Hidetaka Wakabayashi1, Masato Matsushima2, Ryo Momosaki3, Shuhei Yoshida2, Rieko Mutai2, Toshifumi Yodoshi2, Shinichi Murayama2, Tetsuro Hayashi2, Ryoko Horiguchi2, Hiroko Ichikawa2. 1. Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama, Japan; Division of Clinical Epidemiology, Jikei University School of Medicine, Tokyo, Japan. Electronic address: Noventurenoglory@gmail.com. 2. Division of Clinical Epidemiology, Jikei University School of Medicine, Tokyo, Japan. 3. Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawasaki, Japan.
Abstract
OBJECTIVE: This study examined the effects of resistance training of swallowing muscles in community-dwelling older individuals with dysphagia. METHODS: A cluster randomized controlled trial was performed in day-service and day-care facilities. The participants were older (≥65 y) community-dwelling individuals with dysphagia. The intervention group performed a tongue resistance exercise and a head flexion exercise against manual resistance. Both groups received a brochure on dysphagia rehabilitation. The primary endpoint was an improvement in dysphagia assessed by the Eating Assessment Tool (EAT-10) score. Tongue pressure was the secondary endpoint. RESULTS:Participants included 47 men and 57 women, witha mean age ± standard deviation of 80 ± 7 y. At baseline, the median EAT-10 score was 7 (interquartile range, 5-12). A total of 91 patients, 43 in the intervention group (8 clusters) versus 48 in the control group (11 clusters), were assessed postintervention. The percentage of participants with EAT-10 scores <3 was not statistically significantly different between the two groups (intervention group, 23% versus control group, 19%, P = 0.598). Postintervention median EAT-10 scores were 6 (interquartile range, 3-10) in each group (P = 0.665) and mean tongue pressure was 23.9 ± 10.0 versus 25.9 ± 10.9 kPa (P = 0.376). The intervention did not significantly affect the EAT-10 score or tongue pressure in a mixed effects random intercept model. The Mini Nutritional Assessment Short Form score correlated significantly with the postintervention EAT-10 score. CONCLUSIONS:Resistance training of swallowing muscles did not improve dysphagia in this study. Better nutritional status correlated independently with improved swallowing function.
RCT Entities:
OBJECTIVE: This study examined the effects of resistance training of swallowing muscles in community-dwelling older individuals with dysphagia. METHODS: A cluster randomized controlled trial was performed in day-service and day-care facilities. The participants were older (≥65 y) community-dwelling individuals with dysphagia. The intervention group performed a tongue resistance exercise and a head flexion exercise against manual resistance. Both groups received a brochure on dysphagia rehabilitation. The primary endpoint was an improvement in dysphagia assessed by the Eating Assessment Tool (EAT-10) score. Tongue pressure was the secondary endpoint. RESULTS:Participants included 47 men and 57 women, with a mean age ± standard deviation of 80 ± 7 y. At baseline, the median EAT-10 score was 7 (interquartile range, 5-12). A total of 91 patients, 43 in the intervention group (8 clusters) versus 48 in the control group (11 clusters), were assessed postintervention. The percentage of participants with EAT-10 scores <3 was not statistically significantly different between the two groups (intervention group, 23% versus control group, 19%, P = 0.598). Postintervention median EAT-10 scores were 6 (interquartile range, 3-10) in each group (P = 0.665) and mean tongue pressure was 23.9 ± 10.0 versus 25.9 ± 10.9 kPa (P = 0.376). The intervention did not significantly affect the EAT-10 score or tongue pressure in a mixed effects random intercept model. The Mini Nutritional Assessment Short Form score correlated significantly with the postintervention EAT-10 score. CONCLUSIONS: Resistance training of swallowing muscles did not improve dysphagia in this study. Better nutritional status correlated independently with improved swallowing function.