Relationship between Tongue Pressure and Dysphagia in Stroke Patients

Abstract

Background: Although poststroke dysphagia is an important issue for determining prognosis, the pathophysiology of oral-phase dysphagia has yet to be clarified due to a lack of adequate devices and protocols. The present study investigated the relationships between swallowing pressure production by the tongue and dysphagia in stroke patients using a newly developed method of tongue pressure measurement with a sensor sheet system. Methods: Subjects were 64 stroke patients, including 30 patients with dysphagia. A T-shaped sensor sheet with 5 measuring points was attached to the hard palate to record tongue pressure while swallowing 5 ml of water. The average maximal magnitude and incidence of abnormalities such as asynchronous and/or polyphasic patterns in tongue pressure waves in 5 locations were compared between patients with and without dysphagia. Results: The average maximal tongue pressure was significantly smaller in patients with dysphagia than in those without dysphagia. Asynchronous and polyphasic patterns showed a sensitivity of 63 and 87%, and a specificity of 91 and 71%, respectively, for identifying patients with dysphagia. Conclusion: Tongue pressure production during swallowing appears closely related to poststroke dysphagia. Tongue pressure measurement appears useful for evaluating the pathophysiology of oral-phase dysphagia in stroke patients.

Changes in oro-facial function and hand-grip strength during a 2-year observation period after stroke

“…These factors are symptoms of oral-phase dysphagia [2,3,54] and thus might predict quality of life or even mortality. Further research is needed to study in depth the role of oral health in stroke rehabilitation.…”

Biomechanics of human tongue movement during bolus compression and swallowing

“…Miniaturized pressure sensors allow a subject to freely move the tongue in the oral cavity. This device has been widely used for clinical assessment of lingual movements and their involvement in swallowing in patients with stroke-induced dysphagia (7) and postoperative head and neck cancers (unpublished observation), and in elderly adults (8).…”

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

“…Studies with post-stroke patients (6,18,19) also found that the mean and maximum tongue pressure was significantly lower in the dysphagia group. Thus, the decrease in tongue pressure observed in some cases of stroke was basically associated with the presence of dysphagia.…”

“…For these reasons, pressure analysis of the tongue is useful for assessing the pathophysiology of swallowing in dysphagic patients with stroke (19) . In addition, it is a resource that can be used at the bedside and can predict the occurrence of pneumonia if the pressure is below 21.6 kPa (6) .…”

“…In the present study, when analyzing mean and maximum anterior and posterior tongue pressure in post-stroke patients, it was possible to observe that there was also no difference between those who presented hemiplegia on the right or left side. There are no studies in the literature relating hemiplegia and tongue pressure, but some authors (11,19,25) researched the pressure by comparing data from each half portion of the tongue, and observed lower values on the paralyzed side. This fact was not researched in the present study.…”