1
|
Jung ES, Choi YY, Lee KH. Smartphone-based combined oral and whole-body exercise programme aimed at improving oral functions: A randomized clinical trial. Int J Dent Hyg 2024. [PMID: 38606673 DOI: 10.1111/idh.12807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/22/2024] [Accepted: 03/30/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES To investigate the effects of a smartphone-based oral and whole-body exercise programme on oral function in older adults. METHODS Individuals aged 65 years or above were randomized into three groups (non-app use, app use and control group), and a combined oral and whole-body exercise programme was conducted for 5 weeks. Oral muscle strength, saliva flow rate, Oral Health Impact Profile-14 (OHIP-14), and Geriatric Oral Health Assessment Index (GOHAI) were measured before and after the intervention. The changes in each group were analysed at the end of the programme using paired sample t-tests, and the differences among the groups were analysed using the chi-square test, Fisher's exact test and ANOVA. RESULTS The anterior tongue strength increased by 2.80 kPa after the intervention in the non-app use group; however, the change was not statistically significant. In the app use group, the anterior tongue strength significantly increased by 4.48 kPa. The saliva flow rate increased by 0.54 and 0.71 g/min in the non-app and app use groups, respectively, after the intervention (p < 0.05), and the change was greater in the app use group than in the other groups (p < 0.01). There were no significant changes in the posterior tongue strength, cheek strength, OHIP-14 or GOHAI scores over the course of the study. CONCLUSIONS A smartphone-based combined oral and whole-body exercise programme can improve anterior tongue strength and saliva flow rate in older participants. The programme, however, did not result in significant changes in posterior tongue strength, cheek strength and perceived oral health.
Collapse
Affiliation(s)
- Eun Seo Jung
- BK21 FOUR R&E Center for Learning Health Systems and Department of Public Health Science, Graduate School, Korea University, Seoul, Korea
| | - Yoon Young Choi
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Korea
| | - Kyeong Hee Lee
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Korea
| |
Collapse
|
2
|
Baudelet M, Van den Steen L, Duprez F, Goeleven A, Nuyts S, Nevens D, Vandenbruaene C, Massonet H, Vergauwen A, Vauterin T, Verstraete H, Wouters K, Vanderveken O, De Bodt M, Van Nuffelen G. Prophylactic Swallowing Therapy During Head-and-Neck Cancer Radiotherapy: Effect of Service-Delivery Mode and Overall Adherence Level on Swallowing Function and Muscle Strength-the PRESTO Trial. Dysphagia 2024; 39:267-281. [PMID: 37550571 PMCID: PMC10957706 DOI: 10.1007/s00455-023-10609-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 07/24/2023] [Indexed: 08/09/2023]
Abstract
Prophylactic swallowing exercises (PSE) during head-and-neck cancer (HNC) (chemo)radiotherapy (CRT) have a positive effect on swallowing function and muscle strength. Adherence rates to PSE are, however, moderate to low, undermining these effects. PRESTO already showed that the service-delivery mode (SDM), the way the exercises are offered, can influence adherence. The aim of this study was to investigate the effect of SDM on swallowing function and muscle strength during and post-CRT. In addition, the effect of overall adherence (OA), independent of SDM, was also investigated. A total of 148 HNC patients, treated with CRT, were randomly assigned to one of the three SDM's (paper-supported, app-supported, or therapist-supported PSE) and performed a 4-week PSE program. OA was calculated based on the percentage of completed exercises. Patients were divided into OA levels: the OA75+ and OA75- group performed respectively ≥ 75 and < 75% of the exercises. Swallowing function based on Mann Assessment of Swallowing Ability-Cancer (MASA-C), tongue and suprahyoid muscle strength during and up to 3 months after CRT were compared between the SDM's and OA levels. Linear Mixed-effects Models with post hoc pairwise testing and Bonferroni-Holm correction was used. No significant differences were found between the three SDMs. Significant time effects were found: MASA-C scores decreased and muscle strength increased significantly during CRT. By the end of CRT, the OA75+ showed significantly better swallowing function compared to OA75-. Muscle strength gain was significantly higher in the OA75+ group. SDM had no impact on swallowing function and muscle strength; however, significant effects were shown for OA level. Performing a high level of exercise repetitions is essential to benefit from PSE.Trial registration ISRCTN, ISRCTN98243550. Registered December 21, 2018-retrospectively registered, https://www.isrctn.com/ISRCTN98243550?q=gwen%20van%20nuffelen&filters=&sort=&offset=1&totalResults=2&page=1&pageSize=10&searchType=basic-search.
Collapse
Affiliation(s)
- Margot Baudelet
- Department of Radiation Oncology, University Hospital Ghent, 9000, Ghent, Belgium.
- Department of ENT, University Hospital Ghent, 9000 Ghent, Belgium.
| | - Leen Van den Steen
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Hospital Antwerp, Antwerp, Belgium
| | - Fréderic Duprez
- Department of Radiation Oncology, University Hospital Ghent, 9000, Ghent, Belgium
- Faculty of Medicine and Health Sciences Ghent, University of Ghent, Ghent, Belgium
| | - Ann Goeleven
- Department of Head and Neck Surgery, Swallowing Clinic, University Hospital Leuven, Louvain, Belgium
- Faculty of Medicine, Department of Neurosciences, Research Group Experimental Oto-rhino-laryngology, KU Leuven, Louvain, Belgium
| | - Sandra Nuyts
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Daan Nevens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Multi-Disciplinary Oncology Center Antwerp, Antwerp, Belgium
- Iridium Network, Antwerp, Belgium
| | | | - Hanne Massonet
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Head and Neck Surgery, Swallowing Clinic, University Hospital Leuven, Louvain, Belgium
- Faculty of Medicine, Department of Neurosciences, Research Group Experimental Oto-rhino-laryngology, KU Leuven, Louvain, Belgium
| | - Alice Vergauwen
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Hospital Antwerp, Antwerp, Belgium
| | | | - Hilde Verstraete
- Multi-Disciplinary Oncology Center Antwerp, Antwerp, Belgium
- Iridium Network, Antwerp, Belgium
| | - Kristien Wouters
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Olivier Vanderveken
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Hospital Antwerp, Antwerp, Belgium
| | - Marc De Bodt
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Faculty of Medicine and Health Sciences Ghent, University of Ghent, Ghent, Belgium
| | - Gwen Van Nuffelen
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Hospital Antwerp, Antwerp, Belgium
- Faculty of Medicine and Health Sciences Ghent, University of Ghent, Ghent, Belgium
| |
Collapse
|
3
|
Fukuoka T, Hori K, Ono T. Quantitative evaluation of swallowing function in Parkinson's disease using tongue pressure measurement: a mini-review. Front Neurol 2024; 15:1355627. [PMID: 38414553 PMCID: PMC10897025 DOI: 10.3389/fneur.2024.1355627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024] Open
Abstract
Dysphagia is a common symptom of Parkinson's disease (PD) associated with aspiration pneumonia, choking, malnutrition, and a decreased quality of life, and is a leading cause of death among patients with PD. Tongue dysfunction in patients with PD affects the oral phase of swallowing, including the formation and propulsion of a bolus into the pharynx. Assessing tongue pressure, generated between the tongue and palate, is a method that quantitatively measures tongue function and is related to dysphagia in PD. Two assessment methods are used to measure tongue pressure: tongue strength and tongue pressure during swallowing. Previous studies measuring tongue pressure in PD have reported decreased tongue strength and pressure during swallowing, as well as a prolonged tongue pressure rise time, which are symptoms associated with PD severity and dysphagia. In this mini-review, we present a method for measuring tongue pressure and discuss its relationship with dysphagia in PD. We also describe limitations and future perspectives in tongue pressure measurement research.
Collapse
Affiliation(s)
- Tatsuyuki Fukuoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Hiroshima, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takahiro Ono
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| |
Collapse
|
4
|
Drulia T, Szynkiewicz S, Griffin L, Mulheren R, Murray K, Kamarunas E. A Comparison of Lingual Pressure Generation Measures Using Two Devices in Community-Dwelling, Typically Aging Adults: An Important Clinical Implication. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:429-439. [PMID: 38262037 DOI: 10.1044/2023_jslhr-23-00488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
DESIGN A multisite, prospective, and randomized within-subject design study. SETTING Five university settings in varied geographical areas in the United States. PURPOSE The purpose of this study was to compare lingual pressure generation using the Tongueometer (TO) and the Iowa Oral Performance Instrument (IOPI) in typically aging, community-dwelling adults during three measurement tasks: maximum isometric pressure (MIP), regular effort saliva swallow (RESS) pressure, and effortful saliva swallow pressure (ESP). PARTICIPANTS Eighty-seven typically aging, community-dwelling adults (aged 55 years and over) with no self-reported history of swallowing or neurological disorders were recruited to complete this study. RESULTS Strong positive associations were found between the lingual pressure generation measures from the TO and IOPI in all tasks in typically aging adults, with Pearson correlations ranging from r = .780 to .874, p < .001. Agreement between the devices (Lin's concordance correlation coefficient) ranged from moderate for the MIP (ρc = .78) and ESP (ρc = .61) tasks to weak agreement for the RESS task (ρc = .47). MIP, RESS pressure, and ESP were lower when measured by the TO compared with the IOPI, p < .001. CONCLUSIONS The TO measures lingual pressure generation similarly to the IOPI but pressures register lower when using the TO than the IOPI in typically aging persons. This supports the need for developing normative values specific to the TO device or development of a valid and reliable conversion formula from TO to IOPI normative values. At this time, the clinical use of reference values from the TO should not be generalized to IOPI normative values.
Collapse
Affiliation(s)
- Teresa Drulia
- Davies School of Communication Sciences & Disorders, Texas Christian University, Fort Worth
| | - Sarah Szynkiewicz
- Department of Communication Sciences & Disorders, Samford University, Birmingham, AL
| | - Lindsay Griffin
- Department of Communication Sciences and Disorders, Emerson College, Boston, MA
| | - Rachel Mulheren
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Kelsey Murray
- Department of Communication Sciences & Disorders, James Madison University, Harrisonburg, VA
| | - Erin Kamarunas
- Department of Communication Sciences & Disorders, James Madison University, Harrisonburg, VA
| |
Collapse
|
5
|
da Costa FP, Casseb RF, de Lima DP, Ponsoni A, Guimarães RP, Mourão LF. Isometric tongue endurance and incomplete laryngeal vestibule closure in Parkinson's disease. J Oral Rehabil 2023; 50:1401-1408. [PMID: 37605286 DOI: 10.1111/joor.13568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/20/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Dysphagia is a common symptom of Parkinson's disease (PD). A delay in laryngeal vestibule closure (LVC) and a reduction in tongue pressure, may affect swallowing safety and increase the risk of pulmonary aspiration. OBJECTIVE To verify the relationship between tongue pressure and airway protection in PD patients: (1) comparing tongue pressure measures and physiological events in the pharyngeal phase of swallowing between PD and controls and (2) analysing the association between tongue pressure and LVC in the PD group. METHODS Twenty-three patients with idiopathic PD (64.9 years) and 24 healthy controls (64.1 years) participated in this study. All participants underwent the following procedures to verify tongue pressure measurements using the Iowa Oral Performance Instrument: maximum anterior and posterior pressure, isotonic and isometric tongue endurance and anterior and posterior tongue pressure during saliva swallowing. To verify swallowing safety, videofluoroscopic swallowing studies focusing on the pharyngeal phase were performed based on the MBSImP protocol. RESULTS Compared to healthy controls, PD exhibited a statistically significant decline in tongue pressure tasks: posterior maximum pressure, isotonic endurance, anterior and posterior isometric endurance and tongue pressure during posterior swallowing. Patients with PD had worse pharyngeal scores, including LVC scores, than controls. PD and incomplete LVC had lower anterior isometric endurance scores when compared to those with complete LVC. CONCLUSION PD with incomplete LVC scored lower in the anterior isometric endurance task. We observed a potential clinical use of this task for the assessment and management of dysphagia in patients with PD.
Collapse
Affiliation(s)
| | - Raphael Fernandes Casseb
- Department of Neurology, Neuroimaging Laboratory, University of Campinas (Unicamp), Campinas, Brazil
| | - Daniella Priscila de Lima
- Health, Interdisciplinarity and Rehabilitation Department, University of Campinas (Unicamp), Campinas, Brazil
| | - Adriana Ponsoni
- Gerontology Department, University of Campinas (Unicamp), Campinas, Brazil
| | - Rachel Paes Guimarães
- Department of Neurology, Neuroimaging Laboratory, University of Campinas (Unicamp), Campinas, Brazil
| | - Lucia Figueiredo Mourão
- Interdisciplinarity and Rehabilitation Departments, Center for Studies and Research in Rehabilitation, CEPRE, Gerontology and Health, University of Campinas (Unicamp), Campinas, Brazil
| |
Collapse
|
6
|
Sanguanchom M, Keskool P, Sureepong P, Ongard S. Assessing Tongue Strength and Swallowing Function Following Hyoid Bone Resection Surgery. EAR, NOSE & THROAT JOURNAL 2023:1455613231191019. [PMID: 37608452 DOI: 10.1177/01455613231191019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
PURPOSE The tongue and hyoid bone are responsible for the oral phase of swallowing. The purpose of this study was to assess tongue strength and endurance, and to evaluate swallowing functions in patients who underwent hyoid bone resection surgery. MATERIAL AND METHODS This was an experimental, non-randomized trial. It included participants who underwent hyoid bone resection surgery, divided into 2 groups; post-Sistrunk procedure and post-total laryngectomy. Swallowing problem history was recorded, and tongue strength and endurance were measured using the Iowa Oral Performance Instrument (IOPI). Post-Sistrunk procedure participants also underwent flexible endoscopic evaluation of swallowing (FEES) to assess objective swallowing function. Descriptive and bivariate statistics were used to analyze the association between the tongue strength and endurance, and the type of surgeries. RESULTS The study involved 26 participants, including 16 males and 10 females, with a mean age of 58.4 ± 12.8 years. A total of 10 subjects underwent the Sistrunk procedure and 16 underwent total laryngectomy surgery. The average tongue strength of all participants was 40.8 ± 11.7 kPa and the average tongue endurance was 30.6 ± 13.2 s. The difference in average tongue strength between the post-Sistrunk procedure group and post-total laryngectomy group was not significantly different (37.5 ± 11.6 kPa vs. 44.1 ± 11.3kPa, P = .153). However, there was a statistically significant difference in average tongue strength between male and female participants (46.3 ± 10.0 kPa vs. 32.0 ± 8.5 kPa, P = .001). FEES did not reveal any evidence of objective swallowing abnormalities in the post-Sistrunk group. CONCLUSION The resection of the hyoid bone, whether partial or total, did not significantly affect tongue strength and swallowing functions.
Collapse
Affiliation(s)
- Massupa Sanguanchom
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phawin Keskool
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Paiboon Sureepong
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sunun Ongard
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
7
|
Martins FAG, Motta AR, Neves LS, Furlan RMMM. Evaluation of the maximum tongue and lip pressure in individuals with Class I, II, or III Angle malocclusions and different facial types. Codas 2023; 35:e20220102. [PMID: 37436259 PMCID: PMC10449092 DOI: 10.1590/2317-1782/20232022102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/14/2022] [Indexed: 07/13/2023] Open
Abstract
PURPOSE To compare the maximum anterior and posterior tongue pressure, tongue endurance, and lip pressure in Class I, II, and III malocclusions and different facial types. METHODS A cross-sectional observational analytical study was carried out in 55 individuals (29 men and 26 women) aged between 18 and 55 years. The participants were divided into groups according to Angle malocclusion (Class I, II, and III) and facial type. The maximum anterior and posterior tongue pressure, tongue endurance, and maximum lip pressure were measured using the IOPI (Iowa Oral Performance Instrument). To determine the facial type, the cephalometric analysis was accomplished using Ricketts VERT analysis as a reference. RESULTS There was no statistically significant difference when comparing the maximum pressure of the anterior and posterior regions of the tongue, the maximum pressure of the lips, or the endurance of the tongue in the different Angle malocclusion types. Maximum posterior tongue pressure was lower in vertical individuals than in mesofacial individuals. CONCLUSION Tongue and lips pressure, as well as tongue endurance in adults was not associated with the type of malocclusion. However, there is an association between facial type and the posterior pressure of the tongue.
Collapse
Affiliation(s)
| | - Andréa Rodrigues Motta
- Departamento de Fonoaudiologia, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Leniana Santos Neves
- Departamento de Odontologia Restauradora, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | | |
Collapse
|
8
|
Martínez-Arnau FM, Núñez-Cortés R, Valderrama-Mejía JM, Cruz-Montecinos C, Carrasco JJ, Cortés-Amador S. Reduced lip seal strength and missing teeth are associated with poorer masticatory performance in young adults with intellectual disabilities: a cross-sectional analytical study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:630-639. [PMID: 37042218 DOI: 10.1111/jir.13032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/21/2023] [Accepted: 03/24/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Alterations in oral health have a negative impact on the quality of life of persons with intellectual disabilities (PwIDs). Chewing is a process that influences and determines optimal oral health. However, little is known about how intellectual disability (ID) affects masticatory performance. This study aimed to analyse the differences in masticatory performance between young adults with IDs, young adults without IDs and older adults without IDs. METHODS A cross-sectional analytical design was used. The masticatory performance was evaluated with a chewing gum validated instrument. In addition, the labial and tongue strength was assessed with the Iowa Oral Performance Instrument. We compared the masticatory performance between groups using one-way analysis of covariance. Body mass index, muscle mass, missing teeth, lip strength and tongue strength were included as separate covariates. A multivariate regression analysis was performed to identify which independent variables could explain masticatory performance in each group. RESULTS Thirty-two PwIDs, 31 young adults without IDs and 32 older adults without IDs were recruited. PwIDs showed poorer masticatory performance compared with older adults (mean difference: -3.06, 95% confidence interval: -3.87 to -2.26) and healthy controls (mean difference: -2.38, 95% confidence interval: -3.19 to -1.57). The analysis of covariance showed significant difference between groups in the masticatory performance (F = 47.35, P < 0.001, ηp 2 = 0.507). Missing teeth (P < 0.001), right lip strength (P = 0.025) and tongue strength (P = 0.007) as covariables showed a significant interaction with the model. In the PwID group, lip strength and lack of teeth explained 58% of the variance in masticatory performance (R2 = 0.580, standard error = 1.12, P < 0.001). CONCLUSIONS Persons with intellectual disabilities have a poorer masticatory performance than adults without IDs. Our findings indicate that the primary determinants of optimal masticatory function in PwIDs are the strength of the lip seal and the number of missing teeth.
Collapse
Affiliation(s)
- F M Martínez-Arnau
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
- Department of Physiotherapy, University of Valencia, Valencia, Spain
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - R Núñez-Cortés
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - C Cruz-Montecinos
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - J J Carrasco
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - S Cortés-Amador
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| |
Collapse
|
9
|
Diaz-Saez MC, Gil-Martínez A, Gadotti IC, Navarro-Fernández G, Gil-Castillo J, Beltran-Alacreu H. Reliability and Responsiveness of a Novel Device to Evaluate Tongue Force. Life (Basel) 2023; 13:life13051192. [PMID: 37240837 DOI: 10.3390/life13051192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/21/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Measurements of tongue force are important in clinical practice during both the diagnostic process and rehabilitation progress. It has been shown that patients with chronic temporomandibular disorders have less tongue strength than asymptomatic subjects. Currently, there are few devices to measure tongue force on the market, with different limitations. That is why a new device has been developed to overcome them. The objectives of the study were to determine the intra- and inter-rater reliability and the responsiveness of a new low-cost device to evaluate tongue force in an asymptomatic population. MATERIALS AND METHODS Two examiners assessed the maximal tongue force in 26 asymptomatic subjects using a developed prototype of an Arduino device. Each examiner performed a total of eight measurements of tongue force in each subject. Each tongue direction was measured twice (elevation, depression, right lateralization, and left lateralization) in order to test the intrarater reliability. RESULTS The intrarater reliability using the new device was excellent for the measurements of the tongue force for up (ICC > 0.94), down (ICC > 0.93) and right (ICC > 0.92) movements, and good for the left movement (ICC > 0.82). The SEM and MDC values were below 0.98 and 2.30, respectively, for the intrarater reliability analysis. Regarding the inter-rater reliability, the ICC was excellent for measuring the tongue up movements (ICC = 0.94), and good for all the others (down ICC = 0.83; right ICC = 0.87; and left ICC = 0.81). The SEM and MDC values were below 1.29 and 3.01, respectively, for the inter-rater reliability. CONCLUSIONS This study showed a good-to-excellent intra- and inter-reliability and good responsiveness in the new device to measure different directions of tongue force in an asymptomatic population. This could be a new, more accessible tool to consider and add to the assessment and treatment of different clinical conditions in which a deficit in tongue force could be found.
Collapse
Affiliation(s)
- Marta Carlota Diaz-Saez
- Physiotherapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, C/La Salle, 28023 Madrid, Spain
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, C/La Salle, 28023 Madrid, Spain
- Programa de Doctorado en Medicina y Cirugía, Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - Alfonso Gil-Martínez
- Physiotherapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, C/La Salle, 28023 Madrid, Spain
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, C/La Salle, 28023 Madrid, Spain
- Hospital Universitario La Paz-Carlos III. Institute for Health Research (IdiPaz), Paseo la Castellana, 261, 28046 Madrid, Spain
| | - Inae Caroline Gadotti
- Department of Physical Therapy, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, 11865 SW 26th St Suite H3, Miami, FL 33199, USA
| | - Gonzalo Navarro-Fernández
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, C/La Salle, 28023 Madrid, Spain
| | - Javier Gil-Castillo
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Av. Doctor Arce, 37, 28002 Madrid, Spain
| | - Hector Beltran-Alacreu
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physical Therapy and Nursing, Universidad de Castilla-La Mancha, Avenida de Carlos III s/n, 45071 Toledo, Spain
| |
Collapse
|
10
|
Acuna P, Supnet-Wells ML, Spencer NA, de Guzman JK, Russo M, Hunt A, Stephen C, Go C, Carr S, Ganza NG, Lagarde JB, Begalan S, Multhaupt-Buell T, Aldykiewicz G, Paul L, Ozelius L, Bragg DC, Perry B, Green JR, Miller JW, Sharma N. Establishing a natural history of X-linked dystonia parkinsonism. Brain Commun 2023; 5:fcad106. [PMID: 37265597 PMCID: PMC10231801 DOI: 10.1093/braincomms/fcad106] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/08/2023] [Accepted: 04/03/2023] [Indexed: 08/10/2024] Open
Abstract
X-linked dystonia parkinsonism is a neurodegenerative movement disorder that affects men whose mothers originate from the island of Panay, Philippines. Current evidence indicates that the most likely cause is an expansion in the TAF1 gene that may be amenable to treatment. To prepare for clinical trials of therapeutic candidates for X-linked dystonia parkinsonism, we focused on the identification of quantitative phenotypic measures that are most strongly associated with disease progression. Our main objective is to establish a comprehensive, quantitative assessment of movement dysfunction and bulbar motor impairments that are sensitive and specific to disease progression in persons with X-linked dystonia parkinsonism. These measures will set the stage for future treatment trials. We enrolled patients with X-linked dystonia parkinsonism and performed a comprehensive oromotor, speech and neurological assessment. Measurements included patient-reported questionnaires regarding daily living activities and both neurologist-rated movement scales and objective quantitative measures of bulbar function and nutritional status. Patients were followed for 18 months from the date of enrollment and evaluated every 6 months during that period. We analysed a total of 87 men: 29 were gene-positive and had symptoms at enrollment, seven were gene-positive and had no symptoms at enrollment and 51 were gene-negative. We identified measures that displayed a significant change over the study. We used principal variables analysis to identify a minimal battery of 21 measures that explains 67.3% of the variance over the course of the study. These measures included patient-reported, clinician-rated and objective quantitative outcomes that may serve as endpoints in future clinical trials.
Collapse
Affiliation(s)
- Patrick Acuna
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Charlestown, MA 02129, USA
- Sunshine Care Foundation, The Health Centrum, Roxas City, Capiz 5800Philippines
| | - Melanie Leigh Supnet-Wells
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Neil A Spencer
- Department of Statistics, University of Connecticut, Storrs, CT 06269, USA
| | - Jan Kristoper de Guzman
- Department of Neurology, Jose Reyes Memorial Medical Center, Manila, Metro Manila, 1012Philippines
- Sunshine Care Foundation, The Health Centrum, Roxas City, Capiz 5800Philippines
| | - Massimiliano Russo
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Ann Hunt
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Christopher Stephen
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Criscely Go
- Department of Neurology, Jose Reyes Memorial Medical Center, Manila, Metro Manila, 1012Philippines
| | - Samuel Carr
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Niecy Grace Ganza
- Sunshine Care Foundation, The Health Centrum, Roxas City, Capiz 5800Philippines
| | | | - Shin Begalan
- Sunshine Care Foundation, The Health Centrum, Roxas City, Capiz 5800Philippines
| | - Trisha Multhaupt-Buell
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Gabrielle Aldykiewicz
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Lisa Paul
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Laurie Ozelius
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - D Cristopher Bragg
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Bridget Perry
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Charlestown, MA 02129, USA
| | - Jordan R Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Charlestown, MA 02129, USA
| | - Jeffrey W Miller
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Charlestown, MA 02129, USA
| |
Collapse
|
11
|
Gopaul U, Laver D, Carey L, Matyas T, van Vliet P, Callister R. Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke. SENSORS (BASEL, SWITZERLAND) 2023; 23:3291. [PMID: 36992002 PMCID: PMC10059963 DOI: 10.3390/s23063291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
Sensor-based devices can record pressure or force over time during grasping and therefore offer a more comprehensive approach to quantifying grip strength during sustained contractions. The objectives of this study were to investigate the reliability and concurrent validity of measures of maximal tactile pressures and forces during a sustained grasp task using a TactArray device in people with stroke. Participants with stroke (n = 11) performed three trials of sustained maximal grasp over 8 s. Both hands were tested in within- and between-day sessions, with and without vision. Measures of maximal tactile pressures and forces were measured for the complete (8 s) grasp duration and plateau phase (5 s). Tactile measures are reported using the highest value among three trials, the mean of two trials, and the mean of three trials. Reliability was determined using changes in mean, coefficients of variation, and intraclass correlation coefficients (ICCs). Pearson correlation coefficients were used to evaluate concurrent validity. This study found that measures of reliability assessed by changes in means were good, coefficients of variation were good to acceptable, and ICCs were very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s in the affected hand with and without vision for within-day sessions and without vision for between-day sessions. In the less affected hand, changes in mean were very good, coefficients of variations were acceptable, and ICCs were good to very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s and 5 s, respectively, in between-day sessions with and without vision. Maximal tactile pressures had moderate correlations with grip strength. The TactArray device demonstrates satisfactory reliability and concurrent validity for measures of maximal tactile pressures in people with stroke.
Collapse
Affiliation(s)
- Urvashy Gopaul
- KITE Research—Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G 2A2, Canada
| | - Derek Laver
- Human Physiology, School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Leeanne Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne Campus, Melbourne, VIC 3086, Australia
- Neurorehabilitation and Recovery Group, the Florey Institute of Neuroscience and Mental Health, Austin Campus, Heidelberg, VIC 3084, Australia
| | - Thomas Matyas
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne Campus, Melbourne, VIC 3086, Australia
| | - Paulette van Vliet
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Robin Callister
- Human Physiology, School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| |
Collapse
|
12
|
Jung ES, Choi YY, Lee KH. Effects of Integrative Cognitive Function Improvement Program on Cognitive Function, Oral Health, and Mental Health in Older People: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14339. [PMID: 36361215 PMCID: PMC9659034 DOI: 10.3390/ijerph192114339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
We aimed to investigate the effects of an integrative cognitive function improvement program that combined existing cognitive, emotional, and physical therapies on cognitive function, oral health, and mental health in elder participants. Participants were classified into one of the following groups: cognitively normal (CN; n = 18), mild cognitive impairment (MCI; n = 17), and control (n = 17). An integrative cognitive function improvement program was administered to the CN and MCI groups for six weeks. To measure cognitive function, electroencephalogram (EEG) and cerebral blood flow (CBF) were evaluated, and to measure oral health, the O'Leary index, Löe & Silness index, tongue coating, unstimulated saliva flow rate, and oral muscle strength were measured. To measure mental health status, mental health, happiness and social support were measured. The CN and MCI groups showed a significant change in EEG-based indices for awareness level and physical stress. Regarding oral health, the O'Leary and the Löe & Silness index score decreased significantly in the CN and MCI groups. Saliva flow rate increased significantly in the CN and MCI groups. In regards to mental health, the happiness score increased post-intervention in the CN and MCI groups. In conclusion, the integrative cognitive function improvement program was effective in improving cognitive function, oral health, and mental health of elder people.
Collapse
Affiliation(s)
- Eun-Seo Jung
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu 11644, Korea
| | | | - Kyeong-Hee Lee
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu 11644, Korea
| |
Collapse
|
13
|
Quantitative Measurement of Swallowing Performance Using Iowa Oral Performance Instrument: A Systematic Review and Meta-Analysis. Biomedicines 2022; 10:biomedicines10092319. [PMID: 36140420 PMCID: PMC9496474 DOI: 10.3390/biomedicines10092319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 12/12/2022] Open
Abstract
Swallowing is a complex but stereotyped motor activity aimed at serving two vital purposes: alimentary function and the protection of upper airways. Therefore, any impairment of the swallowing act can represent a significant clinical and personal problem that needs an accurate diagnosis by means of reliable and non-invasive techniques. Thus, a systematic review and meta-analysis was performed to investigate the reliability of the Iowa Oral Pressure Instrument (IOPI) in distinguishing healthy controls (HC) from patients affected by swallowing disorders or pathologies and conditions that imply dysphagia. A comprehensive search was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and using PubMed, Scopus, Web of Science, Cochrane, and Lilacs databases. Overall, 271 articles were identified and, after a three-step screening, 33 case-control and interventional studies reporting IOPI measurements were included. The methodological quality of the retrieved studies resulted in being at a low risk of bias. The meta-analysis on case-control studies showed that maximum tongue pressure (MIP) values were always higher in HC than in patients, with an overall effect of the MIP difference of 18.2 KPa (17.7–18.7 KPa CI). This result was also confirmed when the sample was split into adults and children, although the MIP difference between HC and patients was greater in children than in adults (21.0 vs. 15.4 KPa in the MIP mean difference overall effect, respectively). Tongue endurance (TE) showed conflicting results among studies, with an overall effect among studies near zero (0.7 s, 0.2–1.1 s CI) and a slight tendency toward higher TE values in HC than in patients. Among the intervention studies, MIP values were higher after treatment than before, with a better outcome after the experimental tongue training exercise than traditional treatments (the MIP mean difference overall effect was 10.8 and 2.3 KPa, respectively). In conclusion, MIP values can be considered as a reliable measure of swallowing function in adults and in children, with a more marked MIP difference between HC and patients for the children population. MIP measures in patients are also able to detect the best outcome on the tongue function after the training exercise compared to traditional training.
Collapse
|
14
|
Clark HM, Duffy JR, Strand EA, Hanley H, Solomon NP. Orofacial Muscle Strength across the Dysarthrias. Brain Sci 2022; 12:brainsci12030365. [PMID: 35326321 PMCID: PMC8946724 DOI: 10.3390/brainsci12030365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
This study compared orofacial muscle strength between normal and dysarthric speakers and across types of dysarthria, and examined correlations between strength and dysarthria severity. Participants included 79 speakers with flaccid, spastic, mixed spastic–flaccid, ataxic, or hypokinetic dysarthria and 33 healthy controls. Maximum pressure generation (Pmax) by the tongue, lips, and cheeks represented strength. Pmax was lower for speakers with mixed spastic–flaccid dysarthria for all tongue and lip measures, as well as for speakers with flaccid or spastic dysarthria for anterior tongue elevation and lip compression. Anterior tongue elevation and cheek compression tended to be lower than normal for the hypokinetic group. Pmax did not differ significantly between controls and speakers with ataxic dysarthria on any measure. Correlations were generally weak between dysarthria severity and orofacial weakness but were stronger in the dysarthria groups with more prominent orofacial weakness. The results generally support predictions that orofacial weakness accompanies flaccid and/or spastic dysarthria but not ataxic dysarthria. The findings support including type of dysarthria as a variable of interest when examining orofacial weakness in motor speech disorders.
Collapse
Affiliation(s)
- Heather M. Clark
- Mayo Clinic, Rochester, MN 55905, USA; (J.R.D.); (E.A.S.)
- Correspondence: ; Tel.: +1-507-2983-1283
| | | | | | - Holly Hanley
- Department of Communication Sciences and Disorders, Appalachian State University, Boone, NC 28608, USA;
| | - Nancy Pearl Solomon
- National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA;
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| |
Collapse
|
15
|
Alvarado C, Arminjon A, Damieux-Verdeaux C, Lhotte C, Condemine C, Cousin AS, Sigaux N, Bouletreau P, Mateo S. Impaired tongue motor control after temporomandibular disorder: A proof-of-concept case-control study of tongue print. Clin Exp Dent Res 2022; 8:529-536. [PMID: 35220688 PMCID: PMC9033548 DOI: 10.1002/cre2.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/11/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) perturbs the tongue motor control and consequently impairs oral function, but strength training reduces this impairment. However, tongue motor control is widely reduced to a matter of strength. OBJECTIVES To investigate the accuracy of the tongue placement as a measure of tongue motor control in patients with TMD compared with age- and sex-matched healthy participants. MATERIAL AND METHODS This proof-of-concept case-control study was prospective, observational, and part of the TMIQ study (NCT04102306). After pointing against a wood stick while maintaining the tongue as sharp as possible, the examinator drew the contour of the tongue print on the wood stick, which was then scanned for image analyses to compute the area for each participant using ImageJ. RESULTS A total of 94 participants were included, all patients with TMD (n = 47) diagnosed with myalgia, 61% with intra-articular joint disorder accordingly to the DC/TMD. The median (IQR) tongue print area was 117 (111) mm2 for the TMD group and 93.5 (76.2) mm2 for the control group (V = 352, p = .04) and the median [95% confidence interval] difference was 25.4 [1.3; 51.0] mm². Overlapping of the 95% confidence intervals of the area evidenced no significant difference between the categories of the DC/TMD. The corrected each area-total correlation (r = .24) suggests a reasonably homogenous thus valid measure. CONCLUSION The results suggest that TMD impairs the motor control of the tongue. Therefore, the sharpest tongue pointing test may constitute a simple and accessible clinical tool to assess the accuracy of tongue placement in TMD patients. The study was registered on ClinicalTrial.gov with identification number NCT04102306.
Collapse
Affiliation(s)
| | | | | | - Claire Lhotte
- Cabinet de kinésithérapie Saint-Alexandre, Lyon, France
| | - Chloé Condemine
- Cabinet de kinésithérapie Saint-Alexandre, Lyon, France.,Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Anne-Sabine Cousin
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Nicolas Sigaux
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Pierre Bouletreau
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Sébastien Mateo
- Lyon Neuroscience Research Center, Trajectoires Team, CNRS UMR5292, INSERM U1028, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Hôpital Henry Gabrielle, Plate-forme Mouvement et Handicap, Lyon, France
| |
Collapse
|
16
|
Mouffron V, Furlan RMMM, Motta AR. Immediate effects of photobiomodulation on maximum lip pressure. Codas 2022; 34:e20210024. [PMID: 35019078 PMCID: PMC9769423 DOI: 10.1590/2317-1782/20212021024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/25/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To verify the immediate effects of different doses of photobiomodulation on maximum lip pressure. METHODS Experimental, randomized and triple-blind study. The sample consisted of 23 women and 17 men, age between 18 and 33 years old (average 23.18 years old, SD=2.1), distributed in four groups: CG (control group), G1, G4 and G7. The maximum pressure was assessed with the Iowa Oral Performance Instrument (IOPI). The bulb was placed between the lips and the participants were instructed to press it as strong as possible. Infrared LASER (808 nm), manufactured by DMC, Therapy EC model, 100 mW of power output, was applied. The doses tested were 1 J (G1), 4 J (G4) and 7 J (G7), applied at six points of the orbicularis oris muscle. In the CG there was no intervention. The evaluation procedures were repeated after the LASER application. The results were analyzed with a significance level of 95%. RESULTS The maximum lip pressure increased significantly only in the group irradiated with 7 J. CONCLUSION Low level LASER therapy with 7 J dose promoted changes in the performance of the orbicularis oris muscle in the maximum pressure task.
Collapse
Affiliation(s)
- Vanessa Mouffron
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | | | - Andréa Rodrigues Motta
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| |
Collapse
|
17
|
Healthy Women and Men Do Not Show Differences in Tongue Strength and Regular Effort Saliva Swallows as Assessed by Piezo-Resistive Sensors: Results from a Reproducibility Study. Dysphagia 2021; 37:1217-1225. [PMID: 34779910 DOI: 10.1007/s00455-021-10381-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Abstract
The aim of this study was to establish the reproducibility of tongue strength measurements in healthy women and men during maximum anterior isometric pressure (MAIP) and regular effort saliva swallows (RESS). In this cross-sectional study, 30 healthy young adults were required to push with the tip of the tongue on a piezo-resistive sensor glued to the hard palate, immediately above the central incisor line. Tongue pressures exerted on the sensor during MAIP and spontaneous RESS were recorded. Participants underwent a retest procedure within the same session to verify the reproducibility of measurements, as determined by intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (MDC). Complete data were obtained from 30 subjects (15 women, 15 men; mean age 31.4 ± 7.8 years; mean weight 61.3 ± 9.4 kg). Compared to women, men showed a trend for generating larger MAIP (p = 0.06; d = 0.71) and RESS (p = 0.07; d = 0.69). After normalizing to body weight, height, and body mass index (BMI), such trends disappeared. At retest, MAIP and RESS proved stable and highly reliable (all ICCs ≥ 0.93) in men and women but associated to moderate variability as for SEM and MDC, with MAIP estimates associated to smaller SEM and MDC (SEM ranging 7.4-14.2%; MDC 18.6-20.9%) than RESS (SEM ranging 20.4-38.5%; MDC 52.5-55.6%). Piezo-resistive pressure sensors allow clinicians and researchers to perform reproducible measurements of tongue muscle performance. However, if therapeutic interventions are administered, measurement variability in tongue performance should be considered when appraising their clinical efficacy, especially for those populations who display impaired performance and may not be capable to generate high and stable forces. No gender-based differences emerged in the motor tasks tested.
Collapse
|
18
|
Augusto MM, da Silva RG, Teixeira Dourado Júnior ME, Godoy JF, Lopes LW, Pernambuco L. Tongue measurements and pharyngeal residue in amyotrophic lateral sclerosis. Neurodegener Dis Manag 2021; 11:459-468. [PMID: 34747630 DOI: 10.2217/nmt-2021-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We aimed to analyze the relationship between tongue measurements and vallecular residue in patients with amyotrophic lateral sclerosis (ALS). Materials & methods: Twenty-one patients with ALS were assessed for posterior maximum tongue isometric pressure (PMTIP) and posterior tongue isometric endurance (PTIE) by the Iowa Oral Performance Instrument; vallecular residue after 10 ml of moderately thickened consistency by Fiberoptic Endoscopic Evaluation of Swallowing; and tongue thickness (TT) by ultrasonography. Results: PMTIP, PTIE and TT were decreased compared with the reference values for healthy individuals and were not different between patients with and without vallecular residue. Conclusion: In ALS, PMTIP, PTIE and TT are not good predictors of vallecular residue in the tested volume and food consistency.
Collapse
Affiliation(s)
- Milena Magalhães Augusto
- Graduate Program in Speech, Language & Hearing Sciences (PPgFon-UFPB), Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil
| | - Roberta Gonçalves da Silva
- Graduate Program in Speech, Language & Hearing, Department of Speech, Language & Hearing Sciences, São Paulo State University, Marília Campus - UNESP/Marília - Marília, São Paulo, Brazil
| | - Mario Emílio Teixeira Dourado Júnior
- Onofre Lopes University Hospital (HUOL), Brazilian Hospital Services Company, Federal University of Rio Grande do Norte - UFRN - Natal, Rio Grande do Norte, Brazil
| | - Juliana Fernandes Godoy
- Department of Speech, Language & Hearing Sciences, Federal University of Rio Grande do Norte - UFRN - Natal, Rio Grande do Norte, Brazil
| | - Leonardo Wanderley Lopes
- Graduate Program in Speech, Language & Hearing Sciences (PPgFon-UFPB), Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil.,Department of Speech, Language & Hearing Sciences, Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil
| | - Leandro Pernambuco
- Graduate Program in Speech, Language & Hearing Sciences (PPgFon-UFPB), Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil.,Department of Speech, Language & Hearing Sciences, Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil
| |
Collapse
|
19
|
Schimmel M, Domioni T, Bukvic H, Arakawa I, Seifert E, Abou-Ayash S. Oral diadochokinesis and associated oro-facial function in young and old German mother-tongue speakers: A cross-sectional study. Gerodontology 2021; 39:33-40. [PMID: 34741348 PMCID: PMC9298062 DOI: 10.1111/ger.12602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022]
Abstract
Objectives The aims of this study were to compare oral diadochokinesis and to test associations with oro‐facial functional parameters in healthy young and old German speakers. Background Oral diadochokinesis is a key component in the concept of oro‐facial hypofunction and relates to tongue and lip motor function but may depend on the linguistic background. Materials and methods Healthy German speakers with a minimum of 20 teeth were recruited to form a young (<60 years) and an older group (≥60 years). Oral diadochokinesis was assessed as the number of repetitions/s for the monosyllables /pa/, /ta/ and /ka/ to evaluate movement capacity of the lip, the anterior region of the tongue and the posterior region of the tongue, respectively. Maximum voluntary lip force, maximum voluntary bite force, masticatory performance, maximum voluntary tongue pressure, xerostomia and swallowing function were assessed with validated instruments. Results are presented as median (IQR). Results Sixty participants formed the younger group (n = 35, 30.0 years [24.0‐49.0]) and the older group (n = 25, 64.0 years [62.0‐72.0]). Counts/s of /ta/ were different between age groups (younger group: 6.0 vs older group: 5.4) but not for syllables /pa/ (younger group: 6.0 vs older group: 5.8) and /ka/ (younger group: 5.6 vs older group: 5.0). The oral diadochokinesis with /pa/ was overall associated with maximum voluntary lip force; oral diadochokinesis performed with /ta/ was associated with tongue pressure, and oral diadochokinesis with /ka/ with swallowing function. Masticatory performance was not associated with oral diadochokinesis but with maximum voluntary bite force, xerostomia and with maximum voluntary tongue pressure. Conclusions The published thresholds for oral diadochokinesis should be reconsidered in non‐Japanese mother‐tongue speakers. However, they still play an important role in the overall concept of oro‐facial functional assessment.
Collapse
Affiliation(s)
- Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Tania Domioni
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Hristina Bukvic
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Itsuka Arakawa
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Comprehensive Dental Care Unit, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Eberhard Seifert
- Division of Phoniatrics, Department of Otorhinolaryngology, Head Neck Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
20
|
Rodríguez-Alcalá L, Martínez JML, Baptista P, Ríos Fernández R, Javier Gómez F, Parejo Santaella J, Plaza G. Sensorimotor tongue evaluation and rehabilitation in patients with sleep-disordered breathing: a novel approach. J Oral Rehabil 2021; 48:1363-1372. [PMID: 34409644 DOI: 10.1111/joor.13247] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 07/21/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVES To evaluate tone, apraxia and stereognosis dysfunctions in patients with SDB compared with healthy controls, and to monitor the effectiveness of Airway Gym® as an easy-to-use myofunctional therapy (MT) modality in terms of the tongue's motor and sensory responses, comparing results before and after therapy. METHODS This was a prospective, non-randomised pilot study of 25 patients with moderate to severe obstructive sleep apnoea-hypopnoea syndrome (OSAHS), 25 patients with primary snoring (PS) and 20 healthy controls. Qualitative and quantitative instruments-Iowa Oral Performance Instrument (IOPI), lingual apraxia and stereognosis tests were used to assess tongue sensorimotor function. RESULTS 22 patients with PS, 21 with OSAHS and all 20 controls ended the therapy. In OSAHS, the Epworth Sleepiness Scale score decreased from 16 ± 7.3 to 12 ± 4.5 after therapy (p = 0.53). In PS and OSAHS groups, the IOPI scores increased significantly. These measures did not change significantly in the controls. Lingual apraxia testing showed that controls performed all the manoeuvres, whereas PS 5.6 ± 1.4 and OSAHS 4.5 ± 1.9 (p = 0.14). In the stereognosis test, the mean number of figures recognised was 2.6 ± 2.2 in OSAHS, 3.3±1.2 in PS and 5.7±0.9 in control group (p < 0.05). Patients with OSAHS recognised circles and ovals less often. CONCLUSION Using the Airway Gym® app produced improvements in sensorimotor tongue function in patients with SDB, due to continuous stimulation of the brain based on proprioceptive training required to localise responses when doing the exercises.
Collapse
Affiliation(s)
- Laura Rodríguez-Alcalá
- Department of Otorhinolaryngology. Hospital, Universitario Clínico San Cecilio, Granada, Spain.,PhD Programme in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | | | - Peter Baptista
- Department Otolaryngology, Clinica Universitaria de Navarra, Pamplona, Spain
| | - Raquel Ríos Fernández
- Autoinmune Disease Unit. Department of Medicine, Hospital Universitario San Cecilio, Granada, Spain
| | | | | | - Guillermo Plaza
- Department of Otorhinolaryngology. Hospital Sanitas La Zarzuela & Hospital Universitario Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain
| |
Collapse
|
21
|
Suboptimal Tongue Pressure Is Associated with Risk of Malnutrition in Community-Dwelling Older Individuals. Nutrients 2021; 13:nu13061821. [PMID: 34071812 PMCID: PMC8229542 DOI: 10.3390/nu13061821] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/16/2022] Open
Abstract
The tongue plays an important role in swallowing, and its dysfunction theoretically leads to inadequate oral intake and subsequent malnutrition. This study aimed to explore how different levels of tongue pressure are related to malnutrition among community-dwelling older individuals. The target population was community-dwelling adults aged ≥ 65 years. Tongue pressure was measured using the Iowa Oral Performance Instrument, whereas the mini nutrition assessment (MNA) test was administered to determine the nutritional status. A full MNA score of less than 24 points was defined as risk of malnutrition. Multivariate logistic regression analyses were conducted to calculate the odds ratio (OR) of risk of malnutrition among different quartiles of tongue pressure. Among the 362 participants, 26 (7.1%) were classified as having risk of malnutrition. Body weight, body mass index, handgrip strength, skeletal muscle mass index, sum MNA score, and serum levels of albumin were lower in the malnutrition risk groups than in the normal nutrition status group. A positive correlation was identified between tongue pressure and the MNA score (r = 0.143, p < 0.01). Treating the subgroup of the highest quartile of tongue pressure as the reference, the crude odds ratio (OR) of having risk of malnutrition was 5.37 (95% CI, 1.14–25.28) in the subgroup at the third quartile, 3.10 (95% CI, 0.60–15.84) in the subgroup at the second quartile, and 3.95 (95% CI, 0.81–19.15) in the subgroup at the lowest quartile. After adjustment for age and sex, the subgroup in the third quartile still presented with a significantly higher risk (OR, 4.85; 95% CI, 1.02–22.99) of risk of malnutrition. Compared with the subgroup at the highest quartile of tongue pressure, the crude OR for all the subgroups in the lower three quartiles was 4.17 (95% CI, 0.96–18.04), showing borderline significance (p = 0.05). In conclusion, we found hints for an association between decreased tongue pressure and an increased risk of malnutrition in community-dwelling older individuals. Older people with suboptimal tongue pressure should undergo a thorough assessment of their nutritional status and swallowing function for the early identification of subclinical malnutrition and dysphagia.
Collapse
|
22
|
Liu HY, Chen CH, Kuo CH, Feng MC, Chen JH, Wang HW, Chen KC, Lin CL. A Novel Tongue Pressure Measurement Instrument with Wireless Mobile Application Control Function and Disposable Positioning Mouthpiece. Diagnostics (Basel) 2021; 11:diagnostics11030489. [PMID: 33801947 PMCID: PMC8002047 DOI: 10.3390/diagnostics11030489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/16/2022] Open
Abstract
This study developed a novel chair-side tongue pressure (TP) measuring instrument with a disposable positioning mouthpiece controlled using a smartphone application (APP), denoted as the TP wireless application (TPWA). The mouthpiece was designed with a palate-shaped air balloon containing a tongue contact bump and a plastic bite positioning tube. Fatigue load testing was performed to evaluate mouthpiece durability by applying 700 displacement cycles (50 times a day for one week during training, with twice the safety factor) on the air balloon. The main component used in developing this instrument was a silicon pressure sensor equipped with wireless Bluetooth connection. Young (52 adults; mean age = 20.23 ± 2.17) and elderly (40 adults; mean age = 72.60 ± 7.03) individuals participated in the test with the new instrument, with the results compared to those of a commercial device. The TPWA mouthpiece fatigue test showed that mean response pressures were maintained at 12 kPa. No significant (p > 0.05) differences were found during testing repetitions 0–10 and 701–710. There were no significant differences in the maximum TP values presented between the test sequences using different instruments for young and elderly participants. The TPWA results showed that TP values gradually decreased with increasing age (40.77 kPa for young and 16.55 kPa for elderly participants). The maximum TP for males (43.51 kPa) was significantly larger than that for females (35.14 kPa) in the young group, but an opposite trend was seen in the elderly group (12.97 for males and 17.59 for females). Thus, this study developed a novel chair-side TP measurement instrument with Bluetooth wireless mobile application control. A durable positioning oral mouthpiece was approved for measuring pressure sufficiently, reliably, and precisely for TP screening.
Collapse
Affiliation(s)
- Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chun-Hung Chen
- Department of Neurology, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan;
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Chao-Hung Kuo
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Division of Internal Medicine, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung 81267, Taiwan
- Division of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Ming-Chu Feng
- Department of Nursing, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan;
- School of Nursing, Fooyin University, Kaohsiung 83102, Taiwan
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Hsuan-Wen Wang
- Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan; (H.-W.W.); (K.-C.C.)
| | - Kun-Chun Chen
- Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan; (H.-W.W.); (K.-C.C.)
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan; (H.-W.W.); (K.-C.C.)
- Correspondence: (C.-L.L.)
| |
Collapse
|
23
|
Rodríguez-Alcalá L, Martín-Lagos Martínez J, O´Connor-Reina C, Plaza G. Assessment of muscular tone of the tongue using a digital measure spoon in a healthy population: A pilot study. PLoS One 2021; 16:e0245901. [PMID: 33600465 PMCID: PMC7891707 DOI: 10.1371/journal.pone.0245901] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/03/2021] [Indexed: 12/16/2022] Open
Abstract
The study of the muscles of the tongue forms part of a basic evaluation of upper airway function that includes swallowing, speaking and chewing. It is important because the upper airway presents a region of collapse during sleep. Through the action of the dilator muscles, mainly the genioglossus, such collapse can be prevented. In this study, we present a simple tool that can be used to measure the strength of the tongue. This tool may provide an easy way to measure tongue function and allow a simple evaluation of pathologies that affect the tone of the tongue. We have carried out 20 tongue strength measurements using the Tongue Digital Spoon (TDS) in a healthy adult population, using the Iowa Oral Performance Instrument (IOPI) as the gold standard. To validate the procedure, we performed replicate measurements on 20 individuals aged 20-70 years. We found a mean TDS measurement of 115.99 g/cm2 in young subjects, 98.47 g/cm2 in middle-aged subjects and 84.23 g/cm2 in the elderly. There was a significant difference in the measurements between young and elderly participants. There was also a significant correlation between TDS and IOPI measurements (Pearson correlation coefficient, r = 0.69, P < 0.001). We found the TDS to be a useful tool in daily clinical practice for the measurement of the strength of the tongue in the healthy population. It has potential application in oropharyngeal monitoring and rehabilitation.
Collapse
Affiliation(s)
- Laura Rodríguez-Alcalá
- Department of Otorhinolaryngology, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | - Carlos O´Connor-Reina
- Department of Otorhinolaryngology, Hospital Quirón Marbella, Marbella, Spain
- Department of Otorhinolaryngology, Hospital Quirón Campo de Gibraltar, Marbella, Spain
| | - Guillermo Plaza
- Department of Otorhinolaryngology, Hospital Universitario Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain
- Department of Otorhinolaryngology, Hospital Sanitas La Zarzuela, Madrid, Spain
- * E-mail:
| |
Collapse
|
24
|
Oh JC. Effects of Effortful Swallowing Exercise with Progressive Anterior Tongue Press Using Iowa Oral Performance Instrument (IOPI) on the Strength of Swallowing-Related Muscles in the Elderly: A Preliminary Study. Dysphagia 2021; 37:158-167. [PMID: 33566219 DOI: 10.1007/s00455-021-10259-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/27/2021] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to confirm the effect of effortful swallowing (ES) exercise programs applied to increase the swallowing-related muscle strength in the elderly. In this study, 20 healthy elderly people (76.65 ± 5.87 years; 10 women and 10 men) participated and exercised for 7 weeks. The experimental group performed ES exercise combined with external resistance using Iowa Oral Performance Instrument (IOPI), and the control group performed pure ES without external resistance. The exercises were performed for 20 min a day, 2 days a week for 7 weeks in both groups. ES was repeated 60 times in weeks 1 and 2, 80 times in week 3 and 4, and 120 times in weeks 5-7. In the experimental group, the isometric and swallowing tongue pressures at week 8 were significantly improved compared to baseline. At week 8, the anterior and swallowing tongue pressures and anterior tongue endurance were significantly higher than those of the control group. In the control group, no significant change in tongue pressure-related variables was observed after 7 weeks of exercise. ES exercise combined with IOPI resistance for 7 weeks tended to increase the suprahyoid muscle activation level without statistical significance. For clinical application of this exercise protocol, further studies including more elderly people and patients with dysphagia are required.
Collapse
Affiliation(s)
- Jong-Chi Oh
- Department of Occupational Therapy, Cheongju University, 298 Daesung-ro, Cheongwon-gu, Cheongju, Chungcheongbuk-do, 28503, Republic of Korea.
| |
Collapse
|
25
|
Arakawa I, Igarashi K, Imamura Y, Müller F, Abou-Ayash S, Schimmel M. Variability in tongue pressure among elderly and young healthy cohorts: A systematic review and meta-analysis. J Oral Rehabil 2020; 48:430-448. [PMID: 32799377 DOI: 10.1111/joor.13076] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/14/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Tongue pressure (TP) is used for the diagnosis of oral hypofunction; however, the impact of several variables on TP is unclear. Therefore, the current systematic review and meta-analysis aimed to analyse the variability in tongue pressure among healthy individuals aged ≥60 years vs <60 years. Secondary outcomes were the influence of gender and the type of measuring device (Iowa Oral Performance Instrument (IOPI) vs JMS tongue pressure measurement device (JMS)). METHODS PubMed and the Japanese database Ichushi-Web were searched systematically by two independent reviewers for studies reporting TP values in healthy populations. Clinical studies published between 1959 and June 2020 with more than 10 participants, written in English, German or Japanese, were included. A random-effects meta-regression for aggregate-level data was applied (α < 0.05). RESULTS Sixty-eight studies reported TP for a total of 13 773 subjects aged <60 years (n = 3265) and ≥60 years (n = 10 508). TP was significantly higher in subjects <60 years (estimated weighted mean (EWM) ± standard error = 51.9 ± 1.28 kPa; 95% CI = 49.4-54.4) relative to those ≥60 (EWM = 34.7 ± 0.94 kPa; 95% CI = 32.8-36.5) (P < .001), men (EWM = 45.9 ± 2.09 kPa; 95% CI = 41.8-50.0) relative to women (EWM = 39.3 ± 1.68 kPa; 95% CI = 36.0-42.6) (P = .015) and when assessed with the IOPI (EWM = 51.9 ± 1.32 kPa; 95% CI = 49.3-54.5) compared to the JMS (EWM = 33.5 ± 0.63 kPa; 95% CI = 32.2-34.7) (P < .001). In terms of gender, there was no significant difference in TP among subjects ≥60 years (P = .282). However, in subjects younger than 60, a significant difference was observed (P = .004). CONCLUSIONS Healthy populations aged <60 years showed significantly higher TP than those aged ≥60 years. TP values ascertained by the IOPI are significantly higher than those obtained with the JMS.
Collapse
Affiliation(s)
- Itsuka Arakawa
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Comprehensive Dental Care, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Kensuke Igarashi
- Department of Dental Materials Science, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
| | - Yoshiki Imamura
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Geriatric Dentistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
26
|
Oh JC. Effects of Resistive Jaw-Opening Exercise with Elastic Resistance Bands on Suprahyoid Muscle Activation and Tongue Strength in the Elderly: A Pilot Study. Folia Phoniatr Logop 2020; 73:376-383. [PMID: 32862177 DOI: 10.1159/000509441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/15/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The jaw-opening exercise (JOE) is designed to strengthen the suprahyoid muscles. However, it is difficult to apply this strength-training exercise to subjects in a systematic fashion. OBJECTIVE This study examined the effect of resistive JOE on suprahyoid muscle activity and tongue strength in the elderly through the use of an elastic band. METHODS Eight elderly people aged ≥65 years participated in this study. Participants wore an elastic loop around their head and mandible. The strength of the elastic loop used was adjusted based on the participant's sex, and the same strength loop was used for 8 weeks. Participants were required to open their jaw maximally, maintain the position for 10 s, and then rest for 10 s. This process was repeated for 10 min. There was then a rest period of 2 min before subjects began another 10-min exercise set. All participants performed the exercise twice weekly for 8 weeks. All subjects were tested for suprahyoid muscle activation during typical/effortful swallowing as well as isometric tongue pressures and endurances at baseline and at 9 weeks. RESULTS After 8 weeks of exercise, the isometric maximum tongue-base pressure and tongue endurance were significantly improved. However, the swallowing tongue pressure and suprahyoid muscle activation levels had not changed significantly. CONCLUSION This study confirmed that consistent resistance, which provides the same resistance throughout a resistive JOE exercise, is inadequate to reliably improve the muscle strength of swallowing-related muscles. Subsequent research should consider this and plan more efficient exercise programs.
Collapse
Affiliation(s)
- Jong-Chi Oh
- Department of Occupational Therapy, Cheongju University, Cheongju, Republic of Korea,
| |
Collapse
|
27
|
Oh JC. Systematic Effortful Swallowing Exercise Without External Resistance Does Not Increase Swallowing-Related Muscle Strength in the Elderly. Dysphagia 2020; 36:465-473. [PMID: 32720053 DOI: 10.1007/s00455-020-10163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
Effortful swallow (ES) is a maneuver intended to increase pressure on a bolus by swallowing and pushing with sufficient force to facilitate clearance. Although ES is mainly known for its immediate effects, the long-term effects of applying ES as an exercise program remain unclear. This study investigated the effects of a 7-week systematic ES exercise regime on swallowing-related muscle strength in individuals aged 65 years and over. In total, 30 healthy older adults participated in this study (16 women and 14 men, aged 67-90 years). The subjects participated in the exercise program for 20 min a day, twice a week, for 7 weeks. To gradually increase exercise intensity, the number of exercises per session was increased from the initial 60 repetitions (weeks 1-2) to 120 repetitions (weeks 5-7). To measure the effect of the strengthening exercise program, the activation level of suprahyoid muscles was measured using surface electromyography, and a tongue pressure measurement system was used to measure variables related to tongue strength (isometric tongue pressure, swallowing tongue pressure, and tongue endurance). Although the effect of ES exercise on muscle strength through gradual adjustment of exercise frequency was not confirmed, ES remains valuable as an exercise for strengthening the muscles involved in swallowing. Future studies are warranted to determine the effects of ES exercise after adjusting for other variables of exercise intensity.
Collapse
Affiliation(s)
- Jong-Chi Oh
- Department of Occupational Therapy, Cheongju University, 298 Daesung-ro, Cheongwon-gu, Cheongju, Chungcheongbuk-do, Cheongju city, 28503, Republic of Korea.
| |
Collapse
|
28
|
Abstract
(1) Background: Increasing tongue and lip strength may help improve various speech and swallowing disorders, but it is unclear if instrumentalists who use these muscle groups for long periods of time have greater strength and endurance compared to controls. It is also unclear if instrumentalists can more accurately estimate various exercise intensities. The purpose of this study was to determine differences in lip and tongue strength and endurance between instrumentalists and non-instrumentalists (controls). A secondary purpose was to assess differences in ability to estimate various exercise intensities between the two groups. (2) Methods: Instrumentalists and controls’ maximum strength and endurance were measured using the IOPI Pro medical device. In addition, 40%, 60% and 80% of maximum strength were estimated in a randomized order. (3) Results: No significant differences were found between instrumentalists and controls in strength or endurance or the ability to estimate various intensities. Overall, participants were better at estimating tongue strength at moderate intensities and lip strength at higher intensities. (4) Conclusion: Tongue and lip strength and endurance and the ability to estimate exercise intensities are not impacted by years of instrumentalist training compared to healthy controls.
Collapse
|
29
|
Abe T, Viana RB, Wong V, Bell ZW, Spitz RW, Yamada Y, Thiebaud RS, Loenneke JP. The influence of training variables on lingual strength and swallowing in adults with and without dysphagia. JCSM CLINICAL REPORTS 2020. [DOI: 10.1002/crt2.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory The University of Mississippi University MS 38677 USA
| | - Ricardo B. Viana
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory The University of Mississippi University MS 38677 USA
- Faculty of Physical Education and Dance Federal University of Goiás Goiânia Brazil
| | - Vickie Wong
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory The University of Mississippi University MS 38677 USA
| | - Zachary W. Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory The University of Mississippi University MS 38677 USA
| | - Robert W. Spitz
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory The University of Mississippi University MS 38677 USA
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory The University of Mississippi University MS 38677 USA
| | - Robert S. Thiebaud
- Department of Human Performance and Recreation Brigham Young University—Idaho Rexburg 83460 ID USA
| | - Jeremy P. Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory The University of Mississippi University MS 38677 USA
| |
Collapse
|
30
|
Paris-Alemany A, Proy-Acosta A, Adraos-Juárez D, Suso-Martí L, La Touche R, Chamorro-Sánchez J. Influence of the Craniocervical Posture on Tongue Strength and Endurance. Dysphagia 2020; 36:293-302. [PMID: 32445059 DOI: 10.1007/s00455-020-10136-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/15/2020] [Indexed: 12/30/2022]
Abstract
Tongue strength has an important role in the swallowing process, and previous research has suggested that tongue position, concerning the craniomandibular region, could affect the oral function. This study aimed to evaluate the strength and endurance of three areas of the tongue in three experimentally induced craniocervical postures. A cross-sectional study with a nonprobabilistic sample of 37 participants (mean age: 3.85 ± 3.64 years; 20 men, 17 women) was performed. Tongue strength and endurance were assessed using a pressure device entitled Iowa Oral Performance Instrument (IOPI), in three different craniocervical positions: neutral head position (NHP), anterior head translation-or forward head position (FHP), and posterior head translation-or retracted head position (RHP). Measurements taken using the IOPI system showed significant differences in tongue strength for the anterior (p = 0.015) and middle areas of the tongue (p = 0.01). Significant differences were observed in analysis of variance (ANOVA) in the FHP (p = 0.02) and NHP (p = 0.009). The results of tongue endurance measurements showed statistically significant differences for FHP (p = 0.001), NHP (p = 0.00), and RHP (p = 0.007). The craniocervical position influences tongue strength, especially in the anterior and middle tongue areas, concerning the posterior, and, in the anterior and neutral head posture, regarding the retracted position. No differences were found in tongue resistance between the various craniocervical positions, but differences were found in resistance between the different tongue areas.
Collapse
Affiliation(s)
- Alba Paris-Alemany
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain
| | - Alejandro Proy-Acosta
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Daniel Adraos-Juárez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Luis Suso-Martí
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Departament of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain. .,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain. .,Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain.
| | | |
Collapse
|
31
|
Karatrantou K. Dynamic Handgrip Strength Endurance: A Reliable Measurement in Older Women. J Geriatr Phys Ther 2020; 42:E51-E56. [PMID: 29394209 DOI: 10.1519/jpt.0000000000000180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Dynamic handgrip strength endurance is essential for daily activities that require repetitive gripping movements for a sustained period. At this time, there is no information about the reliability of measurement of dynamic handgrip strength endurance in older individuals. Thus, the purpose of this study was to investigate the test-retest reliability of dynamic handgrip strength endurance in older women. METHODS A cross-sectional study was performed. Thirty older women aged 70.5 (3.6) years performed 2 assessment sessions (test and retest), separated by 3 days. During these sessions, the dynamic handgrip strength endurance was evaluated using a testing protocol consisted of 12 repeated maximal isometric contractions for 3 seconds, with a 5-second rest between contractions (repetitions). The maximal handgrip strength at each repetition (repeated maximal repetitions) was evaluated in both hands (preferred and nonpreferred hand) using an hydraulic dynamometer Jamar; while the percentage change (using the mean of the first and the last 3 repetitions as well as the mean of the first and the last 6 repetitions) and the fatigue index were calculated. RESULTS The test-retest reliability for the assessment of repeated maximal repetitions (intraclass correlation coefficient [ICC] = 0.82-0.95, standard error of measurement [SEM] = 0.76-1.22 kg, SEM 95% confidence interval [CI] = 0.53-1.69 kg, SEM% = 3.6-8.6) and of percentage change (ICC = 0.81-0.87, SEM = 3.26%-4.40%, SEM 95% CI = 2.23-6.33%, SEM% = 3.4-4.7) was found to be high, whereas fatigue index exhibited lower reliability (ICC = 0.69-0.84, SEM% = 10.9-11.8). CONCLUSION A dynamic protocol of 12 repeated maximal repetitions may be used for the evaluation of dynamic handgrip strength endurance, using the repeated maximal repetitions and the percentage change as the most reliable indicators for the determination of muscle endurance. However, the assessment of fatigue index should be interpreted with more caution.
Collapse
Affiliation(s)
- Konstantina Karatrantou
- Department of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| |
Collapse
|
32
|
Nishinari K, Ishihara S, Hori K, Fang Y. Tongue-palate squeezing of soft gels in food oral processing. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.02.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
33
|
McKay R, Smart S, Cocks N. Investigating Tongue Strength and Endurance in Children Aged 6 to 11 Years. Dysphagia 2019; 35:762-772. [PMID: 31792616 DOI: 10.1007/s00455-019-10081-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/16/2019] [Indexed: 10/25/2022]
Abstract
Objective measures of tongue strength and endurance are used to assess lingual weakness and fatigue, and may have significant clinical value for dysphagia management. Recent studies investigating age and gender effects on tongue strength in children are limited by small sample sizes. The current study investigated age and gender effects on tongue strength with a larger sample size, and collected preliminary normative data for a paediatric population. This study also investigated the reliability of tongue endurance measures in children using a modified method, which has not previously been investigated. Using a cross-sectional design, this study examined tongue strength and endurance in 119 children aged 6 to 11 years, with no history of speech sound disorders, oro-motor deficits, dysphagia or cognitive impairment. Measures were collected using the Iowa Oral Performance Instrument. Children participated in two sessions, 45 min and 10 min in duration. Tongue strength was found to significantly increase with age (p < 0.001), while no gender effects were found. Modified tongue endurance measures involved using only one measure of maximal tongue strength to set parameters for tongue endurance scores. Despite this modification, data did not reach acceptable test-retest reliability, ICC = 0.68, p < 0.001; however, reliability improved from previous studies. These findings provide normative data for tongue strength, as a basis to compare individuals, and highlights the need for more reliable protocols for measuring tongue endurance. Normative data was collected from city-dwelling Australian children.
Collapse
Affiliation(s)
- R McKay
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - S Smart
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - N Cocks
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| |
Collapse
|
34
|
Gopaul U, Laver D, Carey L, Matyas TA, van Vliet P, Callister R. Measures of maximal tactile pressures of a sustained grasp task using a TactArray device have satisfactory reliability and validity in healthy people. Somatosens Mot Res 2019; 36:249-261. [DOI: 10.1080/08990220.2019.1673721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Urvashy Gopaul
- Department of Health Sciences, Faculty of Science, University of Mauritius, Reduit, Mauritius
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Newcastle, Newcastle, Australia
| | - Derek Laver
- Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
| | - Leeanne Carey
- The Florey Institute of Neuroscience and Mental Health, Neurorehabilitation and Recovery Group, Parkville, Australia
| | - Thomas A. Matyas
- The Florey Institute of Neuroscience and Mental Health, Neurorehabilitation and Recovery Group, Parkville, Australia
| | - Paulette van Vliet
- School of Humanities and Social Science, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Robin Callister
- Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
| |
Collapse
|
35
|
Kim J, Hegland K, Vann W, Berry R, Davenport PW. Measurement of maximum tongue protrusion force (MTPF) in healthy young adults. Physiol Rep 2019; 7:e14175. [PMID: 31293083 PMCID: PMC6640594 DOI: 10.14814/phy2.14175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/15/2019] [Accepted: 06/18/2019] [Indexed: 11/24/2022] Open
Abstract
We propose that tongue protrusive strength and tone may be related to upper airway patency, and when protrusive strength is reduced, individuals are at higher risk of developing sleep apnea, or speech/swallow disorders. The goal of the current study was to determine normative values of maximum tongue protrusion force (MTPF) in healthy young adults, using a unique newly developed device. We hypothesized that MTPF would be greater in males than in females. One hundred and one healthy young adults (mean age: 22.99 years; male: 23, female: 78) participated in this study. The subjects pushed their tongue forward against the device’s piston (protrusion) as hard as possible for 2–5 sec and MTPF was recorded in Newtons (N). A minimum of 5 MTPF measurements were obtained with 1–2 min rest between measurements. The average MTPF for all subjects was 15.4 N (SD: ±3.8), with a range of 8–29. The male average MTPF was higher than female (17.8 N, SD: ±3.7 vs. 14.7 N, SD: ±3.5; P = 0.001). There was no significant difference for age between males and females; males had significantly greater height and weight. The results demonstrate our novel device can effectively measure tongue protrusive force in healthy young adults. This study provides normative values for MTPF, and identified significant tongue protrusion strength differences between males and females.
Collapse
Affiliation(s)
- Jayoung Kim
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida
| | - Karen Hegland
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida
| | - William Vann
- Department of Physiological Sciences, University of Florida, Gainesville, Florida
| | - Richard Berry
- Department of Medicine, University of Florida, Gainesville, Florida
| | - Paul W Davenport
- Department of Physiological Sciences, University of Florida, Gainesville, Florida
| |
Collapse
|
36
|
Szynkiewicz SH, Nobriga CV, O'Donoghue CR, Becerra BJ, LaForge G. Motor Imagery Practice and Increased Tongue Strength: A Case Series Feasibility Report. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1676-1684. [PMID: 31112668 DOI: 10.1044/2019_jslhr-s-18-0128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The aim of the study was to determine the effects of a 6-week progressive resistance tongue exercise protocol in mental practice form on tongue strength. Investigation begins in typically aging adults, a population susceptible to reduced tongue strength and dysphagia secondary to age-related changes in the swallowing mechanism. It was hypothesized that typically aging adults who perform a 6-week progressive resistance tongue exercise protocol in mental practice form would increase tongue strength. Method A prospective, case series intervention study was used. Six healthy women aged 53-78 years completed a 6-week mental practice tongue resistance exercise program utilizing motor imagery to imagine completion of tongue exercises. The main outcome was mean isometric maximum tongue pressures (tongue strength), which were collected at baseline and Weeks 2, 4, and 6 using the Iowa Oral Performance Instrument ( IOPI Medical, 2013 ). Results By Week 6 of the study, all participants had significantly increased their tongue strength compared to baseline. Conclusions The findings indicate that mental practice using motor imagery for tongue exercise may improve tongue strength in healthy individuals at risk for dysphagia and may thus represent a promising direction warranting further investigation in typically aging individuals and patients with dysphagia and decreased tongue strength.
Collapse
Affiliation(s)
- Sarah H Szynkiewicz
- College of Science and Mathematics, University of South Florida Sarasota-Manatee
| | - Christina V Nobriga
- Department of Communication Sciences and Disorders, Loma Linda University, CA
| | - Cynthia R O'Donoghue
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | | | - Garret LaForge
- College of Science and Mathematics, University of South Florida Sarasota-Manatee
| |
Collapse
|
37
|
Curtis JA, Langenstein J, Troche MS, Laus J, Schneider SL. Open Mouth-Maximal Isometric Press: Development and Norms for Clinical Swallowing Evaluations and Treatment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:148-154. [PMID: 31072163 DOI: 10.1044/2018_ajslp-18-0137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The aims of this study were to (a) describe the development and utility of the Open Mouth-Maximal Isometric Press (OM-MIP), a tool designed for the quantitative assessment of suprahyoid-infrahyoid muscle strength; (b) examine the effects of age and sex on the OM-MIP; and (c) establish age- and sex-based OM-MIP norms. Method Two hundred sixteen healthy male and female volunteers were recruited. Participants performed the OM-MIP, and the maximum of 3 trials that were within 10% of each other was recorded. Rest between each trial was allowed to avoid fatigue. Multiple regression examined the influence of age and sex on the OM-MIP. Descriptive statistics outlined normative OM-MIP values for young adult (aged 18-39 years), middle-aged adult (aged 40-59 years), old adult (aged 60-79 years), and very old adult (aged ≥ 80 years) men and women. Two-way analysis of variance determined if normative data differed significantly between the age and sex groups. Results Age and sex significantly influenced the OM-MIP, although no significant interaction effect was identified. Women had lower mean OM-MIPs when compared with men ( p < .0005), and very old adults had lower mean OM-MIPs when compared with young ( p = .001), middle-aged ( p < .0005), and old ( p = .013) adults. Conclusions This study establishes age- and sex-based OM-MIP norms and outlines its potential utility during clinical swallowing evaluations and treatment. By providing these norms, clinicians can begin to quantitatively measure suprahyoid and infrahyoid strength, individualize resistance training programs to patients' OM-MIP 1 repetition maximum, and track strength changes over time in response to therapeutic interventions.
Collapse
Affiliation(s)
- James A Curtis
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Jonelyn Langenstein
- Center for Audiology, Speech, Language, and Learning, Northwestern University, Evanston, IL
| | - Michelle S Troche
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Joey Laus
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco
| | - Sarah L Schneider
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco
| |
Collapse
|
38
|
Mul K, Berggren KN, Sills MY, McCalley A, van Engelen BGM, Johnson NE, Statland JM. Effects of weakness of orofacial muscles on swallowing and communication in FSHD. Neurology 2019; 92:e957-e963. [PMID: 30804066 DOI: 10.1212/wnl.0000000000007013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 10/25/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study explores the use of quantitative data on strength and fatigability of orofacial muscles in patients with facioscapulohumeral muscular dystrophy (FSHD) and assesses the frequency of swallowing and communication difficulties and their relationship to orofacial muscle involvement. METHODS We included 43 patients with FSHD and 35 healthy controls and used the Iowa Oral Performance Instrument (IOPI) to obtain quantitative measurements of strength and endurance of lip compression, cheek (buccodental) compression, and tongue elevation. For the assessment of swallowing and communication difficulties, we used the dysphagia-specific quality of life (SWAL-QOL) and Communicative Participation Item Bank questionnaires. RESULTS Cheek compression strength was reduced in patients with FSHD compared to healthy controls. Dysphagia and difficulty with verbal communication were reported by 25% and 35% of patients, respectively, and correlated to cheek compression strength and endurance and to anterior tongue elevation endurance. Prolonged cheek compression or anterior tongue elevation endurance (decreased fatigability) made swallowing or speech problems less likely to occur. CONCLUSION Cheek compression strength is the most sensitive IOPI measure for orofacial weakness in FSHD. Orofacial weakness contributes to dysphagia and speech difficulties in FSHD, which are both common, though generally mild. Higher endurance of orofacial muscles was associated with a lower chance of dysphagia or speech problems. More research is required for further refinement of the pattern of facial muscle involvement in FSHD and to provide new insights for improvement of speech and language therapy.
Collapse
Affiliation(s)
- Karlien Mul
- From the Department of Neurology (K.M., M.Y.S., A.M., J.M.S.), University of Kansas Medical Center, Kansas City; Department of Neurology (K.N.B., N.E.J.), Virginia Commonwealth University, Richmond; and Department of Neurology (K.M., B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Kiera N Berggren
- From the Department of Neurology (K.M., M.Y.S., A.M., J.M.S.), University of Kansas Medical Center, Kansas City; Department of Neurology (K.N.B., N.E.J.), Virginia Commonwealth University, Richmond; and Department of Neurology (K.M., B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mattie Y Sills
- From the Department of Neurology (K.M., M.Y.S., A.M., J.M.S.), University of Kansas Medical Center, Kansas City; Department of Neurology (K.N.B., N.E.J.), Virginia Commonwealth University, Richmond; and Department of Neurology (K.M., B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ayla McCalley
- From the Department of Neurology (K.M., M.Y.S., A.M., J.M.S.), University of Kansas Medical Center, Kansas City; Department of Neurology (K.N.B., N.E.J.), Virginia Commonwealth University, Richmond; and Department of Neurology (K.M., B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Baziel G M van Engelen
- From the Department of Neurology (K.M., M.Y.S., A.M., J.M.S.), University of Kansas Medical Center, Kansas City; Department of Neurology (K.N.B., N.E.J.), Virginia Commonwealth University, Richmond; and Department of Neurology (K.M., B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nicholas E Johnson
- From the Department of Neurology (K.M., M.Y.S., A.M., J.M.S.), University of Kansas Medical Center, Kansas City; Department of Neurology (K.N.B., N.E.J.), Virginia Commonwealth University, Richmond; and Department of Neurology (K.M., B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jeffrey M Statland
- From the Department of Neurology (K.M., M.Y.S., A.M., J.M.S.), University of Kansas Medical Center, Kansas City; Department of Neurology (K.N.B., N.E.J.), Virginia Commonwealth University, Richmond; and Department of Neurology (K.M., B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| |
Collapse
|
39
|
Vanderwegen J, Van Nuffelen G, Elen R, De Bodt M. The Influence of Age, Sex, Visual Feedback, Bulb Position, and the Order of Testing on Maximum Anterior and Posterior Tongue Strength in Healthy Belgian Children. Dysphagia 2019; 34:834-851. [DOI: 10.1007/s00455-019-09976-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 01/02/2019] [Indexed: 02/06/2023]
|
40
|
VanRavenhorst‐Bell HA, Coufal KL, Patterson JA, Mefferd AS. A comparative study: tongue muscle performance in weightlifters and runners. Physiol Rep 2018; 6:e13923. [PMID: 30460755 PMCID: PMC6246939 DOI: 10.14814/phy2.13923] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/05/2022] Open
Abstract
Exercise mode (i.e., resistance training, endurance training) is known to yield mode-specific effects on strength and endurance of muscles that are directly targeted during the exercise. Such mode-specific effects can also be observed in indirectly involved (i.e., nontargeted) muscles. Mode-specific muscle performance changes of nontargeted muscles, however, have only been investigated within the skeletal system. Therefore, as a first step, this study aimed to determine if bulbar muscle performance (tongue strength [TS], tongue endurance [TE]) differs between weightlifters and runners and if group differences are tongue region-specific. The Iowa Oral Performance Instrument (IOPI) was used to measure TS and TE of the anterior and posterior tongue regions in 21 weightlifters and 23 runners. In weightlifters anterior TS was significantly greater than posterior TS (P = 0.008), whereas in runners anterior and posterior TS were comparable. Furthermore, weightlifters produced significantly greater anterior TS than runners (P = 0.001). Finally, TE was overall significantly greater in runners than in weightlifters (P = 0.001). Findings suggest that exercise mode may differentially impact performance patterns of nontargeted bulbar muscles. More research is warranted to better understand the mechanisms underlying tongue muscle performance differences between weightlifters and runners.
Collapse
Affiliation(s)
| | - Kathy L. Coufal
- Department of Special Education & Communication Disorders, EducationUniversity of NebraskaOmahaNE
| | | | - Antje S. Mefferd
- Department of Hearing and Speech SciencesVanderbilt UniversityNashvilleTN
| |
Collapse
|
41
|
Araújo TGD, Rodrigues TM, Furlan RMMM, Casas EBDL, Motta AR. Reproducibility assessment of an instrument for measuring the axial force of the tongue. Codas 2018; 30:e20170191. [PMID: 29972446 DOI: 10.1590/2317-1782/20182017191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 12/20/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Evaluate the reproducibility of Forling, a portable instrument for measuring axial tongue force. METHODS Axial force of the tongue was measured in 49 individuals (30 women and 19 men) aged 18-25 years using the Forling portable instrument. Measurements were performed in three days at intervals of 7±2 days. On each day, three 7-second measurements were performed with one-minute intervals between them. The coefficient of variation, Wilcoxon paired test, and intraclass correlation coefficient were used in the statistical analysis of the data. Maximum and mean tongue force values were analyzed, and comparison between them was performed using three approaches: the mean of the three values; the mean of the two highest values; the highest value of each measurement. RESULTS In the analysis of mean tongue force, the coefficient of variation was considered desirable and the intraclass correlation coefficient was acceptable. Significant differences were observed regarding the maximum value between the second and third days, mean of the two highest values and mean of the three values between the first and second days and the second and third days. In the analysis of maximum tongue force, the coefficient of variation and the intraclass correlation coefficient were acceptable. Significant difference was found only in the comparison between the second and third days. CONCLUSION Good reproducibility of the data obtained with the use of the Forling portable instrument was observed.
Collapse
|
42
|
Azevedo ND, Lima JC, Furlan RMMM, Motta AR. Tongue pressure measurement in children with mouth-breathing behaviour. J Oral Rehabil 2018; 45:612-617. [DOI: 10.1111/joor.12653] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 12/01/2022]
Affiliation(s)
- N. D. Azevedo
- Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - J. C. Lima
- Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - R. M. M. M. Furlan
- Department of Speech-Language Therapy and Audiology; Instituto Metodista Izabela Hendrix; Belo Horizonte Brazil
| | - A. R. Motta
- Department of Speech-Language Therapy and Audiology; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| |
Collapse
|
43
|
Steele CM. The influence of tongue strength on oral viscosity discrimination acuity. J Texture Stud 2018; 49:249-255. [PMID: 29280136 DOI: 10.1111/jtxs.12318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/16/2017] [Accepted: 12/19/2017] [Indexed: 11/27/2022]
Abstract
The ability to generate tongue pressures is widely considered to be critical for liquid bolus propulsion in swallowing. It has been proposed that the application of tongue pressure may also serve the function of collecting sensory information regarding bolus viscosity (resistance to flow). In this study, we explored the impact of age-related reductions in tongue strength on oral viscosity discrimination acuity. The experiment employed a triangle test discrimination protocol with an array of xanthan-gum thickened liquids in the mildly to moderately thick consistency range. A sample of 346 healthy volunteers was recruited, with age ranging from 12 to 86 (164 men, 182 women). On average, participants were able to detect a 0.29-fold increase in xanthan-gum concentration, corresponding to a 0.5-fold increase in viscosity at 50/s. Despite having significantly reduced tongue strength on maximum isometric tongue-palate pressure tasks, and regardless of sex, older participants in this study showed no reductions in viscosity discrimination acuity. PRACTICAL APPLICATIONS In this article, the relationship between tongue strength and the ability to discriminate small differences in liquid viscosity during oral processing is explored. Given that tongue strength declines with age in healthy adults and is also reduced in individuals with dysphagia, it is interesting to determine whether reduced tongue strength might contribute to difficulties in evaluating liquid viscosity during the oral stage of swallowing. Using an array of mildly to moderately thick xanthan-gum thickened liquids, this experiment failed to find any evidence that reductions in tongue strength influence oral viscosity discrimination acuity.
Collapse
Affiliation(s)
- Catriona M Steele
- Toronto Rehabilitation Institute, University Health Network, 550 University Avenue 12th floor, Toronto, Ontario, Canada M5G 2A2.,Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, Ontario, Canada M5G 1V7
| |
Collapse
|
44
|
Reis VSD, Araújo TGD, Furlan RMMM, Motta AR. Correlation between tongue pressure and electrical activity of the suprahyoid muscles. REVISTA CEFAC 2017. [DOI: 10.1590/1982-021620171968617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to investigate the correlation between the tongue pressure and the electrical activity of the suprahyoid muscles. Methods: a across-sectional, observational and analytical study conducted with 15 men and 22 women. Each participant underwent simultaneous assessment of maximal tongue pressure through the Iowa Oral Performance Instrument (IOPI) and the surface electromyography of the suprahyoid muscles. They were asked to press the tongue against the hard palate in the anterior and posterior region, with and without IOPI. The adopted significance level of the performed analyses was 5%. Results: there was a moderate and significant correlation only between suprahyoid electrical activity and tongue pressure in the posterior region. It was verified that the measured electrical potentials, when using the IOPI, were greater in the tasks of anterior pressure than in the tasks of the posterior one, bilaterally. Without using the IOPI, the electrical potentials were greater in the posterior pressure than in the anterior one, bilaterally. Finally, the values of lingual pressure were compared with the bulb positioned in the anterior and posterior parts, and the anterior tongue pressure was higher. Conclusion: there was a moderate correlation between tongue pressure and electrical potential of the suprahyoid muscles, researched by the surface electromyography, only when performing activities with the posterior portion of the tongue.
Collapse
|
45
|
Partal I, Aksu M. Changes in lips, cheeks and tongue pressures after upper incisor protrusion in Class II division 2 malocclusion: a prospective study. Prog Orthod 2017; 18:29. [PMID: 28944417 PMCID: PMC5610954 DOI: 10.1186/s40510-017-0182-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/27/2017] [Indexed: 11/10/2022] Open
Abstract
Background The etiology of Class II division 2 (CII/2) malocclusion focuses on heredity; however lip, cheek, and tongue pressures that are associated with the environmental effect are considered to have an effect. The aim of this study was to evaluate the relation between perioral pressures and the upper incisor inclination in CII/2 malocclusion. Methods Twenty patients (8 females, 12 males; mean age 10.29 ± 0.90 years) with CII/2 malocclusion were included in the study group, and 15 patients (5 females, 10 males; mean age 10.56 ± 1.06 years) with Class I malocclusion were included. The upper incisors were protruded with a utility arch (0.016 × 0.022 in. blue elgiloy wire). Perioral pressure assessment was made with the Iowa Oral Pressure Instrument. Upper lip pressure, lower lip pressure, vertical lip pressure, left-right buccal pressures, swallowing, and maximum tongue pressures were measured. Repeated measure ANOVA was used to test the intragroup differences. Intergroup comparisons were made using two-way repeated measure ANOVA with Bonferroni correction. Relationships between the variables were analyzed using rank correlation (Spearman’s rho). The significance for all statistical tests was predetermined at p < 0.05. Results A significant change occurred in the upper lip pressure, lower lip pressure, and vertical lip pressure; however, significant difference was not found between the groups. Upper lip pressure increased significantly in both groups. In the CII/2 group, lower lip pressure increased after protrusion and decreased after retention, while vertical lip pressure decreased and then increased significantly. Left buccal pressure changes between the groups were not parallel. Right buccal pressure, swallowing, and maximum tongue pressure changes were not statistically significant. Statistically significant correlation was found between U1-NA (mm) and vertical lip pressure (r −0.467). Conclusions In the CII/2 group, upper lip pressure increased only in retention. Lower lip pressure increased and vertical lip pressure decreased after protrusion. Nevertheless, these changes did not remain stable after the retention period. The difference between groups was not statistically significant at the end of retention.
Collapse
Affiliation(s)
- Irmak Partal
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Muge Aksu
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
| |
Collapse
|
46
|
Gerodimos V, Karatrantou K, Psychou D, Vasilopoulou T, Zafeiridis A. Static and Dynamic Handgrip Strength Endurance: Test-Retest Reproducibility. J Hand Surg Am 2017; 42:e175-e184. [PMID: 28259282 DOI: 10.1016/j.jhsa.2016.12.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 12/06/2016] [Accepted: 12/29/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE This study investigated the reliability of static and dynamic handgrip strength endurance using different protocols and indicators for the assessment of strength endurance. METHODS Forty young, healthy men and women (age, 18-22 years) performed 2 handgrip strength endurance protocols: a static protocol (sustained submaximal contraction at 50% of maximal voluntary contraction) and a dynamic one (8, 10, and 12 maximal repetitions). The participants executed each protocol twice to assess the test-retest reproducibility. Total work and total time were used as indicators of strength endurance in the static protocol; the strength recorded at each maximal repetition, the percentage change, and fatigue index were used as indicators of strength endurance in the dynamic protocol. RESULTS The static protocol showed high reliability irrespective of sex and hand for total time and work. The 12-repetition dynamic protocol exhibited moderate-high reliability for repeated maximal repetitions and percentage change; the 8- and 10-repetition protocols demonstrated lower reliability irrespective of sex and hand. The fatigue index was not a reliable indicator for the assessment of dynamic handgrip endurance. CONCLUSIONS Static handgrip endurance can be measured reliably using the total time and total work as indicators of strength endurance. For the evaluation of dynamic handgrip endurance, the 12-repetition protocol is recommended, using the repeated maximal repetitions and percentage change as indicators of strength endurance. CLINICAL RELEVANCE Practitioners should consider the static (50% maximal voluntary contraction) and dynamic (12 repeated maximal repetitions) protocols as reliable for the assessment of handgrip strength endurance. The evaluation of static endurance in conjunction with dynamic endurance would provide more complete information about hand function.
Collapse
Affiliation(s)
- Vassilis Gerodimos
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece.
| | - Konstantina Karatrantou
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Dimitra Psychou
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Theodora Vasilopoulou
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Andreas Zafeiridis
- Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
| |
Collapse
|
47
|
McIlduff C, Yim S, Pacheck A, Geisbush T, Mijailovic A, Rutkove SB. An improved electrical impedance myography (EIM) tongue array for use in clinical trials. Clin Neurophysiol 2015; 127:932-935. [PMID: 26242815 DOI: 10.1016/j.clinph.2015.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/17/2015] [Accepted: 06/15/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Electrical impedance myography (EIM) measurements of the tongue could provide valuable information about bulbar dysfunction in amyotrophic lateral sclerosis (ALS). A prototype tongue depressor EIM array produced gag reflexes. The objectives of this study were to determine the reliability, mean phase values, and tolerability of tongue EIM measurements using a smaller electrode array. METHODS Tongue EIM measurements were performed in a total of 31 healthy individuals and four neuromuscular patients with lingual abnormalities. Reliability was assessed by calculating the intraclass correlation coefficient (ICC) and percent difference in addition to performing Bland-Altman analyses. Standard descriptive statistics, including results of a Mann-Whitney test, were also determined. RESULTS At the 50 kHz frequency, the ICCs for intra- and inter-rater reliability were 0.76 with 5.17% difference and 0.78 with 5.34% difference respectively. The mean EIM phase values of healthy participants (11.61° ± 1.00°) and patients (9.87° ± 1.28°) were significantly different (p=0.0051). None of the participants experienced gag reflexes or discomfort. CONCLUSIONS The small tongue array provided good inter- and intra-rater reliability, could preliminarily distinguish between healthy and diseased muscle, and was well-tolerated. SIGNIFICANCE Biomarker information about tongue health could be more comfortably obtained with a smaller EIM array.
Collapse
Affiliation(s)
- Courtney McIlduff
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Sung Yim
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Adam Pacheck
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Tom Geisbush
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Aleksandar Mijailovic
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
48
|
Shumway KR, Porfirio DJ, Bailey EF. Phonation-related rate coding and recruitment in the genioglossus muscle. Exp Brain Res 2015; 233:2133-40. [PMID: 25899868 DOI: 10.1007/s00221-015-4284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 04/10/2015] [Indexed: 11/26/2022]
Abstract
Motor unit recruitment was assessed in two muscles with similar muscle fiber-type compositions and that participate in skilled movements: the tongue muscle, genioglossus (GG), and the hand muscle, first dorsal interosseous (FDI). Our primary objectives were to determine in the framework of a voluntary movement whether muscle force is regulated in tongue as it is in limb, i.e., via processes of rate coding and recruitment. Recruitment in the two muscles was assessed within each subject in the context of ramp force (FDI) and in the tongue (GG) during vowel production and specifically, in the context of ramp increases in loudness, and subsequently expressed relative to the maximal. The principle findings of the study are that the general rules of recruitment and rate coding hold true for both GG and FDI, and second, that average firing rates, firing rates at recruitment and peak firing rates in GG are significantly higher than for FDI (P < 0.001) despite tasks performed across comparable force ranges (~2-40 % of max). The higher firing rates observed in the tongue within the context of phonation may be a function of that muscle's dual role as (prime) mover and hydrostatic support element.
Collapse
Affiliation(s)
- K R Shumway
- Department of Physiology, College of Medicine, The University of Arizona, Tucson, AZ, 85721-0093, USA
| | | | | |
Collapse
|
49
|
Tongue weakness and somatosensory disturbance following oral endotracheal extubation. Dysphagia 2015; 30:188-95. [PMID: 25663416 DOI: 10.1007/s00455-014-9594-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 12/27/2014] [Indexed: 10/24/2022]
Abstract
The tongue plays important roles in mastication, swallowing, and speech, but its sensorimotor function might be affected by endotracheal intubation. The objective of this pilot study was to describe disturbances in the sensorimotor functions of the tongue over 14 days following oral endotracheal extubation. We examined 30 post-extubated patients who had prolonged (≥48 h) oral endotracheal intubation from six medical intensive care units. Another 36 patients were recruited and examined from dental and geriatric outpatient clinics served as a comparison group. Tongue strength was measured by the Iowa Oral Performance Instrument. Sensory disturbance of the tongue was measured by evaluating light touch sensation, oral stereognosis, and two-point discrimination with standardized protocols. Measurements were taken at three time points (within 48 h, and 7 and 14 days post-extubation) for patients with oral intubation but only once for the comparison group. The results show that independent of age, gender, tobacco used, and comorbidities, tongue strength was lower and its sensory functions were more impaired in patients who had oral intubation than in the comparison group. Sensory disturbances of the tongue gradually recovered, taking 14 days to be comparable with the comparison group, while weakness of the tongue persisted. In conclusion, patients with oral endotracheal intubation had weakness and somatosensory disturbances of the tongue lasting at least 14 days from extubation but whether is caused by intubation and whether is contributed to postextubation dysphagia should be further investigated.
Collapse
|
50
|
Steele CM. The Blind Scientists and the Elephant of Swallowing: A Review of Instrumental Perspectives on Swallowing Physiology. J Texture Stud 2014. [DOI: 10.1111/jtxs.12101] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Catriona M. Steele
- Swallowing Rehabilitation Research Laboratory; Toronto Rehabilitation Institute; University Health Network; 550 University Avenue Toronto Ontario M5G 2A2
- Department of Speech-Language Pathology; University of Toronto; Toronto Canada
- Graduate Department of Rehabilitation Sciences; University of Toronto; Toronto Canada
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto Canada
- Bloorview Research Institute; Toronto Canada. International Dysphagia Diet Standardisation Initiative Foundation Committee; Brisbane Australia
| |
Collapse
|