Ann Rehabil Med.  2016 Aug;40(4):620-628. 10.5535/arm.2016.40.4.620.

The Relationship Between Tongue Pressure and Oral Dysphagia in Stroke Patients

Affiliations
  • 1Department of Rehabilitation & Physical Medicine, Kyung-Hee Medical Center, Seoul, Korea.
  • 2Department of Rehabilitation & Physical Medicine, Kyung-Hee University Hospital at Gangdong, Seoul, Korea. soyuns@gmail.com
  • 3Department of Occupational Therapy, Inje University Busan Paik Hospital, Busan, Korea.

Abstract


OBJECTIVE
To evaluate the relationships between tongue pressure and different aspects of the oral-phase swallowing function.
METHODS
We included 96 stroke patients with dysphagia, ranging in age from 40 to 88 years (mean, 63.7 years). Measurements of tongue pressure were obtained with the Iowa Oral Performance Instrument, a device with established normative data. Three trials of maximum performance were performed for lip closure pressure (LP), anterior hard palate-to-tongue pressure (AP), and posterior hard palate-to-tongue pressure (PP); buccal-to-tongue pressures on both sides were also recorded (buccal-to-tongue pressure, on the weak side [BW]; buccal-to-tongue pressure, on the healthy side [BH]). The average pressure in each result was compared between the groups. Clinical evaluation of the swallowing function was performed with a videofluoroscopic swallowing study.
RESULTS
The average maximum AP and PP values in the intact LC group were significantly higher than those in the inadequate lip closure group (AP, p=0.003; PP, p<0.001). AP and PP showed significant relationships with bolus formation (BF), mastication, premature bolus loss (PBL), tongue to palate contact (TP), and oral transit time (OTT). Furthermore, LP, BW, and BH values were significantly higher in the groups with intact mastication, without PBL and intact TP.
CONCLUSION
These findings indicate that the tongue pressure appears to be closely related to the oral-phase swallowing function in post-stroke patients, especially BF, mastication, PBL, TP and OTT.

Keyword

Dysphagia; Stroke; Tongue pressure; VFSS; Iowa Oral Performance Instrument

MeSH Terms

Deglutition
Deglutition Disorders*
Humans
Iowa
Lip
Mastication
Palate
Stroke*
Tongue*

Figure

  • Fig. 1 Positioning of the air-filled lingual pressure sensor of the Iowa Oral Performance Instrument between the tongue and an oral structure.

  • Fig. 2 Correlation between premature bolus loss (PBL) and mean tongue pressure. A larger amount of PBL was associated with a lower maximal tongue pressure (Jonckheere– Terpstra rank correlation test, p<0.05). AP, anterior hard palate-to-tongue pressure; PP, posterior hard palate-to-tongue pressure; BW, buccal-to-tongue pressure on the weak side; BH, buccal-to-tongue pressure on the healthy side; LP, lip closure pressure.


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Decreased Maximal Tongue Protrusion Length May Predict the Presence of Dysphagia in Stroke Patients
Hyunchul Cho, Jeong Se Noh, Junwon Park, Changwook Park, No Dam Park, Jun Young Ahn, Ji Woong Park, Yoon-Hee Choi, Seong-Min Chun
Ann Rehabil Med. 2021;45(6):440-449.    doi: 10.5535/arm.21126.

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Back Min Oh, Hyun Seok, Sang-Hyun Kim, Seung Yeol Lee, Su Jung Park, Beom Jin Kim, Hyun Jung Kim
Ann Rehabil Med. 2023;47(3):192-204.    doi: 10.5535/arm.23018.


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