Yutma Bozukluklarının Rehabilitasyonunda Propriyoseptif Nöromusküler Fasilitasyon Tekniğinin Etkisinin Araştırılması

Abstract

Sayaca, C. Investigation of Efectiveness of Proprioceptive Neuromuscular Facilitation Technique in the Rehabilitation of Swallowing Disorders, Hacettepe University Institute of Health Sciences Physical Therapy and Rehabilitation Program Doctorate Thesis, Ankara, 2018. This prospective study was planned to investigate whether the Proprioceptive Neuromuscular Facilitation technique used to increase muscle strength is superior to Shaker exercise in improving the function of the swallowing muscles. Fifty volunteer elderly individuals (30 female, 20 male) were separated two groups randomly. Groups were named as Shaker and PNF. Their mean age were 68 ± 3.89 years. Eating difficulties of elderly individuals were determined with EAT-10 scale. The Yale Swallowing Test was used to assess cognitive status, oropharyngeal motor control, and ability of swallowing water. The anatomical localization of the larynx was determined with tape measure. The 100 ml water swallow test was used to measure capacity, volüme, and speed of swallowing. The deep flexor muscle endurance of the neck was measured with a chronometer. The laryngeal function was measured indirectly with maximum phonation time. Amplitude changes occurring during muscle contraction were measured with superficial EMG. As a result of six weeks of exercise training, EAT-10 scale scores were decreased in both groups (p <0.001). The anatomical localization of the hyoid bone and larynx were higher in the PNF group than the Shaker group (p <0.05 and p <0.01, respectively). Water swallowing capacity and volume were improved in both groups (p <0.001). There was no change in swallowing speed in both groups (p> 0.05). The duration of the deep flexor endurance of the neck was increased in both groups (p <0.001). The maximum phonation time developed significantly (PNF p <0.01; Sheker p <0.001). After exercise program, maximal voluntary contraction values of suprahyoid muscles increased in PNF group (p <0.05). As a result, both types of exercise can be used in the rehabilitation of swallowing difficulties seen in elderly individuals. However, the PNF technique increases the amplitude value that occurs during the maximum contraction according to the Shaker exercise. Key Words: Dysphagia, Proprioceptive Neuromuscular Facilitation, Shaker Exercise, Rehabilitation, Exercise.