Ann Rehabil Med.  2021 Dec;45(6):440-449. 10.5535/arm.21126.

Decreased Maximal Tongue Protrusion Length May Predict the Presence of Dysphagia in Stroke Patients

• Cho H
• Noh JS
• Park J
• Park C
• Park ND
• Ahn JY
• Park JW
• Choi YH
• Chun SM

• KMID: 2523841
• DOI: http://doi.org/10.5535/arm.21126

Abstract

Objective
To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients.
Methods
Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS).
Results
The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%.
Conclusion
There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.

Keyword

Deglutition disorders, Stroke, Videofluoroscopic swallowing study

Figure

• 

  Fig. 1. Measurement of tongue length parameters: (A) MTPL and (B) FTL using quick tongue-tie assessment tool. Ratio of MTPL to FTL was calculated by dividing MTPL by FTL. MTPL, maximal tongue protrusion length; FTL, free tongue length.

• 

  Fig. 2. Correlation between MTPL and dysphagia scales. (A) Videofluoroscopic Dysphagia Scale (VDS). (B) Penetration-Aspiration Scale (PAS) score. (C) Functional Oral Intake Scale (FOIS). MTPL, maximal tongue protrusion length.

• 

  Fig. 3. Correlation between RMF and dysphagia scales. (A) Videofluoroscopic Dysphagia Scale (VDS). (B) PenetrationAspiration Scale (PAS) score. (C) Functional Oral Intake Scale (FOIS). RMF, ratio of maximal tongue protrusion length to free tongue length.

• 

  Fig. 4. Receiver operating characteristic curve of RMF for prediction of aspiration. RMF, ratio of maximal tongue protrusion length to free tongue length; AUC, area under the curve.

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