The effects of tongue pressure strength and accuracy training on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia: a preliminary randomized clinical trial

Abstract

Tongue pressure strength and accuracy training (TPSAT) has been proposed as an intervention to improve dysphagia. However, the effects of TPSAT on dysphagia in subacute stroke patients remain unclear. The aim of this study was to investigate the effects of TPSAT on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia. Sixteen subacute stroke patients were assigned randomly to two groups: the TPSAT group (n=8) or the control group (n=8). In the former, both TPSAT and traditional dysphagia therapies were performed for 30 min each per day; in the latter, only traditional dysphagia therapy was performed for 30 min twice a day. Both groups performed each daily intervention five times per week for 8 weeks. To assess the tongue pressure strength, maximum isometric tongue pressures (MIPs) of the anterior and posterior tongue using the Iowa Oral Performance Instrument were measured before and after the intervention. Mann Assessment of Swallowing Ability (MASA) and Swallowing-Quality of Life (SWAL-QOL) were also used to assess the swallowing function and quality of life, respectively. TPSAT with traditional dysphagia therapy significantly improved MASA, SWAL-QOL, and MIPs both anteriorly and posteriorly, and traditional dysphagia therapy significantly increased MASA, SWAL-QOL, and MIPs anteriorly (P<0.05). The TPSAT group showed a significant improvement in anterior and posterior MIPs and tongue movement score in MASA compared with the control group (P<0.05). Our findings suggest that TPSAT may significantly improve dysphagia management in subacute stroke patients.

The influence of training variables on lingual strength and swallowing in adults with and without dysphagia

“…Eighteen studies 4,9,12,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] were included in our analysis, totalling 374 adults ( Table 1). Ten of the 18 studies targeted healthy adults, 4,9,12,[14][15][16][17][18][19][20] while the other eight studies [21][22][23][24][25][26][27][28] targeted patients with dysphagia. In studies involving healthy individuals, two studies compared tongue strength training vs. a non-exercise control group, 12,14 six studies were composed of only a tongue strength training group, 4,15,16,[18][19][20] one study had two different tongue strength training interventions, 17 and one study compared three different tongue strength interventions and an exercise control group (lip compression).…”

“…9 Seven studies involving patients with dysphagia compared therapy interventions vs. tongue strength training plus therapy interventions. [22][23][24][25][26][27][28] Participants of six of the eight studies involving dysphagia were stroke survivors. 21,23,[25][26][27][28] All studies 4,9,12,14-28 involved men and women; however, it was not possible to identify the number of men and women in each intervention group in three studies 12,17,22 (Table 1).…”

“…[22][23][24][25][26][27][28] Participants of six of the eight studies involving dysphagia were stroke survivors. 21,23,[25][26][27][28] All studies 4,9,12,14-28 involved men and women; however, it was not possible to identify the number of men and women in each intervention group in three studies 12,17,22 (Table 1). In studies involving healthy individuals, five studies were composed of young adults, 12,14,16,18,19 four studies were composed of older individuals, 4,9,17,20 and one had both young and older adults.…”

“…In studies involving healthy individuals, five studies were composed of young adults, 12,14,16,18,19 four studies were composed of older individuals, 4,9,17,20 and one had both young and older adults. 15 Although all studies with dysphagic patients were composed of older patients (according to the mean patients age reported), [21][22][23][24][25][26][27][28] four studies were composed of young and older patients, [20][21][22]24 and the other four studies did not report the patients' age range. 24,[26][27][28] Table 1 shows additional information about participants' characteristics from the included studies.…”

“…15 Although all studies with dysphagic patients were composed of older patients (according to the mean patients age reported), [21][22][23][24][25][26][27][28] four studies were composed of young and older patients, [20][21][22]24 and the other four studies did not report the patients' age range. 24,[26][27][28] Table 1 shows additional information about participants' characteristics from the included studies.…”