Swallow strength training exercise for elderly: A health maintenance need. Issue 10 (29th June 2018)

• Record Type: Journal Article
• Authors: Agrawal, D.; Kern, M.; Edeani, F.; Balasubramanian, G.; Hyngstrom, A.; Sanvanson, P.; Shaker, R.
• Is Part Of: Neurogastroenterology & motility. Volume 30:Issue 10(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-06-29
• Subjects: aging -- dysphagia -- elderly -- exercise -- swallow health maintenance -- swallowing disorders; Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.13382
• Languages: English
• ISSNs: 1350-1925

Abstract

Abstract: Background: Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty‐ and age‐related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly. Methods: A total of 28 volunteers (75 + 7 years; 17 females) with no complaint of dysphagia were studied using video fluoroscopy before and after 6 weeks of the swallow strength training exercise. Eighteen of these volunteers also underwent high‐resolution pharyngeal manometry non‐concurrent with fluoroscopy. Ten additional volunteers (81 + 6 years; 9 females) were studied by videofluoroscopy before and after 6 weeks of a sham exercise. Key Results: Swallow resistance exercise but not the sham exercise resulted in a significant increase in maximum upper esophageal sphincter opening ( P < .01), superior and anterior laryngeal excursion ( P < .01) as well as posterior pharyngeal wall thickness ( P < .01). Resistance exercise but not sham exercise also resulted in a significant increase in deglutitive pharyngeal contractile integral ( P < .01). Conclusions & Inferences: Strength training of muscles involved in the pharyngeal phase of swallowing using the swallowing against laryngeal restriction technique is feasible and significantly improves key physiologic features of the pharyngeal phase of swallowing. These findings provide the basis for consideration of developing an exercise‐based swallow health maintenance program for the elderly swallow health maintenance program for the elderly. Abstract : Although strength training exercises have been advocated for locomotive health maintenance in the elderly with positive outcomes, similar approach for preservation of swallow function in the elderly is not currently available. Strength training of pharyngeal phase of swallowing muscles using the technique of swallowing against laryngeal restriction safely improves key physiologic features of the pharyngeal phase of swallowing in the elderly. In addition to the potential usefulness of this exercise in dysphagic patients, these findings provide the opportunity for consideration of instituting an exercise‐based swallow health maintenance program for the elderly.