The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review

Smaoui, Sana; Langridge, Amy; Steele, Catriona M.

doi:10.1007/s00455-019-10066-1

Cited by 59 publications

(33 citation statements)

References 46 publications

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“…The pre-and post-training comparisons of the exercise group showed a significant improvement of 4.1 kPa in MTP (an 11.53% increase) and 4.53 s in ETP (a 99.86% increase). Previous studies have already shown that TSE with this device increases MTP [7,8]. Previous studies in healthy older adults using a tongue strength training device have shown improvements in MTP from 18 to 72% [11-13, 25, 30].…”

Section: %-85% N=3mentioning

confidence: 83%

“…This study showed that MTP and ETP significantly increased in healthy older adults after the 8 weeks of TSsE using the tongue-strengthening self-exercise tool at home. Previous studies have shown that TSE increased the MTP in stroke patients, patients with acquired brain injury, and healthy participants [7,8]. In particular, many studies have examined TSE using devices and substantial evidence of its efficacy has been accumulated.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that tongue-strengthening exercises (TSE) increase tongue pressure in stroke patients, patients with acquired brain injury, and healthy participants using a tongue-strengthening measuring device [7,8]. Tongue pressure was the one indicator used to evaluate motor function of the tongue, as the force of the tongue press against the palate.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Tongue-Strengthening Self-Exercises in Healthy Older Adults: A Non-Randomized Controlled Trial

et al. 2020

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Tongue-strengthening exercises (TSE) using a device have been proposed as an intervention for improving tongue strength and endurance. However, devices for TSE have been expensive and difficult to manipulate and are not commonly used in home or clinical settings. This study therefore aimed to investigate whether tongue-strengthening self-exercises (TSsE) using a tongue-strengthening self-exercise tool at home can improve tongue strength in healthy older adults. This study included 27 participants (exercise group, η = 16, 7 men, 9 women, median age 84.5 years; control group, n = 11, 2 men, 9 women, median age 79.0 years). Exercises in the exercise group consisted of pushing the anterior tongue against the hard palate 30 times, 3 times a day, 5 days a week, for 8 weeks using a tongue-strengthening self-exercise tool. This tool is available in five levels of hardness. The most suitable hardness of the tool for each participant was calculated based on 60% of maximum tongue pressure (MTP) during the first 2 weeks of the training period and 80% of MTP for the remainder of the training period, as assessed using a tongue pressure-measuring device. The exercise group showed a significant improvement of 4.1 kPa in MTP (an 11.53% increase) and 4.53 s in endurance of tongue pressure (ETP) (a 99.86% increase). Furthermore, adherence in the exercise group was 99.2%. In conclusion, performing TSsE for 8 weeks was effective for increasing MTP and ETP in healthy older adults. This indicates that TSsE may be useful in older individuals at home to prevent age-related tongue muscle weakness.

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Section: %-85% N=3mentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Tongue-Strengthening Self-Exercises in Healthy Older Adults: A Non-Randomized Controlled Trial

et al. 2020

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“…A preliminary study on the efficacy of lingual resistance training in two patients with ALS showed no improvement in swallowing safety and patient‐reported outcome, but swallowing efficacy was not included in the outcomes of the study 43 . A recent systematic review on different populations highlighted that the effects of lingual resistance training on both swallowing safety and swallowing efficacy are still controversial 44 . Thus, the feasibility and efficacy of lingual resistance training in ALS need to be further tested in future studies.…”

Section: Discussionmentioning

confidence: 99%

Association between maximum tongue pressure and swallowing safety and efficacy in amyotrophic lateral sclerosis

Pizzorni

Ginocchio

Bianchi

et al. 2020

Neurogastroenterology Motil

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Background Oropharyngeal dysphagia (OD) is common in amyotrophic lateral sclerosis (ALS), leading to a reduction of swallowing safety and efficacy. The tongue has an important role in swallowing function for oral processing and bolus propulsion through the pharynx. The study aims to analyze the association between instrumental findings of OD and tongue pressure. Methods Patients with ALS referred for fiberoptic endoscopic evaluation of swallowing (FEES) were recruited. FEES was conducted to test swallowing function with liquid (5, 10, and 20 ml), semisolid (5, 10, and 20 ml), and solid. FEES recordings were assessed for swallowing safety, using the penetration‐aspiration scale (PAS), and for swallowing efficacy, using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). PAS scores >2 were suggestive of penetration, PAS scores >5 of aspiration, and YPRSRS scores >2 of residue. Maximum tongue pressure (MTP) and tongue endurance were measured using the Iowa Oral Performance Instrument. Tongue pressure measurements were compared between patients with and without penetration, aspiration, or residue. Key results Fifty‐five patients with ALS were included. Mean MTP was 29.7 kPa, and median tongue endurance was 10 seconds. Patients with residue in the pyriform sinus had a significantly lower MTP than patients without residue in the pyriform sinus with semisolids 10 ml (P = .011) and 20 ml (P = .032). Patients with a tongue endurance <10 seconds exhibited higher frequency of penetration with liquids 5 ml (P = .046), liquids 10 ml (P = .015), and solids (P = .22). Conclusion and inferences In patients with ALS, MTP is significantly associated with an impairment of swallowing efficacy and tongue endurance was significantly associated with an impairment of swallowing safety.

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“…Our results revealed that there was no signi cant difference between the sarcopenia group and their healthy counterparts regarding tongue pressure. Studies have reported that tongue strengthening could enhance the maximum peak lingual pressures in both healthy adults and dysphagic patients; however, whether the gain in lingual pressures generalizes to the functional improvement in swallowing is still undetermined (36,37). A previous study done in Japan demonstrated that reduced tongue pressure is correlated with older individuals with sarcopenia (9); however, 42.3% of their subjects suffered from dysphagia, and all their subjects were hospitalized at the time of enrollment.…”

Section: Discussionmentioning

confidence: 99%

Decreased swallowing function in the sarcopenic elderly without clinical dysphagia: a cross-sectional study

Chen

CHEN

WANG

et al. 2020

Preprint

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Background: Sarcopenia and dysphagia are prevalent health issues as the elderly population continues to grow. However, whether sarcopenia, defined by either reduced handgrip strength or gait speed, would lead to pathological effects on swallowing function is still a matter of debate. Studies focusing on subclinical changes in the swallowing function in the sarcopenic elderly are lacking. This study evaluates the swallowing function in the sarcopenic elderly without dysphagia.Methods: A cross-sectional study was conducted including subjects recruited from the community. Ninety-four individuals aged 65 and older without dysphagia were divided into two groups: sarcopenia and nonsarcopenia. The swallowing assessment included tongue pressure measurement, hyoid displacement (HD), hyoid velocity (HV) measurement with submental ultrasonography, 100-ml water-swallowing test, and the 10-item Eating Assessment Tool (EAT-10).Results: The average tongue pressure was 47.0 ± 13.7 and 48.6 ± 11.5 kPa in the sarcopenia and nonsarcopenia groups, respectively (p = 0.55), whereas the average HD during swallowing was 15.3 ± 4.4 and 13.0 ± 4.2 mm in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). The median of HV during swallowing was 19.5 (6.41–45.86) and 15.9 (3.7–39.7) mm/s in the sarcopenia and nonsarcopenia group (p < 0.05). The median of time needed for consuming 100 ml water was 12.43 (3.56–49.34) and 5.66 (2.07–19.13) seconds in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). The median of the EAT-10 score was 0 (0–2) and 0 (0–1) in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05).Conclusions: In elderly individuals, swallowing function was significantly impaired with sarcopenia before clinical symptoms become clear. However, tongue muscles exhibited resistance to sarcopenia. We observed compensative strategies in patients with sarcopenia, such as reduced swallowing speed and increased hyoid bone movement.

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The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review

Cited by 59 publications

References 46 publications

Effects of Tongue-Strengthening Self-Exercises in Healthy Older Adults: A Non-Randomized Controlled Trial

Effects of Tongue-Strengthening Self-Exercises in Healthy Older Adults: A Non-Randomized Controlled Trial

Association between maximum tongue pressure and swallowing safety and efficacy in amyotrophic lateral sclerosis

Decreased swallowing function in the sarcopenic elderly without clinical dysphagia: a cross-sectional study

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