The effect of laryngeal elevation training on swallowing function in patients with dysphagia

Abstract

Objective To investigate the effect of laryngeal elevation training without highly loaded head lifting on swallowing function in patients with dysphagia. Methods Fifty-seven patients with dysphagia (36 men; mean age, 78.5 ± 11.4 years) were included. All participants performed the swallowing forehead exercise and the chin push–pull manoeuvre for two months. Videoendoscopy to assess swallowing function, the peak expiratory flow test and the hand grip strength test were performed at the initial visit (time 1) and two months after the start of the intervention (time 2). We used the Hyodo score, a scoring method for videoendoscopic assessment, for evaluation of swallowing function. Results The linear mixed model showed a significant main effect of time (the Hyodo score at time 1 was greater than the score at time 2). The effects of the co-variates were not significant. Conclusion The present study demonstrated the significant effect of laryngeal elevation training without head lifting on the Hyodo score.

Swallowing Function and Quality of Life in Patients Treated With Transoral Videolaryngoscopic Surgery for Pharyngolaryngeal Cancer

“…One report showed improvement in endoscopic swallowing scores in elderly patients with dysphagia after laryngeal elevation training such as the swallowing forehead exercise and the chin push-pull maneuver without highly loaded head lifting [ 27 ]. Therefore, the introduction of perioperative rehabilitation may contribute to the maintenance or early recovery of swallowing function after transoral resection.…”

Longitudinal Analysis of Swallowing Displacement Kinematics After Oropharyngeal Cancer Treatment

“…47,54 Mechanistically, hyolaryngeal displacement is critical to airway protection and pharyngeal clearance through the pharyngoesophageal segment and is an important target for swallow therapy. [55][56][57] In prior work, PCR has been identified as a validated surrogate measure of pharyngeal strength, 58 and demonstrated to increase (worsen) after radiation treatment as compared to controls. 33 Although mean PCR worsened in the study cohort, significance was lost after sex and age matching.…”

“…This delayed restriction in hyolaryngeal movement may represent chronic effects of radiation, consistent with progressive collagen accumulation, permanent collagen fiber disorganization, altered microvasculature, production of pro‐fibrotic growth factors, and/or eventual loss of elasticity 47,54 . Mechanistically, hyolaryngeal displacement is critical to airway protection and pharyngeal clearance through the pharyngoesophageal segment and is an important target for swallow therapy 55–57 …”

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“…The VEES, proposed by Hyodo, is widely used in Japan as a standard evaluation tool for oropharyngeal swallowing function that assesses both the non-swallowing and swallowing phases [15,17,18]. The VEES consists of the following items that assess swallowing function: (A) salivary pooling in the vallecula and piriform sinuses, (B) elicitability of the glottal closure reflex or cough reflex by touching the epiglottis or arytenoid with the endoscope, (C) the provocation of the swallowing reflex, and (D) pharyngeal clearance after swallowing 3 mL of dyed water (Table 2).…”