A Systematic Review and Meta-analysis of Iowa Oral Performance Instrument Measures in Persons with Parkinson’s Disease Compared to Healthy Adults

Pitts, Laura L.; Cox, Angie; Morales, Sarah; Tiffany, Hannah

doi:10.1007/s00455-021-10254-y

Cited by 14 publications

(10 citation statements)

References 30 publications

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“…Consensus statements on dysphagia treatment in patients with PD are reported in Box 1. Several swallowing abnormalities are reported in patients with PD [27][28][29]. Pharyngeal impairment leads to reduced swallowing safety, i.e., penetration/aspiration, which is associated with an increased risk of aspiration pneumonia [30].…”

Section: Treatment Of Dysphagiamentioning

confidence: 99%

Consensus on the treatment of dysphagia in Parkinson's disease

Schindler

Pizzorni

Cereda

et al. 2021

Journal of the Neurological Sciences

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Background: Dysphagia is common in Parkinson's disease (PD). The effects of antiparkinsonian drugs on dysphagia are controversial. Several treatments for dysphagia are available but there is no consensus on their efficacy in PD. Objective: To conduct a systematic review of the literature and to define consensus statements on the treatment of dysphagia in PD and related nutritional management. Methods: A multinational group of experts in the field of neurogenic dysphagia and/or Parkinson's disease conducted a systematic evaluation of the literature and reported the results according to PRISMA guidelines. The evidence from the retrieved studies was analyzed and discussed in a consensus conference organized in Pavia, Italy, and the consensus statements were drafted. The final version of statements was subsequently achieved by email consensus. Results: The literature review retrieved 64 papers on treatment and nutrition of patients with PD and dysphagia, mainly of Class IV quality. Based on the literature and expert opinion in cases where the evidence was limited or lacking, 26 statements were developed. Conclusions: The statements developed by the Consensus panel provide a guidance for a multi-disciplinary treatment of dysphagia in patients with PD, involving neurologists, otorhinolaryngologists, gastroenterologists, phoniatricians, speech-language pathologists, dieticians, and clinical nutritionists.

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Section: Treatment Of Dysphagiamentioning

confidence: 99%

Consensus on the treatment of dysphagia in Parkinson's disease

Schindler

Pizzorni

Cereda

et al. 2021

Journal of the Neurological Sciences

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“…Considering that swallowing uses a submaximal force, 22 we observed that even endurance tasks that use 50% of the maximum pressure had already shown greater impairment in PD patients than in healthy controls. A recent meta‐analysis reported a reduction in endurance tasks in one‐fourth of PD patients 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 .…”

Section: Discussionmentioning

confidence: 97%

“…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%

“…3 Changes in the movement of these swallowing components can impact the proper propulsion of the bolus into the pharynx, leading to aspiration. 4 PD patients have reduced anterior tongue strength and endurance 5 and delayed laryngeal vestibule closure (LVC), 6,7 alterations associated with impaired airway protection in PD and which increase the risk for laryngotracheal aspiration. 6,8 The tongue plays an important role in the oral and pharyngeal phases of swallowing, and adequate strength is necessary for safe swallowing.…”

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confidence: 99%

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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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“…This evaluation instrument consisted of a blue plastic bulb 3.5 cm in length, filled with air, and connected by a pressure transducer using an 11.5 cm plastic tube. The pressure values were measured in kilopascals (kPa) [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Stroke: An electromyographic approach to the masseter and temporal muscles, orofacial soft tissue pressure, and occlusal force

Lopes

Palinkas²,

Silva³

et al. 2023

PLoS ONE

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Stroke is a cerebrovascular disease that triggers changes in the central and peripheral nervous systems, and can compromise human body function. This cross-sectional observational study aimed to analyze the electromyographic (EMG) activity of the masseter and temporal muscles, orofacial soft tissue pressure, and strength of occlusal contacts in patients who had suffered a stroke. Twenty-four patients were divided into two groups: stroke (n = 12) and control (n = 12). The EMG of the masseter and temporal muscles was evaluated during mandibular rest, protrusion, right laterality, left laterality, and maximal voluntary contraction. The Iowa Oral Pressure Instrument (IOPI) was used to measure pressure from the tongue, lips, and buccinator muscles. A computerized system for occlusal analysis (T-Scan III) was used to measure the occlusal contact points of the right and left hemiarches (upper and lower) and the upper and lower first molars. Data were subjected to Student’s t-test (p < 0.05). The stroke group had lower normalized electromyographic activity, with a significant difference in the left temporal muscle during rest (p = 0.03) when compared to the control group. There was a significant difference between the groups in tongue pressure (p = 0.004) with a lower mean value in the stroke group. There was a significant difference between the groups in the evaluation of the occlusal contact points of the first permanent molars, with a lower mean percentage in the stroke group. The results indicate that stroke negatively affects functional performance of the stomatognathic system.

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A Systematic Review and Meta-analysis of Iowa Oral Performance Instrument Measures in Persons with Parkinson’s Disease Compared to Healthy Adults

Cited by 14 publications

References 30 publications

Consensus on the treatment of dysphagia in Parkinson's disease

Consensus on the treatment of dysphagia in Parkinson's disease

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

Stroke: An electromyographic approach to the masseter and temporal muscles, orofacial soft tissue pressure, and occlusal force

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