The Relationship Between Lingual Strength and Functional Swallowing Outcomes in Parkinson’s Disease

Sevitz, Jordanna S; Perry, Sarah; Borders, James C; Dakin, Avery E; Curtis, James A.; Troche, Michelle S.

doi:10.1007/s00455-022-10543-0

Cited by 11 publications

(15 citation statements)

References 55 publications

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“…5 Tongue pressure is a factor related to dysphagia in this population and could be highly valuable in clinical practice, offering a signal for instrumental evaluation and earlier intervention. 5,14,15 Research highlights that a reduction in tongue pressure may be a predictor of reduced food intake, increased mealtime and dysphagia. 31 This study also investigated swallowing function using VFSS.…”

Section: Ta B L E 3 Comparison Of Tonguementioning

confidence: 99%

“…37 In PD patients, the presence of reduction in the maximum isometric tongue pressure was associated with a reduction in the safety and efficiency of thin liquids swallowing. 15 An adequate tongue pressure against the palate establishes a general force for the swallowing biomechanics to occur properly. Isometric tongue pressure and/or mean swallowing pressure can indicate inadequate airway protection, which can lead to a high risk of aspiration.…”

Section: Ta B L E 3 Comparison Of Tonguementioning

confidence: 99%

“…Isometric tongue pressure and/or mean swallowing pressure can indicate inadequate airway protection, which can lead to a high risk of aspiration. 15 It is important to focus on evaluating components of airway protective function to understand how tongue pressure interacts with other compromised physiological events, which may negatively contribute to the biomechanics of swallowing. 15 As the LVC is a protective airway function component, we found that PD patients with incomplete LVC have a reduced duration of anterior pressure of the tongue on the bulb against the palate.…”

Section: Ta B L E 3 Comparison Of Tonguementioning

confidence: 99%

“…15 It is important to focus on evaluating components of airway protective function to understand how tongue pressure interacts with other compromised physiological events, which may negatively contribute to the biomechanics of swallowing. 15 As the LVC is a protective airway function component, we found that PD patients with incomplete LVC have a reduced duration of anterior pressure of the tongue on the bulb against the palate. Thus, we observed the potential clinical use of anterior isometric tongue endurance in the assessment of dysphagia in patients with PD.…”

Section: Ta B L E 3 Comparison Of Tonguementioning

confidence: 99%

“…11 The measurements of tongue pressure in association with swallowing instrumental evaluation and the application of The Dysphagia Outcome and Severity Scale (DOSS), 12 and Penetration-Aspiration Scale (PAS) 13 in PD may be useful to identify impairments in swallowing physiology 14 and may contribute to improving diagnostic and treatment targets. 15 The investigation of the association between tongue pressure measurements and LVC deepens our knowledge of the relevance of tongue pressure in the airway protection mechanism in PD.…”

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confidence: 92%

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Isometric tongue endurance and incomplete laryngeal vestibule closure in Parkinson's disease

da Costa,

Casseb,

de Lima

et al. 2023

J of Oral Rehabilitation

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BackgroundDysphagia 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.ObjectiveTo 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.MethodsTwenty‐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.ResultsCompared 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.ConclusionPD 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.

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Section: Ta B L E 3 Comparison Of Tonguementioning

confidence: 99%

Section: Ta B L E 3 Comparison Of Tonguementioning

confidence: 99%

Section: Ta B L E 3 Comparison Of Tonguementioning

confidence: 99%

Section: Ta B L E 3 Comparison Of Tonguementioning

confidence: 99%

mentioning

confidence: 92%

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Isometric tongue endurance and incomplete laryngeal vestibule closure in Parkinson's disease

da Costa,

Casseb,

de Lima

et al. 2023

J of Oral Rehabilitation

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Concurrent Validity of the IOPI and Tongueometer Orofacial Strength Measurement Devices

2023

Self Cite

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Objective(s)This study examined the concurrent validity of two orofacial strength manometers: (1) the Iowa Oral Performance Instrument (IOPI) – the current, gold standard orofacial manometer; and (2) the Tongueometer – a newly‐available, lower cost, orofacial manometer.MethodsThis study compared IOPI and Tongueometer pressure readings across three experimental conditions. Experiment 1 compared full setup (manometer + tongue bulb) pressure readings between the IOPI and Tongueometer. Experiment 2 compared IOPI tongue bulb and Tongueometer tongue bulb pressure readings, while controlling for manometer. Experiment 3 compared IOPI manometer and Tongueometer manometer pressure readings, while controlling for tongue bulb. Pressures were applied manually within a laboratory setting. Lin's concordance correlation (ρc) was used to calculate level of agreement, with ρc interpreted as ‘poor’ if <0.90, ‘moderate’ if 0.90 to <0.95, ‘substantial’ if 0.95 to <0.99, and ‘excellent’ if ≥0.99.Results539 trials were analyzed. There was a median absolute difference of 2.4 kPa in pressure readings between the IOPI and Tongueometer full setups (manometer + tongue bulb). Correlations revealed substantial agreement between IOPI and Tongueometer full setups (experiment 1: n = 292; ρc = 0.986), tongue bulbs (experiment 2: n = 146; ρc = 0.987–0.992), and manometers (experiment 3: n = 101; ρc = 0.970).ConclusionsDifferences in pressures were consistently observed between the Tongueometer and IOPI. Despite these differences, substantial agreement was present. These data suggest the Tongueometer may be a valid, lower cost alternative to the IOPI for objectively assessing orofacial strength in clinical practice.Level of EvidenceLevel 2 Laryngoscope, 2023

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Minimal Detectable Change of Cough and Lingual Strength Outcomes in Neurodegenerative Disease

Borders,

Troche

2024

The Laryngoscope

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ObjectiveMinimal detectable change (MDC) represents the smallest amount of change required for an outcome to be considered real and not merely due to measurement error or task variability. This study aimed to examine MDC for cough and lingual strength outcomes among individuals with neurodegenerative disease.MethodsIn a single session, individuals diagnosed with Parkinson's disease (PD), progressive supranuclear palsy (PSP), and cerebellar ataxia completed repeated measurements of voluntary sequential cough via spirometry (n = 143) and lingual isometric and swallowing pressure with the Iowa Oral Performance Instrument (n = 231). The MDC at the 95% confidence level was calculated with the following formula: MDC = 1.96 × √2 × SEM.ResultsMDC for cough strength was 0.52 L/s (PD), 0.57 L/s (PSP), and 0.20 L/s (ataxia). On trials with the same number of coughs, MDC for cough strength was 0.18 L/s in PD and 0.24 L/s in ataxia. MDC for lingual isometric pressure was 5.44 kPa (PD), 2.35 kPa (PSP), and 3.41 kPa (ataxia), whereas swallowing pressure was 5.60 kPa (PD), 2.97 kPa (PSP), and 7.34 kPa (ataxia).ConclusionsThese findings elucidate MDC for cough and lingual strength outcomes and expand our understanding of change that can be considered “real” and not merely due to task variability. MDC facilitates valid interpretations of changes following treatment, as well as power analyses to determine the smallest effect size of interest before data collection. To illustrate the application of MDC, we situate these findings in the context of hypothetical case studies and research studies.Level of Evidence3 Laryngoscope, 2024

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The Relationship Between Lingual Strength and Functional Swallowing Outcomes in Parkinson’s Disease

Cited by 11 publications

References 55 publications

Isometric tongue endurance and incomplete laryngeal vestibule closure in Parkinson's disease

Isometric tongue endurance and incomplete laryngeal vestibule closure in Parkinson's disease

Concurrent Validity of the IOPI and Tongueometer Orofacial Strength Measurement Devices

Minimal Detectable Change of Cough and Lingual Strength Outcomes in Neurodegenerative Disease

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