PARKİNSON HASTALARINDA KİNEZYO BANTLAMANIN YUTMA FONKSİYONUNA ETKİSİ: BİR YÜZEYEL ELEKTROMİYOGRAFİK YUTMA ÇALIŞMASI

Öz

Amaç: Parkinson hastalarında ilerleyici şekilde yutma bozukluğu görülmektedir. Bu çalışma; kinezyo bantlamanın (KT) yutma bozukluğu şikayeti olmayan ancak risk altındaki Parkinson’lu hastaların yutma fonksiyonu üzerindeki etkisini elektrofizyolojik yöntemler ile incelemek amacıyla planlandı. Yöntem: Çalışmaya 65 yaş ve üzeri, kardiyopulmoner hastalık öyküsü ve aspirasyon/penetrasyon bulgusu olmayan 18 Parkinson hastası ve 15 sağlıklı yaşlı birey dahil edildi. Bireylere altı hafta boyunca ve haftada üç kez olmak üzere kas fasilitasyon tekniği ile KT uygulandı. KT öncesinde ve altı hafta sonrasında yüzeyel elektromiyografik (EMG) yutma değerlendirmesi olarak tek lokma analizi yapıldı. Sonuçlar: KT öncesi sonuçlara bakıldığında Parkinson hastası grubuna ait laringeal relokasyon (p=0,011) ve submental EMG (SM-EMG) toplam (p=0,009) süreleri daha uzun bulunmasına rağmen, KT uygulaması sonrasında sağlıklı yaşlılara göre fark yoktu (p>0,05). Ayrıca bu grubun KT öncesi ve sonrası grup içi karşılaştırmaları sonucunda laringeal relokasyon (p=0,013) ve SM-EMG toplam (p=0,011) sürelerinin kısaldığı bulundu. Tartışma: Çalışmamızın sonucunda altı haftalık KT uygulaması ile Parkinson hastalarında larinks hareket süresi ve submental kas aktivasyonunun gelişerek yutma fonksiyonunda ilerleme sağlandığı görüldü. KT, yutma bozukluğu olan hastalarda destekleyici tedavi yöntemi olarak kullanılabilir. Yutma bozukluğunun ileri evrelerinde ise, etkinliğinin araştırılması gerekmektedir.

Anahtar Kelimeler

• Kinezyo bant
• Yutma
• Parkinson hastalığı
• Elektromiyografi

THE EFFECT OF KINESIO TAPING ON SWALLOWING FUNCTION IN PARKINSONIAN PATIENTS: A SURFACE ELECTROMYOGRAPHY STUDY

Abstract

Purpose: Progressive swallowing disorder is seen in Parkinson's patients. This study was designed to investigate the effect of kinesio taping (KT) on swallowing function by electrophysiological methods in Parkinson patients who had not swallowing problem, however, under risk. Methods: Eighteen with Parkinson’s disease and 15 healthy elderly who were 65 years and older, with no cardiopulmonary history and airway aspiration/penetration symptom were included in this study. They were applied KT with muscle facilitation technique for six weeks and three times per week. Single bolus analysis as surface electromyographic (EMG) swallowing evaluation was performed before and six weeks after the KT procedure. Results: According to pre-KT results, laryngeal relocation (p=0.011) and submental EMG (SMEMG) total duration (p=0.009) were longer at Parkinson patients group although there was not any difference at post-KT (p>0.05). Furthermore, the before-after intragroup comparison showed that laryngeal relocation (p=0.013) and SM-EMG total duration (p=0.011) were found to be shorten. Conclusion: The result of our study shows that larynx movement time and submental muscle activation were improved with six weeks of KT application in Parkinson's patients. KT can be used as a complementary treatment method in patients with swallowing disorder. However, further research is needed to explore the efficiency in advanced stages of swallowing disorder.

Keywords

• Kinesio tape
• Swallowing
• Parkinson’s disease
• Electromyography

References

1. 1. Kalf JG, de Swart BJ, Bloem BR, Munneke M. Prevalence of oropharyngeal dysphagia in Parkinson's disease: a meta-analysis. Parkinsonism Relat Disord. 2012;18(4):311-5.
2. 2. Rosenbek JC TM. Progressive neurologic disease and dysphagia (including Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis, myasthenia gravis, post-polio syndrome). In: Shaker R BP, Postma GN, Easterling C, editor. Principles of deglutition: a mul­tidisciplinary text for swallowing and its disorders. San Diego: Springer; 2013. p. 395-409.
3. 3. Ertekin C. Electrophysiological evaluation of oropharyngeal Dysphagia in Parkinson's disease. J Mov Disord. 2014;7(2):31-56.
4. 4. Mu L, Sobotka S, Chen J, Su H, Sanders I, Adler CH, et al. Altered pharyngeal muscles in Parkinson disease. J Neuropathol Exp Neurol. 2012;71(6):520-30.
5. 5. Baijens LW, Speyer R. Effects of therapy for dysphagia in Parkinson's disease: systematic review. Dysphagia. 2009;24(1):91-102.
6. 6. Menezes C, Melo A. Does levodopa improve swallowing dysfunction in Parkinson's disease patients? J Clin Pharm Ther. 2009;34(6):673-6.
7. 7. Troche MS, Brandimore AE, Foote KD, Okun MS. Swallowing and deep brain stimulation in Parkinson's disease: a systematic review. Parkinsonism Relat Disord. 2013;19(9):783-8.
8. 8. Cho HY, Kim EH, Kim J, Yoon YW. Kinesio taping improves pain, range of motion, and proprioception in older patients with knee osteoarthritis: a randomized controlled trial. Am J Phys Med Rehabil. 2015;94(3):192-200.

9. 9. Kase K, Wallis J, Kase T. Clinical Therapeutic Applications of the Kinesio Taping Method. 2 ed. Tokyo: Japan: Ken Ikai Co. Ltd; 2003.
10. 10. Lin C, Wu W, Chang K, Lin H, Chou L. Application of Kinesio Taping method for newborn swallowing difficulty: A case report and literature review. Medicine. 2016;95(31).
11. 11. Awan W, Aftab A, Janjua U, Ramzan R, Khan N. Effectiveness Of Kinesio Taping With Oromotor Exercises In Improving Drooling In Cerebral Palsy Children. The Rehabilitation Journal. 2017;1(02):3-9.
12. 12. Caneschi W, Paiva C, Frade R, Motta A. Use of elastic bandage associated with speech therapy in the control ofsialorrhea (hypersalivation). Revista CEFAC. 2014;16(5):1558-66.
13. 13. Leite M, de Freitas C. Labial tapping improves oral clinical parameters and the stage of drooling of cerebral palsy children. Journal of Dentistry Oral Care. 2015;1(3):1-5.
14. 14. Heo S, Kim K. Immediate effects of Kinesio Taping on the movement of the hyoid bone and epiglottis during swallowing by stroke patients with dysphagia. Journal of physical therapy science. 2015;27(11):3355-7.
15. 15. Mikami D, Furia C, Welker A. Addition of Kinesio Taping of the orbicularis oris muscles to speech therapy rapidly improves drooling in children with neurological disorders. Developmental Neurorehabilitation. 2017:1-6.
16. 16. Estrada NN, González AE. Effect of neuromuscular electrical stimulation and Kinesio taping in sialorrhea in patients with mild cerebral palsy and moderate. Fisioterapia. 2013;35(06):272-6.
17. 17. Tello C, González S, Blázquez B, Escacho M. Efficacy of kinesiotaping on ptyalism in children with special educational needs: an open clinical trial. Fisioterapia. 2012;34(6):275-81.
18. 18. Özekmekçi S. Parkinson Hastalığı ve Diğer Parkinsonizm Tabloları. In: Apaydın H, editor. Nöroloji Ders Kitabı. İstanbul: İÜ Cerrahpaşa Tıp Fakültesi Yayınları; 2009. p. 565-603.
19. 19. Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. 1967. Neurology. 2001;57(10 Suppl 3):S11-26.20. Ertekin C, Pehlivan M, Aydogdu I, Ertas M, Uludag B, Celebi G, et al. An electrophysiological investigation of deglutition in man. Muscle Nerve. 1995;18(10):1177-86.
20. 21. Aydogdu I, Tanriverdi Z, Ertekin C. Dysfunction of bulbar central pattern generator in ALS patients with dysphagia during sequential deglutition. Clin Neurophysiol. 2011;122(6):1219-28.
21. 22. Ertekin C, Tarlaci S, Aydogdu I, Kiylioglu N, Yuceyar N, Turman AB, et al. Electrophysiological evaluation of pharyngeal phase of swallowing in patients with Parkinson's disease. Mov Disord. 2002;17(5):942-9.
22. 23. Pehlivan M, Yuceyar N, Ertekin C, Celebi G, Ertas M, Kalayci T, et al. An electronic device measuring the frequency of spontaneous swallowing: digital phagometer. Dysphagia. 1996;11(4):259-64.
23. 24. Coriolano M, Belo LR, Carneiro D, Asano AG, Al Oliveira PJ, da Silva DM, et al. Swallowing in patients with Parkinson's disease: a surface electromyography study. Dysphagia. 2012;27(4):550-5.
24. 25. Wang C, Shieh W, Weng Y, Hsu Y, Wu Y. Non-invasive assessment determine the swallowing and respiration dysfunction in early Parkinson's disease. J Parkinsonism Related Disorders. 2017;42:22-7.
25. 26. Belo LR, Gomes NA, Coriolano M, de Souza ES, Moura DA, Asano AG, et al. The relationship between limit of Dysphagia and average volume per swallow in patients with Parkinson's disease. Dysphagia. 2014;29(4):419-24.
26. 27. Ali GN, Wallace KL, Schwartz R, De Carle DJ, Zagami AS, Cook IJ. Mechanisms of oral-pharyngeal dysphagia in patients with Parkinson's disease. Gastroenterology. 1996;110(2):383-92.
27. 28. Garnett R, Stephens JA. Changes in the recruitment threshold of motor units produced by cutaneous stimulation in man. J Physiol. 1981;311:463-73.
28. 29. Kanda K, Burke RE, Walmsley B. Differential control of fast and slow twitch motor units in the decerebrate cat. Exp Brain Res. 1977;29(1):57-74.
29. 30. Macgregor K, Gerlach S, Mellor R, Hodges PW. Cutaneous stimulation from patella tape causes a differential increase in vasti muscle activity in people with patellofemoral pain. J Orthop Res. 2005;23(2):351-8.
30. 31. Rofes L CP, Clavé P. The Effects of Sensory Stimulation on Neurogenic Oropharyngeal Dysphagia. Journal of Gastroenterology and Hepatology Research 2014;3(5):1066-72.
31. 32. Soylu A, Irmak R, Baltaci G. Acute effects of kinesiotaping on muscular endurance and fatigue by using surface electromyography signals of masseter muscle. J Med Sport. 2011;15(1):13-6.