Fatores associados à pressão de língua em pacientes pós-acidente vascular cerebral

Abstract

Introduction:The clinical practice of speech pathology in hospitals shows that there is a high prevalence of dysphagia in post-stroke patients. Purpose: To verify whether the time of occurrence, type of stroke, affected hemisphere, severity of neurological deficit, presence or absence of dysphagia, and degree of dysphagia interfere with tongue pressure in post-stroke patients. Methods: This study was conducted in 31 stroke patients. Three evaluations were performed, one of tongue mobility, another of dysphagia, and another of tongue pressure using the Iowa Oral Performance Instrument. Three measurements were performed of anterior and three of posterior tongue pressure. Data were analyzed using appropriate statistics, considering a significance level of 5%. Results: Only the presence of dysphagia was associated with tongue pressure. Post-stroke patients with dysphagia had lower anterior and posterior tongue pressure (mean and maximum) than those without dysphagia. The time of occurrence, type, and affected hemisphere of the stroke and severity of the neurological deficit were not associated with tongue pressure. Regarding the degree of dysphagia, of the 15 participants who had swallowing difficulties, 14 were classified with mild and one with moderate dysphagia. Conclusion: Dysphagia was the most important factor in the decrease of tongue pressure in post-stroke patients.

Tongue strength as a clinical feature of oral health in neurological patients: A Systematic Review.

“…46,48,50, 53 The option to standardize the assessment procedures with the IOPI allows an adequate comparative analysis of findings showing maximum isometric pressure as the gold standard measure and tongue position in the anterior palate as the optimal position associated with swallowing requirements, even in studies with samples from less than 20 subjects or case studies. 46,48, 52 The use of classical protocols 54 allows researchers in the analyzed studies to provide information that can be reliably and homologously interpreted using measurements such as maximum isometric pressure, resistance and accuracy of lingual movement. This is possible despite the already observed heterogeneity of the studied neurological groups and may help future designs of therapies that include tongue strength training.…”

Aspiration Risk Screening With Tongue Pressure Measurement in Acute Stroke: A Diagnostic Accuracy Study Using STARD Guidelines

“…Nakamori et al (2016) investigated acute stroke patients and found that patients with pneumonia had significantly lower tongue strength than those without and concluded that it is a sensitive indicator for predicting pneumonia occurrence. Oliveira et al (2017) found that stroke patients with dysphagia had lower tongue strength than those without. Beyond that, Lee and Choi (2020) claim that tongue strength has similar predictive abilities to bedside tests screening aspiration and penetration in stroke patients and even call it a new screening test to reduce the risk of pneumonia.…”