{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:02:01Z","timestamp":1779915721747,"version":"3.53.1"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dysphagia rehabilitation using proprioceptive neuromuscular facilitation (PNF) was recently introduced. However, the clinical evidence for this technique remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the effects of multidirectional head\u2010lift exercise using PNF techniques for the oropharyngeal swallowing muscles in older adults with oral frailty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2010lift exercises based on PNF techniques, whereas the control group performed conventional head\u2010lift exercises (90 times\/day, 5\u2009days\/week for 6\u2009weeks). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that multidirectional head\u2010lift exercise based on PNF techniques is more effective than conventional head\u2010lift exercise in increasing the strength and thickness of the oropharyngeal muscles related to swallowing in older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joor.70031","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T11:38:33Z","timestamp":1754480313000},"page":"2282-2290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Multidirectional Head Lift Exercise Based on Proprioceptive Neuromuscular Facilitation Techniques on Oropharyngeal Swallowing Muscles in Community\u2010Dwelling Older Adults With Oral Frailty"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7113-4792","authenticated-orcid":false,"given":"Ji\u2010Su","family":"Park","sequence":"first","affiliation":[{"name":"Research Institute for Korean Medicine Pusan National University  Yangsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HyunDong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Inje University Busan Paik Hospital  Busan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NaMi","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Inje University Busan Paik Hospital  Busan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2008.06.001"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-009-9211-6"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(03)00237-2"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2023.11.019"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-172306"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102854"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2009\/08-0131)"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0594.2009.00560.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S209055"},{"issue":"6","key":"e_1_2_10_11_1","first-page":"1518","article-title":"Augmentation of Deglutitive Upper Esophageal Sphincter Opening in the Elderly by Exercise","volume":"272","author":"Shaker R.","year":"1997","journal-title":"American Journal of Physiology"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.32999"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-86502-w"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-020-10104-3"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12492"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-2358.2012.00638.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-172145"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05772-3"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ger.12347"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-018-9940-5"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12835"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12944"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-019-10071-4"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000017304"},{"issue":"3","key":"e_1_2_10_25_1","first-page":"343","article-title":"Heterogeneity in Vertical Positioning of the Hyoid Bone in Relation to Genioglossal Activity in Men","volume":"74","author":"Pae E. 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