J Korean Dysphagia Soc.  2020 Jul;10(2):159-166. 10.34160/jkds.2020.10.2.003.

Effects of Head Lift Exercise on Oropharyngeal Swallowing Function and Dropout Rate According to Reclining Angle in Patients with Dysphagia after Stroke: A Randomized Trial

Affiliations
  • 1Rehabilitation Medical Center, Seoul North Municipal Hospital, Seoul, Korea
  • 2Department of Occupational Therapy, Busan National University Yangsan Hospital, Yangsan, Korea
  • 3Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan, Korea
  • 4Department of Occupational Therapy, Division of Health Sciences, Dongseo University, Busan, Korea
  • 5Department of Radiological Science, Health Sciences Division, Dongseo University, Busan, Korea
  • 6Department of Multidisciplinary Radiological Science, Graduate School, Dongseo University, Busan, Korea

Abstract


Objective
Although the effects of head lift exercise (HLE) in the reclining position have been reported, there is insufficient clinical evidence of the effects. This study compared the effects of HLE in the 0° supine position and 45° reclining position on the swallowing function and the compliance of patients with dysphagia after stroke after both exercises.
Methods
This was a randomized, assessor-blinded clinical trial. Thirty-five patients with stroke and dysphagia were assigned randomly to HLE in the 0° supine group (n=18) or HLE in the 45° reclining group (n=17). Patients in both groups performed HLE five days a week for four weeks and received the same conventional dysphagia therapy. The videofluoroscopic dy sphagia scale (VDS) was used to evaluate the swallowing function. The dropout rate and subjective feedback related to compliance with the two exercises were monitored.
Results
No significant differences in the baseline characteristics were observed between the two groups. Patients in both groups showed significant improvement in the oral and pharyngeal phases of VDS (P<0.05). After the intervention, no significant differences were observed between the groups (P>0.05). Dropout rates of 22% and 6% owing to neck discomfort or fatigue were observed in the HLE in 0° supine group and the HLE in 45° reclining group, respectively.
Conclusion
HLE in the 45° reclining position has a similar effect on the swallowing function in patients with dysphagia after stroke to that of HLE in the 0° supine position and is associated with better exercise compliance.

Keyword

Dysphagia; Swallowing; Compliance; Reclining position; Videofluoroscopic dysphagia scale
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