Effect of tongue strength training using the Iowa Oral Performance Instrument in stroke patients with dysphagia

Abstract

[Purpose] The aim of this study was to evaluate the effectiveness of a structured program of resistance training for the tongue in order to improve swallowing function in stroke patients with dysphagia. [Subjects and Methods] Twenty-seven stroke patients with dysphagia were randomly divided into two groups. The experimental group participated in a resistance-training program involving a 1-repetition maximum, with an intensity of 80%, along with 50 repetitions per day each for the anterior and posterior regions of the tongue. Both groups received conventional therapy for dysphagia for 30 min per day, 5 times per week, for 6 weeks. [Results] The experimental group showed statistically significant improvements in both, the anterior and posterior regions of the tongue. In contrast, the control group showed significant improvements only in the anterior region of the tongue. In the videofluoroscopic dysphagia scale evaluation, improvement was noted at both, the oral and pharyngeal stages in the experimental group, whereas significant improvements were only noted in the oral stage and total score in the control group. [Conclusion] Our study confirmed that tongue resistance training is an effective intervention for stroke patients with dysphagia, offering improved tongue muscle strength and overall improvement in swallowing.

Effect of orofacial myofunctional exercise on the improvement of dysphagia patients’ orofacial muscle strength and diadochokinetic rate

“…According to the results of the investigation on the effect of orofacial myofunctional exercise on the improvement of orofacial muscle strength and alternating motion rate in dysphagia patients, tongue elevation, tongue protrusion, cheek compression, lip compression, and alternating motion rate were significantly improved. This corresponds with the results of preceding studies that indicated that orofacial muscle exercise improved swallowing functions of stroke patients by reinforcing orofacial muscle strength and formation of oral pressure7, 8 ) .…”

“…For orofacial muscle strength, tongue elevation, tongue protrusion, cheek compression, and lip compression7 ) were measured by using the Iowa Oral Performance Instrument (IOPI)10 ) , which is composed of a tongue bulb and a connecting tube. The measurement methods were as follows: For tongue elevation, the bulb was placed in the hard palate of the subject, who was instructed to compress the bulb with tongue as strongly as possible for 2–3 seconds.…”

“…This program was selected based on information from the Team of Seirei Mikatahara General Hospital14 ) and Park et al7 ) .…”

“…Although many studies have been conducted on the effect of orofacial myofunctional exercise in patients with dysphagia from brain damage, most of them have only focused on improving the strength of individual muscles, such as the tongue and cheek muscles7, 8 ) , and few studies have investigated the holistic improvement of orofacial muscle strength, speed, and functions. Measurement of the alternating motion rate can provide useful information on swallowing rehabilitation in the oral phase by elucidating the speed and regularity of movement of muscles related to the lips, tongue, and chin.…”

Effect of neuromuscular electrical stimulation on facial muscle strength and oral function in stroke patients with facial palsy

“…The Videofluoroscopy Dysphagia Scale (VDS) was used to quantify the functional recovery of swallowing. VDS is a functional evaluation scale that comprehensively reflects the overall swallowing function in stroke patients7, 8 ) . In this study, 7 subtests of oral stage function were analyzed such as lip closure, bolus formation, mastication, apraxia, tongue to palate contact, premature bolus loss, and oral transit time.…”