Efectividad de ejercicios reactivadores deglutorios en la disfagia orofaríngea postaccidente cerebrovascularUna revisión integrativa

  1. Sepúlveda-Contreras, Jorge 1
  2. Jarpa-Muñoz, Francisca 1
  1. 1 Departamento de Fonoaudiología; Facultad de Ciencias de la Salud; Universidad San Sebastián, Sede Valdivia; Valdivia; Chile.
Revista:
Revista de Investigación e Innovación en Ciencias de la Salud: RIICS

ISSN: 2665-2056

Ano de publicación: 2022

Volume: 4

Número: 1

Tipo: Artigo

DOI: 10.46634/RIICS.81 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Outras publicacións en: Revista de Investigación e Innovación en Ciencias de la Salud: RIICS

Resumo

Introducción. La selección del tratamiento para pacientes con disfagia debe basarse en evidencia con la mejor calidad posible. Este tratamiento puede involucrar estrategias reactivadoras con el objetivo de modificar la fisiología de la deglución y promover cambios a largo plazo. Objetivo. Explorar los efectos de ejercicios y maniobras destinadas a la reactivación de la función de deglución en personas con disfagia orofaríngea posterior a un accidente cerebrovascular, a través de publicaciones científicas existentes en los últimos diez años. Metodología. Se realizó una revisión de la literatura en las bases de datos PubMed con los términos MeSH “Deglutition Disorders” y “Exercise Therapy”, y con los términos libres “Dysphagia” y “Swallowing Therapy”, combinados con el booleano de intersección “AND”. Resultados. Los ejercicios con entrenamiento de resistencia de lengua al paladar, entrenamiento de la fuerza muscular espiratoria (EMST), Chin tuck contra resistencia (CTAR), Shaker y apertura mandibular fueron los que mostraron, con mayor respaldo bibliográfico, efectos positivos en el tratamiento de la disfagia. Conclusiones. La información recopilada podría ser de utilidad clínica para guiar la selección de uno u otro procedimiento terapéutico. Se debe continuar generando evidencia relacionada con la efectividad de los ejercicios deglutorios en la disfagia orofaríngea posterior a un ACV.

Referencias bibliográficas

  • Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756–2763. doi: https://doi.org/10.1161/01.STR.0000190056.76543.eb
  • González-Fernández M, Ottenstein L, Atanelov L, Christian AB. Dysphagia after Stroke: an Overview. Current physical medicine and rehabilitation reports. 2013;1(3):187–196. doi: https://doi.org/10.1007/s40141-013-0017-y
  • Arnold M, Liesirova K, Broeg-Morvay A, Meisterernst J, Schlager M, Mono ML, et al. Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome. PloS one. 2016;11(2):e0148424. doi: https://doi.org/10.1371/journal.pone.0148424
  • Terré R, Mearin F. Oropharyngeal dysphagia after the acute phase of stroke: predictors of aspiration. Neurogastroenterology and motility: the official journal of the European Gastrointestinal Motility Society. 2006;18(3):200–205. doi: https://doi.org/10.1111/j.1365-2982.2005.00729
  • Kim DY, Park HS, Park SW, Kim JH. The impact of dysphagia on quality of life in stroke patients. Medicine. 2020;99(34):e21795. doi: https://doi.org/10.1097/MD.0000000000021795
  • Vose A, Nonnenmacher J, Singer ML, González-Fernández M. Dysphagia Management in Acute and Sub-acute Stroke. Current physical medicine and rehabilitation reports. 2014;2(4):197–206. doi: https://doi.org/10.1007/s40141-014-0061-2
  • Bath PM, Lee HS, Everton LF. Swallowing therapy for dysphagia in acute and subacute stroke. The Cochrane database of systematic reviews. 2018;10(10):CD000323. doi: https://doi.org/10.1002/14651858.CD000323.pub3
  • Terré R. Disfagia orofaríngea en el ictus: aspectos diagnósticos y terapéuticos [Oropharyngeal dysphagia in stroke: diagnostic and therapeutic aspects]. Revista de neurologia. 2020;70(12):444–452. doi: https://doi.org/10.33588/rn.7012.2019447
  • Logemann JA. Swallowing disorders. Best practice & research. Clinical gastroenterology. 2007;21(4):563–573. doi: https://doi.org/10.1016/j.bpg.2007.03.006
  • Langmore SE, Pisegna JM. Efficacy of exercises to rehabilitate dysphagia: A critique of the literature. International Journal of Speech-Language. Pathology. 2015;17(3):222–229. doi: https://doi.org/10.3109/17549507.2015.1024171
  • Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009;6(7): e1000097. doi: https://doi.org/10.1371/journal.pmed.1000097
  • Kim HD, Choi JB, Yoo SJ, Chang MY, Lee SW, Park JS. Tongue-to-palate resistance training improves tongue strength and oropharyngeal swallowing function in subacute stroke survivors with dysphagia. Journal of Oral Rehabilitation, 2017;44(1):59-64. doi: https://doi.org/10.1111/joor.12461
  • Moon JH, Hahm SC, Won YS, Cho, HY. The effects of tongue pressure strength and accuracy training on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia. International Journal of Rehabilitation Research. 2018;41(3):204-210. doi: https://doi.org/10.1097/mrr.0000000000000282
  • Steele CM, Bayley MT, Peladeau-Pigeon M, Nagy A, Namasivayam AM, Stokely SL, Wolkin T. A Randomized Trial Comparing Two Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia. Dysphagia. 2016;31(3):452–461. doi: https://doi.org/10.1007/s00455-016-9699-5
  • Hegland KW, Davenport PW, Brandimore AE, Singletary FF, Troche MS. Rehabilitation of Swallowing and Cough Functions Following Stroke: An Expiratory Muscle Strength Training Trial. Archives of Physical Medicine and Rehabilitation. 2016;97(8):1345–1351. doi: https://doi.org/10.1016/j.apmr.2016.03.027
  • Eom MJ, Chang MY, Oh DH, Kim HD, Han NM, Park JS. Effects of resistance expiratory muscle strength training in elderly patients with dysphagic stroke. NeuroRehabilitation. 2017;41(4):747-752. doi: https://doi.org/10.3233/NRE-172192
  • Park JS, Oh DH, Chang MY, Kim KM. Effects of expiratory muscle strength training on oropharyngeal dysphagia in subacute stroke patients: a randomised controlled trial. Journal of Oral Rehabilitation. 2016;43(5):364–372. doi: https://doi.org/10.1111/joor.12382
  • Easterling C, Grande B, Kern M, Sears K, Shaker R. Attaining and Maintaining Isometric and Isokinetic Goals of the Shaker Exercise. Dysphagia. 2005;20(2):133–138. doi: https://doi.org/10.1007/s00455-005-0004-2
  • Choi JB, Shim SH, Yang JE, Kim HD, Lee DH, Park JS. Effects of Shaker exercise in stroke survivors with oropharyngeal dysphagia. NeuroRehabilitation. 2017;41(4):753–757. doi: https://doi.org/10.3233/nre-172145
  • Gao J, Zhang H. Effects of chin tuck against resistance exercise versus Shaker exercise on dysphagia and psychological state after cerebral infarction. European Journal of Physical and Rehabilitation Medicine. 2017;53(3):426-432. doi: https://doi.org/10.23736/S1973-9087.16.04346-X.
  • Park JS, Hwang NK, Oh DH, Chang MY. Effect of head lift exercise on kinematic motion of the hyolaryngeal complex and aspiration in patients with dysphagic stroke. Journal of Oral Rehabilitation. 2017;44(5):385–391. doi: https://doi.org/10.1111/joor.12492
  • Choi JB, Jung YJ, Park JS. Comparison of 2 types of therapeutic exercise: jaw opening exercise and head lift exercise for dysphagic stroke: A pilot study. Medicine. 2020;99(38):e22136. doi: https://doi.org/10.1097/MD.0000000000022136
  • Hara K, Tohara H, Minakuchi S. Treatment and evaluation of dysphagia rehabilitation especially on suprahyoid muscles as jaw-opening muscles. The Japanese dental science review. 2018;54(4):151–159. doi: https://doi.org/10.1016/j.jdsr.2018.06.003
  • Koyama Y, Sugimoto A, Hamano T, Kasahara T, Toyokura M. Masakado Y. Proposal for a modified jaw opening exercise for dysphagia: a randomized, controlled trial. Tokai Journal of Experimental and Clinical Medicine. 2017;42(2):71‐8. Disponible en: http://mj-med-u-tokai.com/pdf/420203.pdf
  • Wada S, Tohara H, Iida T, Inoue M, Sato M, Ueda K. Jaw-Opening Exercise for Insufficient Opening of Upper Esophageal Sphincter. Archives of Physical. Medicine and Rehabilitation. 2012;93(11):1995–1999. doi: https://doi.org/10.1016/j.apmr.2012.04.025
  • Park JS, An DH, Kam KY, Yoon T, Kim T, Chang MY. Effects of resistive jaw opening exercise in stroke patients with dysphagia: A double- blind, randomized controlled study. Journal of Back and Musculoskeletal Rehabilitation. 2020;33(3):507-513. doi: https://doi.org/10.3233/bmr-181477
  • Yoon WL, Khoo JKP, Rickard Liow SJ. Chin Tuck Against Resistance (CTAR): New Method for Enhancing Suprahyoid Muscle Activity Using a Shaker-type Exercise. Dysphagia. 2013;29(2):243–248. doi: https://doi.org/10.1007/s00455-013-9502-9
  • Park JS, Lee G, Jung YJ. Effects of game-based chin tuck against resistance exercise vs head-lift exercise in patients with dysphagia after stroke: An assessor-blind, randomized controlled trial. Journal of rehabilitation medicine. 2019;51(10):749–754. doi: https://doi.org/10.2340/16501977-2603
  • Kim H, Park J. Efficacy of modified chin tuck against resistance exercise using hand‐free device for dysphagia in stroke survivors: A randomised controlled trial. Journal of Oral Rehabilitation. 2019;46(11):1042-1046. doi: https://doi.org/10.1111/joor.12837
  • Park JS, An DH, Oh DH, Chang MY. Effect of chin tuck against resistance exercise on patients with dysphagia following stroke: A randomized pilot study. NeuroRehabilitation. 2018;42(2):191–197. doi: https://doi.org/10.3233/nre-172250
  • Logemann JA, Kahrilas PJ. Relearning to swallow after stroke--application of maneuvers and indirect biofeedback: a case study. Neurology. 1990;40(7):1136–1138. doi: https://doi.org/10.1212/wnl.40.7.1136
  • Logemann JA. Dysphagia: Evaluation and Treatment. Folia Phoniatrica et Logopaedica. 1995;47(3):140–164. doi: https://doi.org/10.1159/000266348
  • McCullough GH, Kim Y. Effects of the Mendelsohn maneuver on extent of hyoid movement and UES opening post-stroke. Dysphagia. 2013;28(4):511–519. doi: https://doi.org/10.1007/s00455-013-9461-1
  • McCullough GH, Kamarunas E, Mann GC, Schmidley JW, Robbins JA, Crary MA. Effects of Mendelsohn maneuver on measures of swallowing duration post stroke. Topics in stroke rehabilitation. 2012;19(3):234–243. doi: https://doi.org/10.1310/tsr1903-234
  • Park HS, Oh DH, Yoon T, Park JS. Effect of effortful swallowing training on tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia: a double-blind, randomized controlled trial. International Journal of Language & Communication Disorders. 2019;54(3):479-484. doi: https://doi.org/10.1111/1460-6984.12453
  • Rosenbek JC, Robbins J, Willford WO, Kirk G, Schiltz A, Sowell TW, et al. Comparing treatment intensities of tactile-thermal application. Dysphagia. 1998;13(1):1–9. doi: https://doi.org/10.1007/PL00009542
  • Logemann JA. Manual for the videofluorographic study of swallowing. San Diego: College-Hill Press; 1986.
  • Nakamura T, Fujishima I. Usefulness of Ice Massage in Triggering the Swallow Reflex. Journal of Stroke and Cerebrovascular Diseases. 2013;22(4):378–382. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2011.09.016
  • Hwang NK, Kim HH, Shim JM, Park JS. Tongue stretching exercises improve tongue motility and oromotor function in patients with dysphagia after stroke: A preliminary randomized controlled trial. Archives of oral biology. 2019;108:104521. doi: https://doi.org/10.1016/j.archoralbio.2019.104521
  • Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am. 2008;19(4):691-vii. doi: https://doi.org/10.1016/j.pmr.2008.06.001
  • Guevara DE, Avendaño SS, Salazar AA, Alarcón BM, Santelices SM. Contribución de la temperatura fría y el sabor ácido en la intervención fonoaudiológica de la disfagia orofaríngea. Revista Chilena de Fonoaudiología. 2016;15:1-9. doi: https://doi.org/10.5354/0719-4692.2016.44206
  • Imada M, Kagaya H, Ishiguro Y, Miho K, Yoko I, Takashi T, et al. Effect of visual biofeedback to acquire supraglottic swallow in healthy individuals: a randomized-controlled trial. Journal of Rehabilitation Research, 2016;39(2):181-184. doi: https://doi.org/10.1097/mrr.0000000000000154
Fonte de datos: Dialnet