Abstract
ABSTRACT Objetive: to identify, in the literature, studies that address the use of motor imagery of swallowing. Methods: a systematic review in SCOPUS databases, Science Direct and Medline, with descriptors and free terms "Motor Imagery"; "Swallow"; "Feeding"; "Stomatognathic System"; "mastication ", "Chew "; "Deglutition "; "Deglutition Disorders "; and "Mental Practice". Original articles using the motor imagery of swallowing were included, while reviews were excluded. For data analysis, at the first and second steps, the reading of titles and abstracts of the studies was carried out. In the third step, all studies that were not excluded were read in full. Results: four manuscripts were selected. The use of motor imagery in the rehabilitation of swallowing shows to be a recent proposal (2014-2015). The sample was reduced and comprised mainly healthy individuals. The EMG of the supra-hyoid muscles was used in two manuscripts. The most used neuroimaging technique was the Near-Infrared Spectroscopy, demonstrating the occurrence of hemodynamic changes during motor imagery and motor execution of swallowing. Conclusion: the motor imagery produces brain response in the motor area of the brain, suggesting that mentalization of actions related to swallowing is effective. However, further studies are needed for the application of this approach in the swallowing rehabilitation.
Highlights
ResultsThe use of motor imagery in the rehabilitation of swallowing shows to be a recent proposal (2014-2015)
Swallowing is an essential function for the maintenance of life, fundamental in the intake and absorption of nutrients by the body
A strategy of search was performed with the syntax: “Motor Imagery” (FT) AND “Swallow” (FT); “Motor Imagery” (FT) AND “Feeding” (DeCS); “Motor Imagery” (FT) AND “Stomatognathic System”(MeSH); “Motor Imagery” (FT) AND “mastication “(MeSH); “Motor Imagery” (FT) AND “Chew “(FT); “Motor Imagery” (FT) AND “Deglutition “(MeSH); “Motor imagery” (FT) AND “Deglutition Disorders “(MeSH)
Summary
Topography: Change of oxy-Hb and desoxy-H during MI and ME. Signal in the lower frontal gyrus, including the Broca area; Oxy-Hb higher during rest than during ME; - Oxy-Hb increased during MI and decreased during MI; Desoxy-Hb with higher concentration in tasks than at rest; DesoxyHb demonstrates positive correlation between MI and ME, mainly in the kinesthetic strategy of MI; Pre-motor; Supplemental motor area and subcentral area were involved in MI and ME; It involves the involvement of the insula during swallowing, not captured by the NIRS; Accuracy in the classification of 70.89% and 73.79% for MI of swallowing and tongue MI respectively in healthy individuals; Crossvalidation on average of 66.40% and 70.24% for MI of swallowing and MI of tongue for patients with stroke; Strong correlation in the classification between the MI of swallowing versus rest; and MI of tongue versus rest; it is possible to perform the swallowing MI to enable the rehabilitation of dysphagia in poststroke patients; Authors (Year) Kober et al, (2015b). The NIRS study with neurological patients 22 showed the occurrence of hemodynamic changes in the MI and ME of swallowing in patients with dysphagia and in a more pronounced form, in the inferior frontal gyrus, reinforcing the possibility to rehabilitate this function through the MI. In this study 6, it is suggested that in clinical practice, the swallowing or tongue MI can be used in the rehabilitation of swallowing in common situations, such as weak swallowing, for examples in patients with post-stroke dysphagia, as well as in those individuals who have late start swallowing, reducing the lag time at the beginning of the pharyngeal phase and avoinding situations related to escape and aspiration It indicates the difficulty of accomplishing the MI swallowing due to the complexity of the movement that involves sensory processing, coordination of chewing movements, breathing and attention. As the study realized with NIRS, it requires a larger number of participants to raise inference to the general population and facilitate the incorporation of the technique as an adjuvant of the conventional 22 swallowing rehabilitation
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