Swallowing Therapy Effects on Oral Muscle Mass, Tongue Function, Swallowing, and Nutrition in Stroke Patients with Dysphagia

• Published in: NeuroRehabilitation (Reading, Mass.) Vol. 56; no. 2; p. 164
• Main Authors: Li, Guan-Yi, Huang, Yu-Chi, Wu, Jia-Ying, Leong, Chau-Peng, Cheng, Chung-Hui
• Format: Journal Article
• Language: English
• Published: United States 01.03.2025
• Subjects: Aged; Deglutition - physiology; Deglutition Disorders - diagnostic imaging; Deglutition Disorders - etiology; Deglutition Disorders - physiopathology; Deglutition Disorders - rehabilitation; Electric Stimulation Therapy; Female; Humans; Male; Masseter Muscle - diagnostic imaging; Masseter Muscle - physiopathology; Middle Aged; Muscle Strength - physiology; Nutritional Status; Stroke - complications; Stroke - diagnostic imaging; Stroke - physiopathology; Stroke Rehabilitation - methods; Tongue - diagnostic imaging; Tongue - physiopathology; Ultrasonography; stroke rehabilitation; dysphagia; rehabilitation; swallowing; ultrasonography; stroke
• ISSN: 1878-6448
• DOI: 10.1177/10538135241308773

BackgroundDysphagia, common post-stroke, elevates clinical risks. Muscle atrophy and compromised function correlate with malnutrition and secondary sarcopenia.ObjectiveWe studied oral muscle thickness, tongue strength/endurance in post-stroke dysphagia (PSD) using sonography and Iowa Oral Performance Instrument (IOPI), and assessed swallowing therapy's impact.Methods17 healthy and 15 PSD participants were analyzed. Healthy subjects underwent baseline sonography and IOPI. PSD patients received a 3-week swallowing therapy including traditional methods, neuromuscular electrical stimulation, and IOPI-guided oral exercises. Pre/post-swallowing therapy sonography and swallowing-related evaluations were conducted.ResutlsPSD group exhibited significant differences in affected masseter muscle thickness (P = 0.001), tongue strength (P ≤ 0.001), but not posterior tongue endurance (P = 0.066). After swallowing therapy, PSD patients showed notable improvement in masseter muscle thickness (P = 0.011) and tongue strength (P = 0.005-0.009). Clinical metrics like Functional Oral Intake Scale (P = 0.004), Mini Nutritional Assessment (P = 0.007), and gait speed (P = 0.018) also improved.ConclusionsStroke-induced dysphagia correlates with reduced masseter muscle thickness, tongue strength, and endurance. Swallowing therapy enhanced masseter muscle thickness and tongue strength, potentially improving swallowing function, nutrition, and gait speed.