Yutma Bozukluklarında Ekspiratuar Kas Kuvvet Eğitimi

Öz

Yutma ve solunum koordineli olarak çalışan hayati fonksiyonlardır. Yutma solunum koordinasyonun bozulması kişileri hava yolu aspirasyonuna açık hale getirmektedir. Yutma rehabilitasyonunda temel amaç aspirasyonu önlemek ve hava yolu koruması sağlamaktır. Ekspiratuar kas kuvvet eğitimi (EMST), ekspiratuar kasları kuvvetlendirmek ve solunum fonksiyonlarını iyileştirmek için tasarlanmış bir tedavi yöntemidir. Yutma bozukluklarında solunum temelli yaklaşımlar nispeten yeni olmakla birlikte fizyoterapi ve rehabilitasyon tekniği olan EMST yutma literatüründe hızlı bir ilerleme kaydetmektedir ve en çok kullanılan teknik olarak karşımıza çıkmaktadır. Literatüre bakıldığında EMST’nin yutma rehabilitasyonunda kullanılmaya başlanması 2000’li yılların başına dayanmaktadır. Süreçte EMST ile ilgili çalışmalar yoğunlaşmış ve sıklıkla nörolojik hastalık gruplarında çalışmalar yapılmıştır. EMST’nin suprahyoid kas aktivasyonunu artırarak hava yolu kapanışını sağlaması ve aspirasyonu önlemek için kuvvetli bir öksürük oluşumunu kolaylaştırması yutma rehabilitasyonundaki etki mekanizmaları olarak düşünülmektedir. EMST yutma rehabilitasyonu için umut verici bir yaklaşımdır. Etki mekanizmasının daha iyi tanımlanması için daha büyük örneklem gruplarında ve farklı hastalık gruplarında yapılacak çalışmalara ihtiyaç olduğu düşünülmüştür.

Anahtar Kelimeler

• Yutma bozukluğu
• Solunum
• Rehabilitasyon
• Disfaji
• yutma

Expiratory Muscle Strength Training in Swallowing Disorders

Abstract

Swallowing and breathing are vital functions that work in coordination. Impaired coordination of swallowing and breathing makes people vulnerable to airway aspiration. The main aim of swallowing rehabilitation is to prevent aspiration and provide airway protection. Expiratory muscle strength training (EMST) is a treatment method designed to strengthen expiratory muscles and improve respiratory function. Although respiratory-based approaches in swallowing disorders are relatively new, EMST, a physiotherapy and rehabilitation technique, is making rapid progress in the swallowing literature and is the most widely used technique. Looking at the literature, the use of EMST in swallowing rehabilitation dates back to the early 2000s. In the process, studies on EMST have intensified and studies have often been conducted in neurological disease groups. The mechanisms of action of EMST in swallowing rehabilitation are thought to be that it provides airway closure by increasing suprahyoid muscle activation and facilitates the formation of a strong cough to prevent aspiration. EMST is a promising approach for swallowing rehabilitation. It was thought that studies on larger sample groups and different disease groups were needed to better define the mechanism of action.

Keywords

• Swallowing disorder
• Respiration
• Rehabilitation
• Dysphagia
• swallowing

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