[Improve Physical Fitness and Reduce Nasogastric Tube Insertions: Working to Achieve a 'No Tube' Life]

It is common in clinical settings for patients to suffer from dysphagia-related malnutrition and coughing-related aspiration pneumonia because of reduced levels of food intake. Nasogastric tube feeding provides nutrition and water and prevents choking related to oral feeding. Although dysphagia is often treated using medical and surgical treatments, degenerative-disease-related dysphagia is currently widely treated using nutritional support and rehabilitation to enhance muscle strength and coordination and reduce the risk of nasogastric tube placement in the future. Generally, the focus of muscle strength training for dysphagia is on muscle training related to swallowing and breathing. However, the process of eating requires the coordinated operation of the muscles of the lower limbs and the trunk to support the body's physical weight and maintain stable posture. When consuming food, an individual must rely on the activities of the upper limb muscles. Therefore, training the relevant muscles may effectively reduce the eating difficulties caused by muscle strength loss. In this article, empirical literature evidence related to improving frailty is collected and principles and practical suggestions are provided for improving physical fitness programs, including breathing muscle strengthening training, sitting and balance training, upper limb muscle strength training, and lower limb muscle strength training. It is hoped that the findings will be used as a guide in clinical practice.