頭部挙上訓練の嚥下改善効果：系統的レビュー

頭部挙上訓練の嚥下機能への効果に関する系統的レビューを紹介します。

Eva Bolle Antunes, Nuno Lunet. Effects of the head lift exercise on the swallow function: a systematic review. Gerodontology, Article first published online: 21 MAY 2012, DOI: 10.1111/j.1741-2358.2012.00638.x

頭部挙上訓練（Shaker exercise）に関する9つの論文を系統的にレビューしています。結果ですが、喉頭の前方移動の増加、上部食道括約筋開大時の前後距離の増加、嚥下障害の症状の消失が報告されていました。

頭部挙上訓練は嚥下機能訓練の中で数少ない、エビデンスのある訓練の1つです。今回、系統的レビューでも有効性が検証されました。ただ、1分挙上、1分休憩を30回、これを1日3回で計3時間というのは実現可能性が低いので、修正版頭部挙上訓練の有効性の検証も望まれます。

Objective:  Ageing is associated with modifications in upper oesophageal sphincter function that may be deleterious to deglutition. The head lift exercise (Shaker exercise) is a head-raising work out aiming to improve the opening of this segment, and ultimately to reduce aspiration. We aimed to review critically the evidence on the effects of this structured intervention programme and to identify gaps to be filled by future research.

Material and Methods:  We identified published reports addressing the effect of this exercise in increasing the anteroposterior diameter and cross-sectional area of the deglutitive upper oesophageal sphincter opening or dysphagic symptoms.

Results:  Nine methodologically heterogeneous studies were included in the review, and the reported effects of the head lift exercise were an increase in the anterior excursion of the larynx and in the anteroposterior diameter of the upper oesophageal sphincter opening, and the elimination of dysphagic symptoms.

Conclusion:  Further studies including control groups and accounting for potential confounders are needed for a sound assessment of the effectiveness of this technique. The data on the functional results are, however, promising for dysphagia interventions.