Improving physical performance reduces dysphagia via improvement of tongue strength in patients with acute heart failure: a two-wave cross-lagged mediation model analysis.

Abstract

Physical performance improvement through whole-body exercise may have a positive impact on dysphagia via improvement of maximum tongue pressure (MTP). The present study aimed to quantitatively analyze whether improvement in physical performance reduces dysphagia by improving MTP in patients with acute heart failure (AHF). A total of 146 patients with AHF and dysphagia were included. Dysphagia was defined as a functional oral intake scale (FOIS) score < 6. The short physical performance battery (SPPB) indexed physical performance. A two-wave cross-lagged mediation model was used to examine whether an improvement in SPPB results improves the FOIS score via an improvement in MTP. The SPPB, MTP, and FOIS scores (T1: baseline, T2: hospital discharge) were included in the model. A total of 146 patients were included in the final analysis. The SPPB result at T1 positively affected MTP (β = 0.150, P = 0.030) and the FOIS score (β = 0.249, P = 0.002) at T2. MTP at T1 also positively affected the FOIS score at T2 (β = 0.189, P = 0.026). Furthermore, the SPPB result indirectly affected the FOIS score by affecting the MTP (indirect effect = 0.028; 95% CI = 0.010, 0.078). This study contributes to the knowledge base regarding the potential of exercise therapy as a new treatment strategy for dysphagia in patients with AHF. An improvement in SPPB results improved the FOIS score by improving the MTP in patients with AHF.