Effects of a tongue training program in Parkinson's disease: Analysis of electrical activity and strength of suprahyoid muscles

Quantitative Measurement of Swallowing Performance Using Iowa Oral Performance Instrument: A Systematic Review and Meta-Analysis

“…An initial screening of the titles and abstracts identified 47 studies. After reading the full texts, 33 studies [ 44 , 45 , 46 , 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ] were included, thus eliminating 14 studies [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 78 ] that did not meet the inclusion/exclusion criteria. The summary of the search strategy is depicted in Figure 2 .…”

“…Among the 14 intervention studies [ 44 , 45 , 46 , 47 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ], participants included dysphagic post-stroke subjects in 3 studies (21.4%) [ 45 , 46 , 60 ], older adults in 4 studies (28.6%) [ 47 , 61 , 62 , 63 ], and subjects with sleep breathing disorders in 4 studies (28.6%) [ 64 , 65 , 66 , 67 ]. Subjects with tongue thrust [ 68 ], as well as patients with Parkinson’s disease [ 69 ], were included in only 1 study (7.1%). Moreover, the sample in 1 out of 14 intervention studies (7.1%) was totally composed of HC without any reported pathologies [ 44 ].…”

“…In 1 study (7.1%) [ 65 ], the experimental group performed myofunctional therapy, consisting of isometric and isotonic oropharyngeal exercises divided into three categories: (1) nasal breathing rehabilitation, (2) labial seal and lip tone exercises, and (3) tongue posture exercises; in 1 study (7.1%) [ 45 ], the experimental group performed conventional dysphagia therapy and effortful swallowing training (EST), consisting of pushing the tongue onto the palate, while squeezing the neck muscles, and swallow as forcefully as possible, whereas the control group performed saliva swallowing without intentional force from the tongue and the neck muscles, and conventional dysphagia therapy, including orofacial muscle exercises, thermal tactile stimulation, expiratory training. In 2 studies (14.2%) [ 44 , 61 ], the experimental exercise was divided into isotonic and isometric types; in 1 study (7.1%) [ 62 ], participants performed a home-based mHealth app therapy program based on three therapy maneuvers: (1) effortful prolonged swallowing, (2) effortful pitch glide, and (3) effortful tongue rotation; in 1 (7.1%) study [ 68 ], participants underwent orofacial myofunctional therapy (OMT), consisting of isotonic and isometric exercises involving the tongue, soft palate, and lateral pharyngeal wall; in 3 studies (21.4%) [ 64 , 66 , 67 ], participants performed an AirwayGym app myofunctional therapy, based on exercises that are aimed at improving the tonicity of the various muscles involved in the pathogenesis of OSAHS; in 1 study (7.1%) [ 47 ], one group performed a tongue progressive resistance exercise (effortful water swallow) whereas the comparative group performed an instrumental tongue isometric exercise (lingual pressing tasks) using IOPI; in 1 study (7.1%) [ 69 ], participants in the experimental group performed traditional tongue exercises (tongue presses against the palate and lateral lingual movements) and instrumental tongue pressure exercises using the IOPI, whereas the comparative group performed only traditional tongue exercises.…”

“…Among randomized intervention studies, a low risk of bias was found in eight studies [ 44 , 45 , 46 , 47 , 60 , 64 , 65 , 69 ]. One study instead [ 61 ] resulted in being at a moderate risk of bias because of inadequate information about the “Randomization process” domain, according to the RoB 2 tool ( Figure 3 ).…”

“…To assess if IOPI outcomes were able to highlight possible effects of treatments on swallowing performance, interventional studies on HC and patients were included. From all investigated studies and outcomes, 11 intervention studies [ 44 , 45 , 46 , 47 , 60 , 61 , 62 , 63 , 66 , 67 , 69 ] (33.33%) had MIP mean values before and after therapy and were used for statistical analyses. Eight studies [ 45 , 46 , 60 , 62 , 63 , 66 , 67 , 69 ] (24.24%) reported MIP mean values in patients before and after experimental training exercises ( Table 7 ).…”