Tesis

Efek Tongue-to-Palate Resistance Training terhadap Penetration Aspiration Scale (PAS) dan Aktivitas Listrik Suprahyoid pada Pasien Geriatri dengan Disfagia Fase Orofaringeal = Effect of Tongue-to-Palate Resistance Training on Penetration-Aspiration Scale and Suprahyoid Muscle Electrical Activity in Geriatric Patients with Oropharyngeal Dysphagia.

Latar Belakang: Disfagia orofaring sering terjadi pada lansia berhubungan dengan malnutrisi, aspirasi, serta peningkatan morbiditas. Tongue-to-Palate Resistance Training (TPRT) dapat dilakukan di rumah berfungsi memperkuat otot lidah dan otot suprahyoid, namun efeknya pada pasien geriatri belum banyak diteliti. Objektif: Studi ini mengevaluasi pengaruh TPRT terhadap aktivitas listrik otot suprahyoid dan keamanan menelan pasien geriatri dengan disfagia orofaring. Metode: Penelitian single-blind randomized controlled trial pada pasien geriatri yang didiagnosis disfagia fase orofaringeal melalui videofluoroscopic swallowing study (VFSS). Kelompok intervensi menjalani TPRT selama delapan minggu, sedangkan kelompok kontrol melakukan latihan menelan standar. Aktivitas listrik otot suprahyoid diukur menggunakan surface electromyography (sEMG), fungsi menelan dinilai melalui PAS (Penetration Aspiration Scale). Hasil: Sebanyak 17 peserta menyelesaikan penelitian (9 intervensi, 8 kontrol). Kedua kelompok menunjukkan peningkatan signifikan seiring waktu pada aktivitas listrik otot suprahyoid (p < 0,001), dengan effect size yang lebih besar pada kelompok TPRT; perbedaan antar kelompok tidak signifikan. Skor PAS membaik pada kedua kelompok (median intervensi 4→2; kontrol 4,5→2) tanpa perbedaan signifikan antar kelompok. Kesimpulan: TPRT meningkatkan aktivitas listrik otot suprahyoid, namun tidak ada perbedaan signifikan secara statistik pada skor PAS pada pasien geriatri dengan disfagia fase orofaringeal, dibutuhkan studi lebih lanjut dengan sampel lebih besar.
Kata kunci: aspirasi, disfagia, rehabilitasi, menelan, lidah, suprahyoid


Background: Oropharyngeal dysphagia is common in elderly and is associated with malnutrition, aspiration, and morbidity. Tongue-to-palate resistance training (TPRT) is a home-based exercise design to strengthen tongue and suprahyoid muscles, however its effects in the geriatric are not well studied. Objective: This study evaluates the effect of TPRT on electrical activity suprahyoid muscle and swallowing safety in geriatric patients with oropharyngeal dysphagia. Methods: A single-blind randomized controlled trial was conducted on geriatric patients diagnosed with oropharyngeal dysphagia via a videofluoroscopic swallowing study (VFSS). The intervention group underwent TPRT for eight weeks, while the control group performed standard swallowing exercises. Suprahyoid muscle electrical activity was measured using surface electromyography (sEMG), and swallowing function was assessed using the Penetration-Aspiration Scale (PAS). Results: Seventeen participants completed the study (9 intervention, 8 control). Both groups showed significant improvement over time in suprahyoid muscle activity (p < 0.001), with a larger effect size observed in the TPRT group; however, the difference between groups was not significant. PAS scores improved in both groups (intervention median: 4→2; control median: 4.5→2) with no significant difference between the groups. Conclusion: TPRT increases the electrical activity of suprahyoid muscles; however, there were no statistically significant differences in PAS scores among geriatric patients with oropharyngeal dysphagia. Further studies with larger sample sizes are required.
Keywords: aspiration; dysphagia; rehabilitation; swallowing; tongue, suprahyoid