嚥下障害を簡単に⑩訓練編

今回は、喉の訓練法についてご紹介します。声門が閉まりづらく誤嚥のリスクがある方に対して、声門を閉める訓練を中心に挙げてみました。以下に挙げる訓練法は、比較的導入しやすいものばかりですので、ぜひ患者さんに適した方法を試してみてください🫡

①プッシング・プリング訓練

壁を押したり、肘掛けを引っ張ったりしながら強く発声することで、声帯の内転を強化し誤嚥を防止する訓練です。やり過ぎると声帯を痛めてしまう可能性があるため、可能であれば内視鏡で正しい運動ができているか確認することをお勧めします。

②咳嗽訓練

咽頭残留や誤嚥物を喀出するための訓練です。できるだけ深く息を吸ってもらった後、強い咳をしてもらいます。咳をする際に、必要に応じて下位肋骨や腹筋群の圧迫を行います。

今回は、簡単に行える喉の訓練についてご紹介しました。これらの訓練は呼吸とも深く関わっているため、理学療法士さんと相談しながら行うことをお勧めします😊

Dysphagia Made Simple ⑩training edition

In this issue, we will discuss throat training methods. For those who have difficulty closing the glottis and are at risk for aspiration, we have listed training mainly for closing the glottis. The training methods listed below are relatively easy to implement, so please try the methods that are appropriate for your patients 🫡.

1) Pushing/Pulling exercise

This training strengthens the internal rotation of the vocal cords and prevents aspiration by pushing against a wall or pulling on an armrest while vocalizing strongly. Excessive use of this exercise may damage the vocal cords, so if possible, it is recommended to confirm that the correct exercise is being performed by endoscopy.

(2) Cough training

This is a training to expel pharyngeal residues and aspirated material. After having the patient inhale as deeply as possible, ask the patient to cough strongly. During coughing, pressure is applied to the lower ribs and abdominal muscle groups as needed.

In this article, we have introduced some simple throat exercises that can be done easily. Since these exercises are closely related to breathing, we recommend that you do them in consultation with a physical therapist 😊.