Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora

Sepúlveda-Contreras, Jorge; Jarpa-Muñoz, Francisca

doi:10.46634/riics.81

Titulo:

Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora
.

Sumario:

Introducción. La selección del tratamiento para pacientes con disfagia debe basarse en evidencia con la mejor calidad posible. Este tratamiento puede involucrar ejercicios de rehabilitación con el objetivo de modificar la fisiología de la deglución y promover cambios a largo plazo. Objetivo. Explorar los efectos de ejercicios y maniobras destinadas a la reactivación de la función de deglución en personas con disfagia orofaríngea posterior a un accidente cerebrovascular, a través de publicaciones científicas existentes en los últimos diez años. Metodología. Se realizó una revisión de la literatura en las bases de datos PubMed con los términos MeSH “Deglutition Disorders” y “Exercise Therapy”, y con los términos libres “Dysphagia” y “Swallowi... Ver más

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Revista:

Revista de Investigación e Innovación en Ciencias de la Salud

EISSN:

2665-2056

Autores:

Sepúlveda-Contreras, Jorge

Jarpa-Muñoz, Francisca

Editor:

FUNDACION UNIVERSITARIA MARIA CANO

DOI:

10.46634/riics.81

Volumen:

Año de publicación:

2022-02-05

Pagina inicial:

Pagina final:

Pais:

Colombia

Palabras claves:

Trastornos de la deglución

deglución

orofaringe

rehabilitación

rehabilitación de accidente cerebro vascular

accidente cerebro vascular

terapia de ejercicio

accidente cerebro vascular isquémico

accidente cerebro vascular hemorrágico

neumonía por aspiración

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Revista de Investigación e Innovación en Ciencias de la Salud - 2022

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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country_str	Colombia
collection	Revista de Investigación e Innovación en Ciencias de la Salud
title	Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora
spellingShingle	Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora Sepúlveda-Contreras, Jorge Jarpa-Muñoz, Francisca Trastornos de la deglución deglución orofaringe rehabilitación rehabilitación de accidente cerebro vascular accidente cerebro vascular terapia de ejercicio accidente cerebro vascular isquémico accidente cerebro vascular hemorrágico neumonía por aspiración Deglutition disorders deglutition oropharynx rehabilitation stroke rehabilitation exercise therapy stroke ischemic stroke hemorrhagic stroke pneumonia aspiration
title_short	Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora
title_full	Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora
title_fullStr	Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora
title_full_unstemmed	Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora
title_sort	efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora
description	Introducción. La selección del tratamiento para pacientes con disfagia debe basarse en evidencia con la mejor calidad posible. Este tratamiento puede involucrar ejercicios de rehabilitación con el objetivo de modificar la fisiología de la deglución y promover cambios a largo plazo. Objetivo. Explorar los efectos de ejercicios y maniobras destinadas a la reactivación de la función de deglución en personas con disfagia orofaríngea posterior a un accidente cerebrovascular, a través de publicaciones científicas existentes en los últimos diez años. Metodología. Se realizó una revisión de la literatura en las bases de datos PubMed con los términos MeSH “Deglutition Disorders” y “Exercise Therapy”, y con los términos libres “Dysphagia” y “Swallowing Therapy”, combinados con el booleano de intersección “AND”. Resultados. Los ejercicios con entrenamiento de resistencia de lengua al paladar, entrenamiento de la fuerza muscular espiratoria (EMST), chin tuck contra resistencia (CTAR), Shaker y apertura mandibular fueron los que mostraron, con mayor respaldo bibliográfico, efectos positivos en el tratamiento de la disfagia. Conclusiones. La información recopilada podría ser de utilidad clínica para guiar la selección de uno u otro procedimiento terapéutico. Se debe continuar generando evidencia relacionada con la efectividad de los ejercicios deglutorios en la disfagia orofaríngea posterior a un ACV.
description_eng	Introduction. The treatment selection for patients with dysphagia should be based on the best possible quality evidence. This treatment may involve rehabilitative exercises with the aim of modifying swallowing physiology and promoting long-term changes. Objective. To explore the effects of exercises and maneuvers aimed at reactivating swallowing function in people with oropharyngeal dysphagia after a stroke, through existing scientific publications from the last ten years. Methodology. A literature review was carried out in the PubMed databases with the MeSH terms “Deglutition Disorders” and “Exercise Therapy”, and with the free terms “Dysphagia” and “Swallowing Therapy”, combined with the Boolean intersection "AND". Results. The tongue-to-palate resistance training exercises, expiratory muscle strength training (EMST), chin tuck against resistance (CTAR), Shaker, and jaw opening were those that showed, with greater bibliographic support, positive effects in the treatment of dysphagia. Conclusions. The information collected could be of clinical utility to guide the selection of one or another therapeutic procedure. Evidence should continue to be generated regarding the effectiveness of swallowing exercises in oropharyngeal dysphagia after stroke.
author	Sepúlveda-Contreras, Jorge Jarpa-Muñoz, Francisca
author_facet	Sepúlveda-Contreras, Jorge Jarpa-Muñoz, Francisca
topicspa_str_mv	Trastornos de la deglución deglución orofaringe rehabilitación rehabilitación de accidente cerebro vascular accidente cerebro vascular terapia de ejercicio accidente cerebro vascular isquémico accidente cerebro vascular hemorrágico neumonía por aspiración
topic	Trastornos de la deglución deglución orofaringe rehabilitación rehabilitación de accidente cerebro vascular accidente cerebro vascular terapia de ejercicio accidente cerebro vascular isquémico accidente cerebro vascular hemorrágico neumonía por aspiración Deglutition disorders deglutition oropharynx rehabilitation stroke rehabilitation exercise therapy stroke ischemic stroke hemorrhagic stroke pneumonia aspiration
topic_facet	Trastornos de la deglución deglución orofaringe rehabilitación rehabilitación de accidente cerebro vascular accidente cerebro vascular terapia de ejercicio accidente cerebro vascular isquémico accidente cerebro vascular hemorrágico neumonía por aspiración Deglutition disorders deglutition oropharynx rehabilitation stroke rehabilitation exercise therapy stroke ischemic stroke hemorrhagic stroke pneumonia aspiration
citationvolume	4
citationissue	1
publisher	Fundación Universitaria María Cano
ispartofjournal	Revista de Investigación e Innovación en Ciencias de la Salud
source	https://riics.info/index.php/RCMC/article/view/81
language	spa
format	Article
rights	https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es Revista de Investigación e Innovación en Ciencias de la Salud - 2022 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2
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Kim DY, Park HS, Park SW, Kim JH. The impact of dysphagia on quality of life in stroke patients. Medicine. 2020;99(34):e21795. doi: https://doi.org/10.1097/MD.0000000000021795 6. Vose A, Nonnenmacher J, Singer ML, González-Fernández M. Dysphagia Management in Acute and Sub-acute Stroke. Current physical medicine and rehabilitation reports. 2014;2(4):197–206. doi: https://doi.org/10.1007/s40141-014-0061-2 7. Bath PM, Lee HS, Everton LF. Swallowing therapy for dysphagia in acute and subacute stroke. The Cochrane database of systematic reviews. 2018;10(10):CD000323. doi: https://doi.org/10.1002/14651858.CD000323.pub3 8. Terré R. Disfagia orofaríngea en el ictus: aspectos diagnósticos y terapéuticos [Oropharyngeal dysphagia in stroke: diagnostic and therapeutic aspects]. Revista de neurologia. 2020;70(12):444–452. doi: https://doi.org/10.33588/rn.7012.2019447 9. Logemann JA. Swallowing disorders. Best practice & research. Clinical gastroenterology. 2007;21(4):563–573. doi: https://doi.org/10.1016/j.bpg.2007.03.006 10. Langmore SE, Pisegna JM. Efficacy of exercises to rehabilitate dysphagia: A critique of the literature. International Journal of Speech-Language. Pathology. 2015;17(3):222–229. doi: https://doi.org/10.3109/17549507.2015.1024171 11. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009;6(7): e1000097. doi: https://doi.org/10.1371/journal.pmed.1000097 12. 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. Journal of Oral Rehabilitation, 2017;44(1):59-64. doi: https://doi.org/10.1111/joor.12461 13. Moon JH, Hahm SC, Won YS, Cho, HY. The effects of tongue pressure strength and accuracy training on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia. International Journal of Rehabilitation Research. 2018;41(3):204-210. doi: https://doi.org/10.1097/mrr.0000000000000282 14. Steele CM, Bayley MT, Peladeau-Pigeon M, Nagy A, Namasivayam AM, Stokely SL, Wolkin T. A Randomized Trial Comparing Two Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia. Dysphagia. 2016;31(3):452–461. doi: https://doi.org/10.1007/s00455-016-9699-5 15. Hegland KW, Davenport PW, Brandimore AE, Singletary FF, Troche MS. Rehabilitation of Swallowing and Cough Functions Following Stroke: An Expiratory Muscle Strength Training Trial. Archives of Physical Medicine and Rehabilitation. 2016;97(8):1345–1351. doi: https://doi.org/10.1016/j.apmr.2016.03.027 16. Eom MJ, Chang MY, Oh DH, Kim HD, Han NM, Park JS. Effects of resistance expiratory muscle strength training in elderly patients with dysphagic stroke. NeuroRehabilitation. 2017;41(4):747-752. doi: https://doi.org/10.3233/NRE-172192 17. Park JS, Oh DH, Chang MY, Kim KM. Effects of expiratory muscle strength training on oropharyngeal dysphagia in subacute stroke patients: a randomised controlled trial. Journal of Oral Rehabilitation. 2016;43(5):364–372. doi: https://doi.org/10.1111/joor.12382 18. Easterling C, Grande B, Kern M, Sears K, Shaker R. Attaining and Maintaining Isometric and Isokinetic Goals of the Shaker Exercise. Dysphagia. 2005;20(2):133–138. doi: https://doi.org/10.1007/s00455-005-0004-2 19. Choi JB, Shim SH, Yang JE, Kim HD, Lee DH, Park JS. Effects of Shaker exercise in stroke survivors with oropharyngeal dysphagia. NeuroRehabilitation. 2017;41(4):753–757. doi: https://doi.org/10.3233/nre-172145 20. Gao J, Zhang H. Effects of chin tuck against resistance exercise versus Shaker exercise on dysphagia and psychological state after cerebral infarction. European Journal of Physical and Rehabilitation Medicine. 2017;53(3):426-432. doi: https://doi.org/10.23736/S1973-9087.16.04346-X. 21. Park JS, Hwang NK, Oh DH, Chang MY. Effect of head lift exercise on kinematic motion of the hyolaryngeal complex and aspiration in patients with dysphagic stroke. Journal of Oral Rehabilitation. 2017;44(5):385–391. doi: https://doi.org/10.1111/joor.12492 22. Choi JB, Jung YJ, Park JS. Comparison of 2 types of therapeutic exercise: jaw opening exercise and head lift exercise for dysphagic stroke: A pilot study. Medicine. 2020;99(38):e22136. doi: https://doi.org/10.1097/MD.0000000000022136 23. Hara K, Tohara H, Minakuchi S. Treatment and evaluation of dysphagia rehabilitation especially on suprahyoid muscles as jaw-opening muscles. The Japanese dental science review. 2018;54(4):151–159. doi: https://doi.org/10.1016/j.jdsr.2018.06.003 24. Koyama Y, Sugimoto A, Hamano T, Kasahara T, Toyokura M. Masakado Y. Proposal for a modified jaw opening exercise for dysphagia: a randomized, controlled trial. Tokai Journal of Experimental and Clinical Medicine. 2017;42(2):71‐8. Disponible en: http://mj-med-u-tokai.com/pdf/420203.pdf 25. Wada S, Tohara H, Iida T, Inoue M, Sato M, Ueda K. Jaw-Opening Exercise for Insufficient Opening of Upper Esophageal Sphincter. Archives of Physical. Medicine and Rehabilitation. 2012;93(11):1995–1999. doi: https://doi.org/10.1016/j.apmr.2012.04.025 26. Park JS, An DH, Kam KY, Yoon T, Kim T, Chang MY. Effects of resistive jaw opening exercise in stroke patients with dysphagia: A double- blind, randomized controlled study. Journal of Back and Musculoskeletal Rehabilitation. 2020;33(3):507-513. doi: https://doi.org/10.3233/bmr-181477 27. Yoon WL, Khoo JKP, Rickard Liow SJ. Chin Tuck Against Resistance (CTAR): New Method for Enhancing Suprahyoid Muscle Activity Using a Shaker-type Exercise. Dysphagia. 2013;29(2):243–248. doi: https://doi.org/10.1007/s00455-013-9502-9 28. Park JS, Lee G, Jung YJ. Effects of game-based chin tuck against resistance exercise vs head-lift exercise in patients with dysphagia after stroke: An assessor-blind, randomized controlled trial. Journal of rehabilitation medicine. 2019;51(10):749–754. doi: https://doi.org/10.2340/16501977-2603 29. Kim H, Park J. Efficacy of modified chin tuck against resistance exercise using hand‐free device for dysphagia in stroke survivors: A randomised controlled trial. Journal of Oral Rehabilitation. 2019;46(11):1042-1046. doi: https://doi.org/10.1111/joor.12837 30. Park JS, An DH, Oh DH, Chang MY. Effect of chin tuck against resistance exercise on patients with dysphagia following stroke: A randomized pilot study. NeuroRehabilitation. 2018;42(2):191–197. doi: https://doi.org/10.3233/nre-172250 31. Logemann JA, Kahrilas PJ. Relearning to swallow after stroke--application of maneuvers and indirect biofeedback: a case study. Neurology. 1990;40(7):1136–1138. doi: https://doi.org/10.1212/wnl.40.7.1136 32. Logemann JA. Dysphagia: Evaluation and Treatment. Folia Phoniatrica et Logopaedica. 1995;47(3):140–164. doi: https://doi.org/10.1159/000266348 33. McCullough GH, Kim Y. Effects of the Mendelsohn maneuver on extent of hyoid movement and UES opening post-stroke. Dysphagia. 2013;28(4):511–519. doi: https://doi.org/10.1007/s00455-013-9461-1 34. McCullough GH, Kamarunas E, Mann GC, Schmidley JW, Robbins JA, Crary MA. Effects of Mendelsohn maneuver on measures of swallowing duration post stroke. Topics in stroke rehabilitation. 2012;19(3):234–243. doi: https://doi.org/10.1310/tsr1903-234 35. 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. International Journal of Language & Communication Disorders. 2019;54(3):479-484. doi: https://doi.org/10.1111/1460-6984.12453 36. Rosenbek JC, Robbins J, Willford WO, Kirk G, Schiltz A, Sowell TW, et al. Comparing treatment intensities of tactile-thermal application. Dysphagia. 1998;13(1):1–9. doi: https://doi.org/10.1007/PL00009542 37. Logemann JA. Manual for the videofluorographic study of swallowing. San Diego: College-Hill Press; 1986. 38. Nakamura T, Fujishima I. Usefulness of Ice Massage in Triggering the Swallow Reflex. Journal of Stroke and Cerebrovascular Diseases. 2013;22(4):378–382. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2011.09.016 39. Hwang NK, Kim HH, Shim JM, Park JS. Tongue stretching exercises improve tongue motility and oromotor function in patients with dysphagia after stroke: A preliminary randomized controlled trial. Archives of oral biology. 2019;108:104521. doi: https://doi.org/10.1016/j.archoralbio.2019.104521 40. Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am. 2008;19(4):691-vii. doi: https://doi.org/10.1016/j.pmr.2008.06.001 41. Guevara DE, Avendaño SS, Salazar AA, Alarcón BM, Santelices SM. Contribución de la temperatura fría y el sabor ácido en la intervención fonoaudiológica de la disfagia orofaríngea. Revista Chilena de Fonoaudiología. 2016;15:1-9. doi: https://doi.org/10.5354/0719-4692.2016.44206 42. Imada M, Kagaya H, Ishiguro Y, Miho K, Yoko I, Takashi T, et al. Effect of visual biofeedback to acquire supraglottic swallow in healthy individuals: a randomized-controlled trial. Journal of Rehabilitation Research, 2016;39(2):181-184. doi: https://doi.org/10.1097/mrr.0000000000000154
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spelling	Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora Introducción. La selección del tratamiento para pacientes con disfagia debe basarse en evidencia con la mejor calidad posible. Este tratamiento puede involucrar ejercicios de rehabilitación con el objetivo de modificar la fisiología de la deglución y promover cambios a largo plazo. Objetivo. Explorar los efectos de ejercicios y maniobras destinadas a la reactivación de la función de deglución en personas con disfagia orofaríngea posterior a un accidente cerebrovascular, a través de publicaciones científicas existentes en los últimos diez años. Metodología. Se realizó una revisión de la literatura en las bases de datos PubMed con los términos MeSH “Deglutition Disorders” y “Exercise Therapy”, y con los términos libres “Dysphagia” y “Swallowing Therapy”, combinados con el booleano de intersección “AND”. Resultados. Los ejercicios con entrenamiento de resistencia de lengua al paladar, entrenamiento de la fuerza muscular espiratoria (EMST), chin tuck contra resistencia (CTAR), Shaker y apertura mandibular fueron los que mostraron, con mayor respaldo bibliográfico, efectos positivos en el tratamiento de la disfagia. Conclusiones. La información recopilada podría ser de utilidad clínica para guiar la selección de uno u otro procedimiento terapéutico. Se debe continuar generando evidencia relacionada con la efectividad de los ejercicios deglutorios en la disfagia orofaríngea posterior a un ACV. Introduction. The treatment selection for patients with dysphagia should be based on the best possible quality evidence. This treatment may involve rehabilitative exercises with the aim of modifying swallowing physiology and promoting long-term changes. Objective. To explore the effects of exercises and maneuvers aimed at reactivating swallowing function in people with oropharyngeal dysphagia after a stroke, through existing scientific publications from the last ten years. Methodology. A literature review was carried out in the PubMed databases with the MeSH terms “Deglutition Disorders” and “Exercise Therapy”, and with the free terms “Dysphagia” and “Swallowing Therapy”, combined with the Boolean intersection "AND". Results. The tongue-to-palate resistance training exercises, expiratory muscle strength training (EMST), chin tuck against resistance (CTAR), Shaker, and jaw opening were those that showed, with greater bibliographic support, positive effects in the treatment of dysphagia. Conclusions. The information collected could be of clinical utility to guide the selection of one or another therapeutic procedure. Evidence should continue to be generated regarding the effectiveness of swallowing exercises in oropharyngeal dysphagia after stroke. Sepúlveda-Contreras, Jorge Jarpa-Muñoz, Francisca Trastornos de la deglución deglución orofaringe rehabilitación rehabilitación de accidente cerebro vascular accidente cerebro vascular terapia de ejercicio accidente cerebro vascular isquémico accidente cerebro vascular hemorrágico neumonía por aspiración Deglutition disorders deglutition oropharynx rehabilitation stroke rehabilitation exercise therapy stroke ischemic stroke hemorrhagic stroke pneumonia aspiration 4 1 Artículo de revista Journal article 2022-02-05T00:00:00Z 2022-02-05T00:00:00Z 2022-02-05 application/pdf text/xml Fundación Universitaria María Cano Revista de Investigación e Innovación en Ciencias de la Salud 2665-2056 https://riics.info/index.php/RCMC/article/view/81 10.46634/riics.81 https://doi.org/10.46634/riics.81 spa https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es Revista de Investigación e Innovación en Ciencias de la Salud - 2022 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. 73 91 Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756–2763. doi: https://doi.org/10.1161/01.STR.0000190056.76543.eb 2. González-Fernández M, Ottenstein L, Atanelov L, Christian AB. Dysphagia after Stroke: an Overview. Current physical medicine and rehabilitation reports. 2013;1(3):187–196. doi: https://doi.org/10.1007/s40141-013-0017-y 3. Arnold M, Liesirova K, Broeg-Morvay A, Meisterernst J, Schlager M, Mono ML, et al. Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome. PloS one. 2016;11(2):e0148424. doi: https://doi.org/10.1371/journal.pone.0148424 4. Terré R, Mearin F. Oropharyngeal dysphagia after the acute phase of stroke: predictors of aspiration. Neurogastroenterology and motility: the official journal of the European Gastrointestinal Motility Society. 2006;18(3):200–205. doi: https://doi.org/10.1111/j.1365-2982.2005.00729 5. Kim DY, Park HS, Park SW, Kim JH. The impact of dysphagia on quality of life in stroke patients. Medicine. 2020;99(34):e21795. doi: https://doi.org/10.1097/MD.0000000000021795 6. Vose A, Nonnenmacher J, Singer ML, González-Fernández M. Dysphagia Management in Acute and Sub-acute Stroke. Current physical medicine and rehabilitation reports. 2014;2(4):197–206. doi: https://doi.org/10.1007/s40141-014-0061-2 7. Bath PM, Lee HS, Everton LF. Swallowing therapy for dysphagia in acute and subacute stroke. The Cochrane database of systematic reviews. 2018;10(10):CD000323. doi: https://doi.org/10.1002/14651858.CD000323.pub3 8. Terré R. Disfagia orofaríngea en el ictus: aspectos diagnósticos y terapéuticos [Oropharyngeal dysphagia in stroke: diagnostic and therapeutic aspects]. Revista de neurologia. 2020;70(12):444–452. doi: https://doi.org/10.33588/rn.7012.2019447 9. Logemann JA. Swallowing disorders. Best practice & research. Clinical gastroenterology. 2007;21(4):563–573. doi: https://doi.org/10.1016/j.bpg.2007.03.006 10. Langmore SE, Pisegna JM. Efficacy of exercises to rehabilitate dysphagia: A critique of the literature. International Journal of Speech-Language. Pathology. 2015;17(3):222–229. doi: https://doi.org/10.3109/17549507.2015.1024171 11. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009;6(7): e1000097. doi: https://doi.org/10.1371/journal.pmed.1000097 12. 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. Journal of Oral Rehabilitation, 2017;44(1):59-64. doi: https://doi.org/10.1111/joor.12461 13. Moon JH, Hahm SC, Won YS, Cho, HY. The effects of tongue pressure strength and accuracy training on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia. 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Revista Chilena de Fonoaudiología. 2016;15:1-9. doi: https://doi.org/10.5354/0719-4692.2016.44206 42. Imada M, Kagaya H, Ishiguro Y, Miho K, Yoko I, Takashi T, et al. Effect of visual biofeedback to acquire supraglottic swallow in healthy individuals: a randomized-controlled trial. Journal of Rehabilitation Research, 2016;39(2):181-184. doi: https://doi.org/10.1097/mrr.0000000000000154 https://riics.info/index.php/RCMC/article/download/81/231 https://riics.info/index.php/RCMC/article/download/81/266 info:eu-repo/semantics/article http://purl.org/coar/resource_type/c_6501 http://purl.org/coar/resource_type/c_dcae04bc http://purl.org/redcol/resource_type/ARTREV info:eu-repo/semantics/publishedVersion http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 Text Publication

Efectividad de ejercicios para rehabilitar la disfagia orofaríngea posterior a un accidente cerebrovascular: una revisión integradora .

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