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https://codas.org.br/article/doi/10.1590/2317-1782/20232021324en
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Revisão Sistemática

The effects of lingual training: a systematic review with meta-analysis

Efeitos do treinamento da língua: revisão sistemática com metanálise

Nathalya de Faria Fonseca; Andréa Rodrigues Motta; Fernanda Campos de Freitas; Mariana Rezende Nonato; Elton Mendes Francelino; Renata Maria Moreira Moraes Furlan

http://dx.doi.org/10.1590/2317-1782/20232021324en CoDAS, vol.35, n5, e20210324, 2023
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Abstract

Purpose

To assess the effectiveness of myotherapy exercises in increasing tongue pressure and strength. A secondary aim was to analyze the exercise types, training parameters, and functional results.

Research strategies

This systematic literature review was based on the Prisma protocol guidelines.

Selection criteria

The review included clinical trials that assessed the effects of tongue muscle training, with no restriction on the language or year of publication.

Data analysis

The steps included eliminating duplicates; reading abstracts and excluding studies that did not meet the inclusion criteria; reading selected articles in full text, extracting important data, and gathering them in a table; and meta-analysis, using the inverse variance method. The methodological quality of the studies was assessed with the Joanna Briggs Institute’s tool. The quality of evidence was assessed with the Grading System of Recommendations Assessment, Development and Evaluation.

Results

The meta-analysis indicated a significant increase in maximum anterior and posterior pressure as an effect of training. The most performed exercise was tongue pressure against the palate. However, training parameters varied between studies, and whether exercises alone led to functional improvement cannot be stated. The quality of the evidence was considered low.

Conclusion

Myotherapy exercises increased anterior and posterior tongue pressure in adults, but the quality of this evidence is low. The studies used various exercise types and training parameters. It cannot be stated whether exercises alone led to functional improvement.

Keywords

Tongue; Exercise Therapy; Myofunctional Therapy; Rehabilitation; Speech; Language and Hearing Sciences

Resumo

Objetivo

Avaliar a eficácia de exercícios mioterápicos no aumento da pressão e da força lingual. Buscou-se, de forma secundária, analisar quais os tipos de exercícios utilizados, os parâmetros de treinamento e os resultados funcionais obtidos.

Estratégia de pesquisa

Revisão sistemática da literatura guiada conforme as diretrizes do protocolo Prisma.

Critérios de seleção

Foram incluídos ensaios clínicos que avaliaram efeitos do treinamento muscular da língua, sem limite quanto ao idioma ou ano de publicação.

Análise dos dados

Incluiu as etapas de eliminação de artigos duplicados; leitura de resumos e exclusão de estudos que não contemplaram os critérios de elegibilidade; leitura na íntegra dos artigos selecionados com extração de informações importantes, reunidas em tabela; e metanálise, realizada por meio do método do inverso da variância. A avaliação da qualidade metodológica dos estudos foi realizada pela ferramenta do Joanna Briggs Institute. A qualidade da evidência foi avaliada pelo Sistema Grading of Recommendations Assessment, Development and Evaluation.

Resultados

A metanálise indicou aumento significativo da pressão máxima anterior e posterior como efeito do treinamento. O exercício mais utilizado foi pressão de língua contra o palato, mas os parâmetros de treinamento variaram entre estudos, não sendo possível afirmar que exercícios isolados promovem melhora funcional. A qualidade da evidência foi considerada baixa.

Conclusão

Os exercícios mioterápicos promovem o aumento da pressão anterior e posterior da língua de indivíduos adultos, porém a qualidade dessa evidência é baixa. Há variabilidade quanto aos tipos de exercícios utilizados e parâmetros de treinamento. Não é possível afirmar que os exercícios promovem melhora funcional.

Palavras-chave

Língua; Terapia por Exercício; Terapia Miofuncional; Reabilitação; Fonoaudiologia

Referências

  1. Motta AR, Las Casas EB, César CC, Bommarito S, Chiari BM. Caracterização da força da língua por meio de medidas objetivas. Rev CEFAC. 2017;19(1):82-9. http://dx.doi.org/10.1590/1982-021620171919116
  2. Miller JL, Watkin KL, Chen MF. Muscle, adipose, and connective tissue variations in intrinsic musculature of the adult human tongue. J Speech Lang Hear Res. 2002;45(1):51-65. http://dx.doi.org/10.1044/1092-4388(2002/004) PMid:14748638.
  3. Gilbert RJ, Napadow VJ, Gaige TA, Wedeen VJ. Anatomical basis of lingual hydrostatic deformation. J Exp Biol. 2007;210(23):4069-82. http://dx.doi.org/10.1242/jeb.007096 PMid:18025008.
  4. Maia AV, Furlan RMMM, Moraes KO, Amaral MS, Medeiros AM, Motta AR. Reabilitação da força da língua utilizando biofeedback: relato de caso. CoDAS. 2019;31(5):e20180163. http://dx.doi.org/10.1590/2317-1782/20182018163 PMid:31664370.
  5. Burkhead LM, Sapienza CM, Rosenbek JC. Strength-training exercise in dysphagia rehabilitation: principles, procedures, and directions for future research. Dysphagia. 2007;22(3):251-65. http://dx.doi.org/10.1007/s00455-006-9074-z PMid:17457549.
  6. Rezende BA, Furlan RMMM, Casas EBL, Motta AR. Avaliação clínica da língua em adultos jovens. Rev CEFAC. 2016;18(3):559-67. http://dx.doi.org/10.1590/1982-021620161832516
  7. Bacha SM, Rispoli CF. Myofunctional therapy: brief intervention. Int J Orofacial Myology. 1999;25(1):37-47. http://dx.doi.org/10.52010/ijom.1999.25.1.5 PMid:10863453.
  8. Furlan RMMM, Valentim AF, Motta AR, Barroso MFS, Costa CG, Las Casas EB. Métodos quantitativos para avaliação da força de língua. Rev CEFAC. 2012;14(6):1215-25. http://dx.doi.org/10.1590/S1516-18462012005000099
  9. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372(71):n71. http://dx.doi.org/10.1136/bmj.n71 PMid:33782057.
  10. The Joanna Briggs Institute [Internet]. (2017). Adelaide: The Joanna Briggs Institute; c2023 [citado em 2021 Ago 22]. Disponível em: https://jbi.global/critical-appraisal-tools
  11. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. Grade guidelines: 1. Introduction-Grade evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383-94. http://dx.doi.org/10.1016/j.jclinepi.2010.04.026 PMid:21195583.
  12. Marchesan IQ, Duarte LIM. Histórico e áreas de domínio da Motricidade Orofacial. In: Silva HJ, Tessitore A, Motta AR, Cunha DA, Berretin-Felix G, Marchesan IQ, editores. Tratado de Motricidade Orofacial. São José dos Campos: Pulso Editorial; 2019. p. 37-44.
  13. Ieto V, Kayamori F, Montes MI, Hirata RP, Gregório MG, Alencar AM, et al. Effects of oropharyngeal exercises on snoring: a randomized trial. Chest. 2015;148(3):683-91. http://dx.doi.org/10.1378/chest.14-2953 PMid:25950418.
  14. Diaféria G, Santos-Silva R, Truksinas E, Haddad FLM, Santos R, Bommarito S, et al. Myofunctional therapy improves adherence to continuous positive airway pressure treatment. Sleep Breath. 2017;21(2):387-95. http://dx.doi.org/10.1007/s11325-016-1429-6 PMid:27913971.
  15. Park JS, Kim HJ, Oh DH. Effect of tongue strength training using the Iowa Oral Performance Instrument in stroke patients with dysphagia. J Phys Ther Sci. 2015;27(12):3631-4. http://dx.doi.org/10.1589/jpts.27.3631 PMid:26834320.
  16. Byeon H. Effect of orofacial myofunctional exercise on the improvement of dysphagia patients’ orofacial muscle strength and diadochokinetic rate. J Phys Ther Sci. 2016;28(9):2611-4. http://dx.doi.org/10.1589/jpts.28.2611 PMid:27799705.
  17. 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. J Oral Rehabil. 2017;44(1):59-64. http://dx.doi.org/10.1111/joor.12461 PMid:27883209.
  18. Byeon H. Is the combined application of tongue pressure training and tongue base exercise more effective in improving the strength of tongue and lips in Korean patients with flaccid dysarthria? Indian J Public Health. 2018;9(11):1041-7. http://dx.doi.org/10.5958/0976-5506.2018.01594.2
  19. 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. Int J Lang Commun Disord. 2019;54(3):479-84. http://dx.doi.org/10.1111/1460-6984.12453 PMid:30693627.
  20. Park JS, Hwang NK, Kim HH, Choi JB, Chang MY, Jung YJ. Effects of lingual strength training on oropharyngeal muscles in South Korean adults. J Oral Rehabil. 2019;46(11):1036-41. http://dx.doi.org/10.1111/joor.12835 PMid:31206763.
  21. Park JS, Lee SH, Jung SH, Choi JB, Jung YJ. Tongue strengthening exercise is effective in improving the oropharyngeal muscles associated with swallowing in community-dwelling older adults in South Korea: a randomized trial. Medicine. 2019;98(40):e17304. http://dx.doi.org/10.1097/MD.0000000000017304 PMid:31577721.
  22. Lee KH, Jung ES, Choi YY. Effects of lingual exercises on oral muscle strength and salivary flow rate in elderly adults: a randomized clinical trial. Geriatr Gerontol Int. 2020;20(7):697-703. http://dx.doi.org/10.1111/ggi.13944 PMid:32489001.
  23. Lazarus C, Logemann JA, Huang CF, Rademaker AW. Effects of two types of tongue strengthening exercises in young normals. Folia Phoniatr Logop. 2003;55(4):199-205. http://dx.doi.org/10.1159/000071019 PMid:12802092.
  24. Clark HM. Specificity of training in the lingual musculature. J Speech Lang Hear Res. 2012;55(2):657-67. http://dx.doi.org/10.1044/1092-4388(2011/11-0045) PMid:22215031.
  25. Hsiang CC, Chen AW, Chen CH, Chen MK. Early postoperative oral exercise improves swallowing function among patients with oral cavity cancer: a randomized controlled trial. Ear Nose Throat J. 2019;98(6):E73-80. http://dx.doi.org/10.1177/0145561319839822 PMid:31088304.
  26. Van den Steen L, Vanderwegen J, Guns C, Elen R, De Bodt M, Van Nuffelen G. Tongue-strengthening exercises in healthy older adults: does exercise load matter? A randomized controlled trial. Dysphagia. 2019;34(3):315-24. http://dx.doi.org/10.1007/s00455-018-9940-5 PMid:30209561.
  27. Furlan RMMM, Motta AR, Las Casas EB. Pressão e força de língua. In: Silva HJ, Tessitore A, Motta AR, Cunha DA, Berretin-Felix G, Marchesan IQ, editores. Tratado de Motricidade Orofacial. São José dos Campos: Pulso Editorial; 2019. p. 385-95.
  28. Bianchini EMG, Kayamori F, Lorenzi-Filho G. Distúrbios do sono: classificações e tipos de tratamentos. In: Silva HJ, Tessitore A, Motta AR, Cunha DA, Berretin-Felix G, Marchesan IQ, editores. Tratado de Motricidade Orofacial. São José dos Campos: Pulso Editorial; 2019. p. 733-50.
  29. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557-60. http://dx.doi.org/10.1136/bmj.327.7414.557 PMid:12958120.
  30. Furlan RMMM, Valenti AF, Perilo TVC, Costa CG, Barroso MFS, Las Casas EB, et al. Quantitative evaluation of tongue protrusion force. Int J Orofacial Myology. 2010;36(1):33-43. http://dx.doi.org/10.52010/ijom.2010.36.1.4 PMid:23362601.
     
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