2021 Volume 25 Issue 3 Pages 229-237
Purpose: The Tsubame (swallow) exercise was developed to maintain and promote swallowing, pulmonary function and limb motor function among community-dwelling elderly people. To confirm its applicability to patients with esophageal cancer scheduled for neoadjuvant chemotherapy (NAC) and surgery, this pilot study examined the effect when the exercise was performed by young women for 3 weeks and its intensity level.
Methods: The participants were 14 females with a mean age of 21. The Tsubame Exercise consists of neck, shoulder, chest and limb movements to be executed while singing lyrics containing many words that start with “p” and “t” (duration: 1 min and 11 s/time). The participants performed 1 set (4 times) of the Tsubame Exercise, with a Lifecoder GS (4-second edition) attached to measure the exercise intensity level. They were instructed to perform 3 sets every day during a 3-week period. Before and after implementation, tongue pressure, functions to produce the 3 s of “pa”, “ta”, and “ka”, maximum expiratory volume, sternocleidomastoid (SCM) and trapezius (TPZ) elasticity/stiffness, hand grip strength, skeletal muscle mass and gait speed when walking 4 m were measured using a tongue pressure meter, oral function test device (Kenko-kun®), digital peak flow meter, myotonometer (MyotonPRO Digital Palpation Device®), digital hand dynamometer, and a body composition analyzer (InBody270®). The measurement values at both points were analyzed using statistical analysis software, with the significance level set at 5%.
Results: The intensity level of the Tsubame Exercise was 1.41±0.13 METs. The task (continuously performing the exercise for 3 weeks) completion rate was 79%. On comparing the pre- and post-implementation values of 11 participants with a task completion rate of 70% or higher, tongue pressure and gait speed significantly increased after intervention (p＜0.05). SCM and TPZ elasticity and stiffness decreased after intervention, and the differences in SCM stiffness (left), TPZ stiffness (both sides), and TPZ elasticity (right) were significant (p＜0.05). On the other hand, frequency of producing “pa” significantly decreased after implementation (p＜0.05).
Discussion: The intensity level of the Tsubame Exercise was shown to be low. However, it was suggested that tongue pressure and gait speed increased, and TPZ elasticity and stiffness decreased after continuously performing it for 3 weeks. In future, it is necessary to examine effects such as the frequency of interactions with people as the number of utterances of /pa/ decreased after implementation.
