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Section: Training Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Longstanding Effect and Outcome Differences of Palatal Plate and Oral Screen Training on Stroke-Related Dysphagia

Hägg¹,

Tibbling

2013

TOREHJ

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Quantifying Labial Strength and Function in Facial Paralysis

Starmer

Lyford-Pike

Ishii

et al. 2015

JAMA Facial Plast Surg

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IMPORTANCE Facial muscle weakness from paralysis or muscle dystrophy can significantly affect lip strength and function. Lip muscle weakness may result in articulation difficulties and spillage of food, both of which are socially and functionally disruptive for patients. There are few quantitative data on the effect of facial paralysis on lip strength.OBJECTIVES To quantify the effect of facial paralysis and muscular dystrophy on lip strength and evaluate the effectiveness of targeted lip injection augmentation.

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Training lip force by oral screens. Part 3: Outcome for patients with stroke and peripheral facial palsy

Wertsén

Stenberg

2020

Clinical & Exp Dental Res

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The aim of this study was to investigate whether training with an oral screen can improve oral motor function in patients with stroke and peripheral palsy. The participants in the study were eight patients with orofacial dysfunction after stroke, included 7-14 months after onset, and seven patients with peripheral palsy, included 14-28 months after onset. A customized oral screen in acrylic was made for each participant. The screen had a tube around the handle to allow air to pass when measurements were made of the perioral muscle force. When measuring the ability to suck, the hole was sealed with wax. The participants trained with the oral screen two times daily for 5 min. Measurements were made at baseline, after 1 month and thereafter every third month until no further improvement was achieved. Measurements were made with two different instructions, to squeeze and to suck. In the stroke group, muscles around the mouth improved when pouting and smiling; these participants also achieved statistically significant changes when sucking. For the peripheral palsy group, little improvement could be seen when pouting and smiling. However, these patients reported less or no drooling, and the measurements for sucking increased significantly for six of the seven patients. The first recorded significant change was seen in the stroke group after 4 weeks training and in the group with peripheral palsy after 6 weeks. Training with a custom-made oral screen can significantly improve perioral muscle force and the ability to create negative intraoral pressure. The patients reported less leakage in saliva, drink, and food as well as fewer bite injuries and less food accumulation.

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Lip muscle training in stroke patients with dysphagia

Cited by 67 publications

References 12 publications

Longstanding Effect and Outcome Differences of Palatal Plate and Oral Screen Training on Stroke-Related Dysphagia

Longstanding Effect and Outcome Differences of Palatal Plate and Oral Screen Training on Stroke-Related Dysphagia

Quantifying Labial Strength and Function in Facial Paralysis

Training lip force by oral screens. Part 3: Outcome for patients with stroke and peripheral facial palsy

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