Effects of Multidirectional Head Lift Exercise Based on Proprioceptive Neuromuscular Facilitation Techniques on Oropharyngeal Swallowing Muscles in Community‐Dwelling Older Adults With Oral Frailty

Background Dysphagia rehabilitation using proprioceptive neuromuscular facilitation (PNF) was recently introduced. However, the clinical evidence for this technique remains unclear. Objective This study aimed to investigate the effects of multidirectional head‐lift exercise using PNF techniques for the oropharyngeal swallowing muscles in older adults with oral frailty. Methods Older adults with oral frailty were enrolled in this study and randomly assigned to the experimental or control group. The experimental group performed multidirectional head‐lift exercises based on PNF techniques, whereas the control group performed conventional head‐lift exercises (90 times/day, 5 days/week for 6 weeks). Tongue strength and thickness were measured using an Iowa Oral Performance Instrument and ultrasonography, respectively. Additionally, suprahyoid muscle activation and thickness were measured using surface electromyography and ultrasonography, respectively. Results The experimental group showed significant improvements in tongue strength and thickness compared to the control group, as well as significant improvements in suprahyoid muscle activation and thickness (all, p < 0.05). Conclusion This study demonstrates that multidirectional head‐lift exercise based on PNF techniques is more effective than conventional head‐lift exercise in increasing the strength and thickness of the oropharyngeal muscles related to swallowing in older adults.