51
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Relationship between Rate of Force Development of Tongue Pressure and Physical Performance. J Clin Med 2022; 11:jcm11092347. [PMID: 35566473 PMCID: PMC9101244 DOI: 10.3390/jcm11092347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023] Open
Abstract
In the assessment of skeletal muscle strength, rate of force development (RFD) is clinically identified as a functional index that reflects the effects of aging, but there are few reports on RFD of the tongue. The purpose of this study was to examine the relationship between RFD of tongue pressure (RFD-TP) and oral and whole-body physical performance in older adults, and to clarify its characteristics. We enrolled adults aged ≥65 years with pathological occlusal contact in premolar and molar regions of teeth in the Tamba-Sasayama area, Japan, from 2017 to 2018. Maximum tongue pressure (MTP) and the speed to reach the maximum tongue pressure (RFD-TP) were evaluated as measures of tongue function. Oral functions related to objective measures of tongue function, such as repetitive saliva swallowing test, oral diadochokinesis, and physical status or performance, such as mini mental state examination, body mass index, skeletal mass index, knee extension force, one-leg standing time, grip strength, walking speed, timed up-and-go test, and five-time chair stand speed was evaluated. No significant correlation was found between MTP and age, but RFD-TP had a significant negative correlation with age. Neither RFD-TP nor MTP showed a significant correlation with oral function. RFD-TP was associated with physical performance, such as knee extension force and one-leg standing time. RFD-TP is more sensitive to aging than MTP. In addition, RFD-TP is related to physical performance and may be useful for the early detection of frailty.
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52
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Effect of decreased tongue pressure on dysphagia and survival rate in elderly people requiring long-term care. J Dent Sci 2022; 17:856-862. [PMID: 35756815 PMCID: PMC9201529 DOI: 10.1016/j.jds.2021.09.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/21/2021] [Indexed: 12/11/2022] Open
Abstract
Background/purpose Tongue pressure plays an important role in swallowing function. The purpose of this study is to investigate whether decreased tongue pressure is associated with dysphagia and the development of pneumonia in the elderly requiring long-term care. Materials and methods Tongue pressure measurement and swallowing videoendoscopic (VE) examination were performed in 60 hospitalized elderly people (33 males and 27 females, with an average age of 84.3 years) to investigate the relationship with the clinical course. Factors related with dysphagia was analyzed by Fisher's exact test and one-way ANOVA, followed by multivariate logistic regression. The relationship between each variable and survival were analyzed by cox regression. Results Twenty-one patients had dysphagia by VE examination. Multivariate analysis showed that smaller BMI and reduced tongue pressure were significantly correlated with dysphagia. Smaller number of remaining teeth and dysphagia were significantly related to pneumonia-related death. No patients with tongue pressure of larger than 20 kpa died by pneumonia within one year, while in those with tongue pressure of smaller than 20 kpa, one-year cumulative survival rate by pneumonia was 44.3%. Conclusion Decreased tongue pressure was significantly associated with dysphagia and may increase the risk of pneumonia-related death in the elderly requiring long-term care.
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53
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Kato K, Sato K, Chiba K, Koseki C, Sato T. Characteristics of Three Oral Functions in Young and Older Females—A Pilot Study. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2055251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kanna Kato
- Area of Occupational Therapy, Graduate School of Health Science, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Kanako Sato
- Department of Rehabilitation, General Incorporated Association Hamadori Home-Visit Rehabilitation Promotion Foundation, Haramachi, Japan
| | - Kyoka Chiba
- Department of Rehabilitation, Osaki Citizen Hospital, Osaki, Japan
| | - Chika Koseki
- Department of Rehabilitation, Social Welfare Corporation Yamagata City Social Welfare Council, Yamagata, Japan
| | - Toshiaki Sato
- Area of Occupational Therapy, Graduate School of Health Science, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
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54
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Kohyama K. Application of a balloon-type pressure sensor in texture evaluation of tongue-crushable foods. J Texture Stud 2022; 53:357-365. [PMID: 35322422 DOI: 10.1111/jtxs.12677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Abstract
A relationship has recent been suggested to exist between tongue pressure measured using balloon-type sensors and the tongue-crushable food range of individuals. This study was conducted to investigate the applicability of a balloon-type pressure sensor for texture evaluation of tongue-crushable soft foods. Six gellan gum gels were used as a soft food model. The fracture force and strain of gels were controlled at two and three levels by changing the gum concentration and acyl-group content, respectively. The pressure sensor was inserted between a food sample and texture analyzer probe, and pressure values during compression of gels was measured. During the compression test, both the food and tongue-pressure sensor were deformed, eventually leading to fracture of food gels. Using the tongue-pressure sensor, the food gels fractured at lower force because of the shape of the sensor but showed longer displacement as the sensor deformed compared to without the sensor. Gels with low fracture force in the conventional test without the sensor exhibited lower fracture force, work, gradient, and true stress than those with high fracture force in the sensor test. Displacement, clearance or distance from the bottom plate, and true stress at fracture were appropriate parameters for expressing the fracture characteristics. Both the true fracture stress and fracture pressure in the sensor test decreased with the fracture strain of gels in a conventional test. These results suggest that by using a larger balloon and faster sampling, the sensor can be used to determine the fracture behavior of tongue-crushable foods.
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Affiliation(s)
- Kaoru Kohyama
- Institute of Food Research, National Agriculture and Food Research Organization (NFRI), Ibaraki, Japan
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55
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Yamawaki K, Mori T, Itaki S, Haruta A, Takeda C, Hiraoka A, Maruyama M, Yoshikawa M, Yoshida M, Tsuga K. Relationship between Food Crushing and Oral Function in Older Adults Requiring Nursing Home Care: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063419. [PMID: 35329105 PMCID: PMC8949916 DOI: 10.3390/ijerph19063419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 01/25/2023]
Abstract
We investigated how jelly is crushed and examined the relationship between tongue pressure and tongue food crushing ability among older adults requiring nursing home care. Seventy-two participants were instructed to freely crush the test foods soft jelly (SJ) and hard jelly (HJ). We visually evaluated the crushability of the test food and identified the intraoral tissues (active sites) used to crush the test food. The active sites were consistent for all participants for both SJ and HJ, and they included the maxillary and mandibular teeth in 41 participants, teeth and residual ridges in 15 participants, maxillary and mandibular residual ridges in 10 participants, and tongue and palate in six participants. Two participants failed to crush the SJ; the active sites in both participants were the tongue and palate. No participant using the tongue and palate as active sites could crush the HJ. Furthermore, 64 participants could crush the SJ and 23 could crush the HJ using the tongue and palate. The cutoff value of the tongue pressure for crushability of the HJ was 22.0 kPa. Assessing tongue pressure and intraoral active sites involved in food crushing could help determine an appropriate diet for older adults requiring nursing home care.
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Affiliation(s)
- Kanako Yamawaki
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
- Correspondence:
| | - Takahiro Mori
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Sakiko Itaki
- PIA Nakamura Hospital, Tsuboi, 3-818-1, Saeki-ku, Hiroshima 731-5142, Japan;
| | - Azusa Haruta
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Chiho Takeda
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Aya Hiraoka
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Mariko Maruyama
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Mineka Yoshikawa
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Mitsuyoshi Yoshida
- Departments of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Dengakugakubo, 1-98, Kutsukake-cho, Toyoake 470-1192, Japan;
| | - Kazuhiro Tsuga
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
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56
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Tamura T, Tanaka Y, Watanabe Y, Sato K. Relationships between maximum tongue pressure and second formant transition in speakers with different types of dysarthria. PLoS One 2022; 17:e0264995. [PMID: 35259200 PMCID: PMC8903301 DOI: 10.1371/journal.pone.0264995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/21/2022] [Indexed: 11/18/2022] Open
Abstract
The effects of muscle weakness on speech are currently not fully known. We investigated the relationships between maximum tongue pressure and second formant transition in adults with different types of dysarthria. It focused on the slope in the second formant transition because it reflects the tongue velocity during articulation. Sixty-three Japanese speakers with dysarthria (median age, 68 years; interquartile range, 58–77 years; 44 men and 19 women) admitted to acute and convalescent hospitals were included. Thirty neurologically normal speakers aged 19–85 years (median age, 22 years; interquartile range, 21.0–23.8 years; 14 men and 16 women) were also included. The relationship between the maximum tongue pressure and speech function was evaluated using correlation analysis in the dysarthria group. Speech intelligibility, the oral diadochokinesis rate, and the second formant slope were based on the impaired speech index. More than half of the speakers had mild to moderate dysarthria. Speakers with dysarthria showed significantly lower maximum tongue pressure, speech intelligibility, oral diadochokinesis rate, and second formant slope than neurologically normal speakers. Only the second formant slope was significantly correlated with the maximum tongue pressure (r = 0.368, p = 0.003). The relationship between the second formant slope and maximum tongue pressure showed a similar correlation in the analysis of subgroups divided by sex. The oral diadochokinesis rate, which is related to the speed of articulation, is affected by voice on/off, mandibular opening/closing, and range of motion. In contrast, the second formant slope was less affected by these factors. These results suggest that the maximum isometric tongue strength is associated with tongue movement speed during articulation.
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Affiliation(s)
- Toshiaki Tamura
- Department of Speech, Language, and Hearing Sciences, Niigata University of Health and Welfare, Niigata city, Niigata, Japan
- Major in Health and Welfare, Niigata University of Health and Welfare Graduate School, Niigata city, Niigata, Japan
- * E-mail:
| | - Yasuhiro Tanaka
- Faculty of Psychological and Physical Science, Aichi Gakuin University, Nisshin city, Aichi, Japan
| | - Yoshihiro Watanabe
- Department of Rehabilitation, Uonuma Kikan Hospital, Uonuma city, Niigata, Japan
| | - Katsuro Sato
- Department of Speech, Language, and Hearing Sciences, Niigata University of Health and Welfare, Niigata city, Niigata, Japan
- Major in Health and Welfare, Niigata University of Health and Welfare Graduate School, Niigata city, Niigata, Japan
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57
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Murakami K, Hori K, Uehara F, Salazar SE, Ishihara S, Nakauma M, Funami T, Ono T. Effect of maximal voluntary tongue pressure and mechanical properties of gels on tongue pressure production when squeezing gels. Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2021.107323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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58
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Casey V, Perry A, Conway R. Intraoral Swallow Pressure Profiles: General Features and Aids to Categorization. J Med Biol Eng 2022. [DOI: 10.1007/s40846-022-00682-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Purpose
The primary goal of this study was to establish a normative data set representing intraoral time series swallow pressure profiles for healthy adults using a novel wearable intraoral pressure sensing system, OroPress, developed to help with dysphagia (swallow disorder) clinical screening.
Methods
Swallow intraoral pressure-time profiles for 35 healthy adults (17 male, 18 female) swallowing water ($$3 \times 5\, {\text{cm}^3}$$
3
×
5
cm
3
; $$3 \times 10\, {\text{cm}^3}$$
3
×
10
cm
3
) and custard ($$3 \times 5\, {\text{cm}^3}$$
3
×
5
cm
3
) boluses ($$N=9 \times 35 = 315$$
N
=
9
×
35
=
315
) were recorded using OroPress.
Results
General swallow profile traits are identified to characterise an effective, efficient swallow. A profile-specific swallow envelope function is devised which in combination with profile metrics, provides a simple means of categorizing swallows as effective or impaired.
Conclusion
The swallow profile data trace with superimposed and colour coded peaks, envelope function and related swallow metrics provides a simple human readable graphic to aid the real-time instrumented identification of subjects warranting more in-depth clinical assessment. It may also prove useful in the selection of training set profiles for machine learning and other analysis tools which could improve the discriminatory capabilities of intraoral pressure measurement in dysphagia diagnostics.
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59
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Murakami T, Kamide N, Ando M, Hata W, Sakamoto M. Association between tongue pressure and skeletal muscle mass and muscle function in community-dwelling older people without sarcopenia. Eur Geriatr Med 2022; 13:649-653. [PMID: 35122216 DOI: 10.1007/s41999-022-00608-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/30/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to cross-sectionally investigate relationships between maximum tongue pressure (MTP) and whole-body muscle mass and strength for non-sarcopenic older adults. METHODS Study participants comprised 341 adults (105 men, 236 women) ≥ 65 years old (mean age, 72.7 ± 4.8 years). Participants were measured for MTP, grip strength, five-time chair stand test (FCST), gait speed, and skeletal muscle mass index (SMI). Multiple regression analysis adjusted for confounding factors was used to analyze relationships between MTP and each other variable. RESULTS MTP was significantly related to SMI (r = 0.15, p < 0.001), grip strength (r = 0.12, p < 0.05), FCST (r = - 0.14, p < 0.05), and age (r = 0.25, p < 0.001). Multiple regression analysis showed a positive association between MTP and SMI, even after accounting for the influence of age, sex, physical performance, and other potential confounding factors. CONCLUSION Whole-body muscle mass was suggested to be decreasing with tongue pressure decline before sarcopenia diagnosis in community-dwelling older adults.
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Affiliation(s)
- Takeshi Murakami
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.
- Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan.
| | - Naoto Kamide
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
| | - Masataka Ando
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Wakana Hata
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
| | - Miki Sakamoto
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
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60
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Impact of Maximum Tongue Pressure in Patients with Jaw Deformities Who Underwent Orthognathic Surgery. Diagnostics (Basel) 2022; 12:diagnostics12020404. [PMID: 35204495 PMCID: PMC8871112 DOI: 10.3390/diagnostics12020404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 02/01/2023] Open
Abstract
Malocclusion and morphological abnormalities of the jawbone often affect the stomatognathic function and long-term postoperative stability in patients with jaw deformities. There are few reports on the effect of maximum tongue pressure (MTP) in these patients. We investigated the relationship between the MTP and jawbone morphology and the effect of the MTP on surgery in 42 patients with jaw deformity who underwent surgical orthodontic treatment at Hiroshima University Hospital. The MTP was measured using a tongue pressure measurement device; the average value was considered as the MTP. Based on the MTP measured before surgery, patients were classified into the high- or the low-MTP group. The clinical findings and results of the cephalometric analysis were compared. Posterior movement of the mandible in the high-MTP group was significantly lower than that in the low-MTP group. The ANB angle, overjet, and overbite in the high-MTP group were significantly smaller than those in the low-MTP group. On the other hand, there was no difference between the two groups in the measured values, indicating a labial inclination of the anterior teeth (U1 to SN, U1 to FH, IMPA, and FMIA). MTP has been suggested to affect mandibular prognathism in patients with jaw deformities.
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Yanagida R, Hara K, Iida T, Tohara T, Tamada Y, Minakuchi S, Namiki C, Okumura T, Tohara H. Jaw-Opening Force as a Useful Index for Dysphagia: A Cross-Sectional and Multi-Institutional Study. Gerontology 2022; 68:1258-1265. [DOI: 10.1159/000521392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/08/2021] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Jaw-opening force (JOF) can be a potential screening tool for dysphagia. However, confounding variables such as comorbidities or physical and oral functions that are associated with the physiology of swallowing have not previously been examined. Adjusting for these variables could reveal the relationship between JOF and dysphagia and indicate whether JOF is an independent factor associated with dysphagia. We therefore aimed to assess the efficacy of using JOF for dysphagia screening in this multi-institutional study. <b><i>Methods:</i></b> Community-dwelling older adults over the age of 65 years (<i>N</i> = 403) who visited the university dental hospitals and participated in health surveys (mean age ± standard deviation, 77.1 ± 7.0 years; range, 65–96 years) between November 2018 and January 2020 were included in this study. The JOFs of all participants were measured. The measured JOF was compared with the presence of dysphagia, which was defined using the Functional Oral Intake Scale and the Eating Assessment Tool-10. <b><i>Results:</i></b> Multiple logistic regression analysis revealed that the presence of dysphagia was independently associated with JOF, calf circumference, and dependence after adjusting for age and sex. <b><i>Discussion/Conclusion:</i></b> Decreased JOF can be a risk factor for dysphagia in older adults.
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Sasaki Y, Otsugu M, Sasaki H, Fujikawa N, Okawa R, Kato T, Nakano K. Relationship between Dental Occlusion and Maximum Tongue Pressure in Preschool Children Aged 4-6 Years. CHILDREN (BASEL, SWITZERLAND) 2022; 9:141. [PMID: 35204862 PMCID: PMC8870039 DOI: 10.3390/children9020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
Tongue function is regarded as a primary factor in the etiology of malocclusion, but details of the relationship remain unknown. The purpose of the present study was to investigate maximum tongue pressure, in preschool children to examine its relationship with dental occlusion. A total of 477 healthy children (248 boys, 229 girls, aged 4-6 years) were recruited. Dental occlusion was assessed visually to record sagittal, vertical, and transverse malocclusion, and space discrepancies. Maximum tongue pressure was measured using a balloon-based tongue pressure measurement device. Additionally, 72 children (37 boys, 35 girls, aged 4-5 years) were recruited for a 1-year follow-up study. Approximately half of the children (53.5%) showed some type of malocclusion in the present study. Maximum tongue pressure was highest in the 6-year-old children. The results of a two-way ANCOVA show that the effect of age was significant (p < 0.001); however, the effects of sex and dental occlusion, or the interactions among these variables, did not reach significance. Additionally, maximum tongue pressure increased significantly in the 1-year follow-up study (p < 0.001), especially in the normal occlusion group. Maximum tongue pressure increases markedly with growth in the preschool years and can be associated with some types of malocclusion in preschool children.
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Affiliation(s)
- Yumi Sasaki
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan; (Y.S.); (H.S.); (R.O.); (K.N.)
| | - Masatoshi Otsugu
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan; (Y.S.); (H.S.); (R.O.); (K.N.)
| | - Hidekazu Sasaki
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan; (Y.S.); (H.S.); (R.O.); (K.N.)
- Hanahaku Sasaki Dental Clinic, Osaka 538-0052, Japan;
| | - Naho Fujikawa
- Hanahaku Sasaki Dental Clinic, Osaka 538-0052, Japan;
| | - Rena Okawa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan; (Y.S.); (H.S.); (R.O.); (K.N.)
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan;
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan; (Y.S.); (H.S.); (R.O.); (K.N.)
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63
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Comparison of Tongue Characteristics Classified According to Ultrasonographic Features Using a K-Means Clustering Algorithm. Diagnostics (Basel) 2022; 12:diagnostics12020264. [PMID: 35204355 PMCID: PMC8870935 DOI: 10.3390/diagnostics12020264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 11/17/2022] Open
Abstract
The precise correlations among tongue function and characteristics remain unknown, and no previous studies have attempted machine learning-based classification of tongue ultrasonography findings. This cross-sectional observational study aimed to investigate relationships among tongue characteristics and function by classifying ultrasound images of the tongue using a K-means clustering algorithm. During 2017–2018, 236 healthy older participants (mean age 70.8 ± 5.4 years) were enrolled. The optimal number of clusters determined by the elbow method was 3. After analysis of tongue thickness and echo intensity plots, tongues were classified into three groups. One-way ANOVA was used to compare tongue function, tongue pressure, and oral diadochokinesis for /ta/ and /ka/ in each group. There were significant differences in all tongue functions among the three groups. The worst function was observed in patients with the lowest values for tongue thickness and echo intensity (tongue pressure [P = 0.023], /ta/ [P = 0.007], and /ka/ [P = 0.038]). Our results indicate that ultrasonographic classification of tongue characteristics using K-means clustering may aid clinicians in selecting the appropriate treatment strategy. Indeed, ultrasonography is advantageous in that it provides real-time imaging that is non-invasive, which can improve patient follow-up both in the clinic and at home.
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64
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Chen HH, Lin PY, Lin CK, Lin PY, Chi LY. Effects of oral exercise on tongue pressure in Taiwanese older adults in community day care centers. J Dent Sci 2022; 17:338-344. [PMID: 35028056 PMCID: PMC8740383 DOI: 10.1016/j.jds.2021.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/27/2021] [Indexed: 01/29/2023] Open
Abstract
Background/purpose Oral exercise is a training method for swallowing dysfunction in older adults. The study investigated the effect of oral exercise on tongue pressure in older adults in Taiwanese community day care centers over a 3-month period. Materials and methods Participants over age 50 who were able to communicate and participating for the duration of the 12-week period were recruited from five community day care centers. A 15-min weekly group oral exercise activity was conducted. The tongue pressures were measured and multivariable linear regression models were used to assess the effect of oral exercise intervention on the participants’ tongue pressures. Results A total of 66 older adult participants, among whom the mean age was 78.06 ± 10.74 years. Tongue pressure continued improving during the intervention period, and the mean tongue pressure at the end of the study was 20.63 ± 10.45 kPa, which was significantly higher than the baseline measurement (16.92 ± 10.62 kPa, p < 0.001). Participants exhibited significant improvement in tongue pressure regardless of their age groups. Moreover, participants with one to seven pairs of functional tooth units (FTUs) exhibited significantly more improvement in tongue pressure (16.00 kPa, 95% CI = 2.58–29.43) than those without FTUs (p = 0.021). Conclusion Oral exercise over a 3-month period significantly improved tongue pressure among the study participants regardless of their gender or age group. Oral exercise should be integrated into comprehensive health promotion programs to assist in the improvement and maintenance of oral function among older adults.
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Affiliation(s)
- Hsiu-Hsien Chen
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Po-Yen Lin
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Kai Lin
- Department of Dentistry, National Defense Medical Center, Taipei, Taiwan
- Department of Dentistry, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Ping-Yi Lin
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Corresponding author. Department of Dentistry, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 220, Taiwan.
| | - Lin-Yang Chi
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Corresponding author. Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei 112, Taiwan.
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Ohta M, Imamura Y, Chebib N, Schulte-Eickhoff RM, Allain S, Genton L, Mojon P, Graf C, Ueda T, Müller F. Oral function and nutritional status in non-acute hospitalised elders. Gerodontology 2021; 39:74-82. [PMID: 34913521 PMCID: PMC9299802 DOI: 10.1111/ger.12612] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 12/26/2022]
Abstract
Introduction Malnutrition and risk of malnutrition continues to be a common finding in elders, yet its association with oral function in hospitalised patients remains unclear. Material and methods Patients aged 70 years or over who had been hospitalised for non‐acute rehabilitation were recruited. Nutritional risk was screened using the Mini‐Nutritional Assessment Short Form (MNA‐SF) and Nutritional Risk Screening (NRS) scores. Malnutrition was assessed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. All participants underwent the oral hypofunction test battery, evaluating oral hygiene, oral dryness, occlusal force, tongue‐lip motor function, tongue pressure, masticatory and swallowing function. Statistical analyses comprised Mann‐Whitney or Kruskal‐Wallis tests. Bivariate associations between categorical variables were tested using the Pearson chi‐square test; for continuous variables, the Spearman correlation was calculated. A P‐value < .05 was considered statistically significant. Results Sixty patients aged a mean 82.5 ± 7.0 years participated. Some 88.3% were diagnosed with oral hypofunction, and this was more common in older patients (P = .020). Analysing the 7 oral hypofunction tests as an interval variable (NiOF) revealed additional correlations with number of teeth (ρ = 0.477) as well as the nutritional risk, evaluated by the MNA‐SF (ρ = −0.284) and NRS (ρ = 0.317) scores. NiOF scores were higher among denture wearers (P = .003). GLIM did not confirm the correlation with NiOF. Biomarkers such as serum albumin and CRP were not associated with the NiOF score. Conclusion In this sample, the association between oral function and nutritional state is more obvious in nutritional risk scores than in the malnutrition diagnosis by GLIM.
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Affiliation(s)
- Midori Ohta
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland.,Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Yoshiki Imamura
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland.,Department of Geriatric Dentistry, School of Dentistry, Showa University, Tokyo, Japan.,Division of Fixed Prosthodontics, School of Dentistry, Meikai University, Saitama, Japan
| | - Najla Chebib
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | | | - Sandrine Allain
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Laurence Genton
- Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland
| | - Philippe Mojon
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland.,Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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Ota C, Ishizaki A, Yamaguchi S, Utsumi A, Ikeda R, Kimoto S, Hironaka S, Funatsu T. Predictors of Developmental Insufficiency of Oral Function in children. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Nishi T, Ohta M, Takano T, Ogami K, Ueda T, Sakurai K. Oral function is associated with the body and muscle mass indices of middle-aged dental patients. Clin Exp Dent Res 2021; 8:217-224. [PMID: 34791824 PMCID: PMC8874037 DOI: 10.1002/cre2.514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 08/04/2021] [Accepted: 10/02/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives Undernutrition is associated with frailty, one of the common reasons for seeking long‐term care. In older adults, nutritional status is known to be associated with oral function; however, it is not yet known if there is a similar association in middle‐aged adults. The present study determined the association between nutritional status and oral function in middle‐aged adults. Material and methods This cross‐sectional study was conducted in 117 outpatients aged 40–64 years who underwent dental check‐up at a private dental clinic. Factors associated with oral function, including oral moisture, number of teeth present, oral diadochokinesis, tongue pressure, lip‐seal strength, and masticatory performance, were evaluated. Body mass index (BMI), fat‐free mass index (FFMI), and skeletal muscle mass index (SMI) were analyzed as nutritional statuses. Pearson's correlation analysis was conducted to determine the correlation between nutritional statuses and other variables. Multiple linear regression analysis was performed, with adjustment for age and sex, using BMI, FFMI, or SMI as response variables and oral moisture, maximum tongue pressure, lip‐seal strength, oral diadochokinetic rate, and masticatory performance as explanatory variables. Results All nutritional statuses showed significant correlation with maximum tongue pressure and lip‐seal strength. Multiple linear regression analysis revealed that BMI was associated with maximum tongue pressure and lip‐seal strength, whereas FFMI and SMI showed significant association with sex, maximum tongue pressure, and lip‐seal strength. Conclusions In middle‐aged outpatients at a regional dental clinic, lip‐seal strength and tongue pressure were positively associated with BMI, FFMI, and SMI.
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Affiliation(s)
- Tomotaka Nishi
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Midori Ohta
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Tomofumi Takano
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Takayuki Ueda
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
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Schimmel M, Domioni T, Bukvic H, Arakawa I, Seifert E, Abou-Ayash S. Oral diadochokinesis and associated oro-facial function in young and old German mother-tongue speakers: A cross-sectional study. Gerodontology 2021; 39:33-40. [PMID: 34741348 PMCID: PMC9298062 DOI: 10.1111/ger.12602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022]
Abstract
Objectives The aims of this study were to compare oral diadochokinesis and to test associations with oro‐facial functional parameters in healthy young and old German speakers. Background Oral diadochokinesis is a key component in the concept of oro‐facial hypofunction and relates to tongue and lip motor function but may depend on the linguistic background. Materials and methods Healthy German speakers with a minimum of 20 teeth were recruited to form a young (<60 years) and an older group (≥60 years). Oral diadochokinesis was assessed as the number of repetitions/s for the monosyllables /pa/, /ta/ and /ka/ to evaluate movement capacity of the lip, the anterior region of the tongue and the posterior region of the tongue, respectively. Maximum voluntary lip force, maximum voluntary bite force, masticatory performance, maximum voluntary tongue pressure, xerostomia and swallowing function were assessed with validated instruments. Results are presented as median (IQR). Results Sixty participants formed the younger group (n = 35, 30.0 years [24.0‐49.0]) and the older group (n = 25, 64.0 years [62.0‐72.0]). Counts/s of /ta/ were different between age groups (younger group: 6.0 vs older group: 5.4) but not for syllables /pa/ (younger group: 6.0 vs older group: 5.8) and /ka/ (younger group: 5.6 vs older group: 5.0). The oral diadochokinesis with /pa/ was overall associated with maximum voluntary lip force; oral diadochokinesis performed with /ta/ was associated with tongue pressure, and oral diadochokinesis with /ka/ with swallowing function. Masticatory performance was not associated with oral diadochokinesis but with maximum voluntary bite force, xerostomia and with maximum voluntary tongue pressure. Conclusions The published thresholds for oral diadochokinesis should be reconsidered in non‐Japanese mother‐tongue speakers. However, they still play an important role in the overall concept of oro‐facial functional assessment.
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Affiliation(s)
- Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Tania Domioni
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Hristina Bukvic
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Itsuka Arakawa
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Comprehensive Dental Care Unit, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Eberhard Seifert
- Division of Phoniatrics, Department of Otorhinolaryngology, Head Neck Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Hatta K, Murotani Y, Takahashi T, Gondo Y, Kamide K, Masui Y, Ishizaki T, Ogata S, Matsuda KI, Mihara Y, Fukutake M, Nishimura Y, Hagino H, Higashi K, Maeda Y, Ikebe K. Decline of oral functions in old-old adults and their relationship with age and sex: The SONIC study. J Am Geriatr Soc 2021; 70:541-548. [PMID: 34719784 DOI: 10.1111/jgs.17535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/09/2021] [Accepted: 10/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Many physical functions decline with aging, but it is not known whether oral functions vary according to sex or decline with aging, as it occurs with physical functions. The present study aimed to examine the association of sex, age, and elapsed years with occlusal force and tongue pressure using a generalized linear mixed-effect model (GLMM) over a 3-year period among old-old Japanese adults. METHODS Participants were community-dwelling older adults who participated in a survey (June 2014-March 2017) and a follow-up survey (July 2017-December 2019) after 3 years (n = 951: 70-year group, n = 466; 80-year group, n = 391; 90-year group, n = 94). Dental examinations including the number of teeth, occlusal force, and tongue pressure were conducted, and a GLMM was used to estimate the association of sex, age, and elapsed years with occlusal force and tongue pressure, adjusting for the number of teeth. RESULTS The GLMM showed that occlusal force was significantly associated with sex (reference; male, non-standardized coefficient: B = -66.9 [female], p < 0.001), age (reference; 70-year group, B = -81.7 [80-year group], p < 0.001, B = -87.2 [90-year group], p < 0.001), and the number of teeth (B = 13.8, p < 0.001), but did not significantly decrease with elapsed years. Tongue pressure was significantly associated with sex (reference; male, B = -0.94 [female], p = 0.034) and age (reference; 70-year group, B = -1.78 [80-year group], p < 0.001, B = -5.47 [90-year group], p < 0.001). Tongue pressure decreased significantly with elapsed years (B = -0.82, p < 0.001). CONCLUSIONS These findings suggest that tongue pressure significantly decreased over time, but occlusal force did not. Tongue-related muscles may be more susceptible to aging than masticatory muscles.
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Affiliation(s)
- Kodai Hatta
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuki Murotani
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Toshihito Takahashi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, Osaka, Japan
| | - Kei Kamide
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yukie Masui
- Research Team for Human Care, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Research Team for Human Care, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Ken-Ichi Matsuda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yusuke Mihara
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Motoyoshi Fukutake
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuichi Nishimura
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiromasa Hagino
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kotaro Higashi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
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Fujita Y, Ohno Y, Ohno K, Takeshima T, Maki K. Differences in the factors associated with tongue pressure between children with class I and Class II malocclusions. BMC Pediatr 2021; 21:476. [PMID: 34711201 PMCID: PMC8555142 DOI: 10.1186/s12887-021-02956-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background The relationship between tongue pressure and masticatory performance during the mixed dentition period in cases of Class II malocclusion has not been clarified. The aim of this study was to determine differences in tongue pressure-related factors, including maxillofacial morphology and masticatory performance, between Class I and Class II malocclusions during the mixed dentition period. Methods A total of 56 children with Class I malocclusion (12 boys, 16 girls) or Class II malocclusion (16 boys, 12 girls) with mixed dentition were included in the present study. Height, body weight, hand grip strength, maximum occlusal force, maximum tongue pressure, masticatory performance, and the number of decayed, missing, and filled teeth were measured in all participants. Their lateral cephalograms were also evaluated. The means of all measurements were compared between Class I and Class II malocclusions. Pearson’s correlation coefficients were used to determine associations between maximum tongue pressure and other variables for each type of malocclusion. Results The maximum tongue pressure, hand grip strength, and maximum occlusal force in the Class II malocclusion group were significantly lower than those in the Class I malocclusion group (all, p < 0.05). The maximum tongue pressure was significantly positively correlated with hand grip strength, maximum occlusal force, masticatory performance, and SNB (sella, nasion, B point) angle in the Class I group (all, p < 0.05), and with height, body weight, and labial inclination of the central incisors in the Class II group (all, p < 0.05). Conclusions The maxillofacial morphometric factors associated with tongue pressure were clearly different between cases of Class I and Class II malocclusion with mixed dentition. Masticatory performance and tongue pressure were significantly positively correlated in cases of Class I malocclusion, but not in cases of Class II malocclusion.
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Affiliation(s)
- Yuko Fujita
- Division of Developmental Stomatognathic Function Science, Department of Health Promotion, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, 803-8580, Kitakyushu, Japan.
| | - Yoma Ohno
- Division of Developmental Stomatognathic Function Science, Department of Health Promotion, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, 803-8580, Kitakyushu, Japan
| | - Keitaro Ohno
- Division of Developmental Stomatognathic Function Science, Department of Health Promotion, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, 803-8580, Kitakyushu, Japan
| | - Tomohiro Takeshima
- Division of Developmental Stomatognathic Function Science, Department of Health Promotion, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, 803-8580, Kitakyushu, Japan
| | - Kenshi Maki
- Division of Developmental Stomatognathic Function Science, Department of Health Promotion, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, 803-8580, Kitakyushu, Japan
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Hasegawa Y, Tsuji S, Nagai K, Sakuramoto-Sadakane A, Tamaoka J, Oshitani M, Ono T, Sawada T, Shinmura K, Kishimoto H. The relationship between bone density and the oral function in older adults: a cross-sectional observational study. BMC Geriatr 2021; 21:591. [PMID: 34686146 PMCID: PMC8539774 DOI: 10.1186/s12877-021-02547-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Falls among older adults with a low bone density can lead to a bedridden state. Declining bone density increases the risk of falls resulting fractures in older adults. A person's physical performance is known to be closely related to bone density, and a relationship between the physical performance and the oral function is also known to exist. However, there currently is a lack of evidence regarding the relationship between bone density and the oral function. We assessed the relationship between the bone density and the both the oral function and physical performance among older adults. PATIENTS AND METHODS 754 older adults aged 65 years or older who independently lived in rural regions and who were not taking any medications for osteoporosis participated. We checked all participants for osteoporosis using an ultrasonic bone density measuring device. Regarding the oral function, we evaluated the following factors: remaining teeth, occlusal support, masticatory performance, occlusal force, and tongue pressure. We also evaluated body mass index (BMI) and skeletal muscle mass Index as clinical characteristics. The normal walking speed, knee extension force and one-leg standing test were evaluated as physical performance. For the statistical analyses, we used the Mann-Whitney U test, chi-square test, the Kruskal-Wallis, and a multiple regression analysis. RESULTS Eighty-one percent of the females and 58% of the males had osteoporosis or a decreased bone mass. The occlusal force, masticatory performance and the tongue pressure showed significant association with the bone density. The participants physical performance showed a significant association with their bone states except for walking speed. According to a multiple regression analysis, clinical characteristics (sex, age, BMI), one-leg standing and occlusal force showed independent associations with the bone density. It was suggested that the bone density tends to increase if the occlusal force is high and/or the one-leg standing test results are good. CONCLUSIONS The bone density in the older adults showed a significant relationship not only with clinical characteristics or physical performance, but also with occlusal force. It may also be effective to confirm a good oral function in order to maintain healthy living for older adults.
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Affiliation(s)
- Yoko Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 5274, Gakkocho-dori 2-bancho, Chuo-ku, Niigata, 951-8514 Japan
| | - Shotaro Tsuji
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo Japan
| | - Ayumi Sakuramoto-Sadakane
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Joji Tamaoka
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Masayuki Oshitani
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 5274, Gakkocho-dori 2-bancho, Chuo-ku, Niigata, 951-8514 Japan
| | - Takashi Sawada
- Hyogo Dental Association, 5-7-18 Yamamoto-dori, Chuo-ku, Kobe, Hyogo Japan
| | - Ken Shinmura
- Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Hiromitsu Kishimoto
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
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Izumi M, Akifusa S. Tongue cleaning in the elderly and its role in the respiratory and swallowing functions: Benefits and medical perspectives. J Oral Rehabil 2021; 48:1395-1403. [PMID: 34612518 DOI: 10.1111/joor.13266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
Abstract
Oral dysfunction, including oral uncleanness and decline in tongue motor function, tongue pressure and swallowing function, precedes frailty. The tongue's dorsum is a reservoir of oral microbiota, desquamated epithelial mucosa and leukocytes due to the multi-papillate anatomy, and leads to tongue coating. The tongue coating is frequently found in older adults because of hyposalivation, immunity's hypoactivity, diminished motor function and compromised tongue's pressure with age. Anaerobe-driven volatile sulphur compounds in tongue coating are a major cause of intra-oral malodor. Dysbiosis of the tongue-coating microbiome rather than the amount of microorganisms is associated with a risk of aspiration pneumonia. Daily tongue cleaning with a brush or scraper is an easy way to control tongue coating deposits and quality. Using mouth wash or rinse-containing germicides is also a way to control the microbiota of tongue coating. The tongue function is closely related to swallowing. Tongue and suprahyoid muscles are linked with respiratory muscles through the endothoracic fascia. The mechanical stimulation during the cleaning of the tongue may stimulate the respiratory muscles. An intervention trial revealed that tongue cleaning by mucosal brush improves tongue pressure, swallowing and respiratory function in old residents of nursing homes, suggesting a rehabilitative effect of tongue cleaning on the swallowing and respiratory functions, preventing aspiration pneumonia. This narrative review assesses the tongue-cleaning benefits for respiratory and swallowing functions and the possibility of preventing aspiration pneumonia.
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Affiliation(s)
- Maya Izumi
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | - Sumio Akifusa
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
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Jones CA, Colletti CM. Age-Related Functional Reserve Decline Is Not Seen in Pharyngeal Swallowing Pressures. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3734-3741. [PMID: 34525307 PMCID: PMC9132052 DOI: 10.1044/2021_jslhr-21-00164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose Functional reserve represents the difference between an individual's ability to produce a maximum output function and the ability to perform a functional task. Several studies have documented an age-related decrease in functional reserve with oral tongue pressure generation. Whether this pattern is seen in pharyngeal swallowing pressures is unknown. The aim of this study was to investigate pharyngeal functional reserve using high-resolution manometry during normal-effort and effortful swallows. Method Pharyngeal high-resolution manometry was performed on 38 younger healthy individuals (≤ 40 years) and 18 older healthy individuals (≥ 60 years) during normal-effort and effortful water swallows. Pressure metrics included maximum pressure in the velopharynx, tongue base, and hypopharynx, as well as pharyngeal contractile integral and minimum pressure in the upper esophageal sphincter (UES). Repeated-measures analysis of variance was used to determine the effects of swallow task, age, and pharyngeal region on pressure generation. Results Maximum pharyngeal pressures and pharyngeal contractile integral were significantly increased during the effortful swallows compared to normal-effort swallows (p < .001), but there were no interactions between task and age in pharyngeal pressures. In the UES, minimum pressures were significantly elevated in older individuals during effortful swallows compared to normal-effort swallows (p = .007) but did not follow a pattern consistent with reduced functional reserve. Conclusions Healthy individuals increase pharyngeal driving pressures during effortful swallows, without an age-related reduction in the magnitude of pressure increase. Thus, this study did not find evidence for an age-related reduction in pharyngeal functional reserve. The preserved ability to increase pharyngeal pressures during effortful swallowing in aging may support the use of behavioral swallowing interventions in older individuals without neuromuscular conditions. Supplemental Material https://doi.org/10.23641/asha.16606709.
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Affiliation(s)
- Corinne A. Jones
- Department of Neurology, Dell Medical School, The University of Texas at Austin
- Department of Speech, Language, and Hearing Sciences, Moody College of Communication, The University of Texas at Austin
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Associations between Oral Hypofunction Tests, Age, and Sex. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910256. [PMID: 34639564 PMCID: PMC8508206 DOI: 10.3390/ijerph181910256] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/25/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022]
Abstract
Oral function declines in older individuals due to disease and age-related changes, making them vulnerable to oral and physical frailty. Therefore, it is important to manage the decline in oral function in older outpatients. Oral hypofunction is diagnosed by seven tests related to oral function, oral hygiene, oral moisture, occlusal force, oral diadochokinesis, tongue pressure, masticatory function, and swallowing function. However, sex or age were not factored into the current reference values of these tests. We included subjects attending the dental hospital clinic for maintenance, and recorded and analyzed oral hypofunction and the factors associated with its diagnosis. Of the 134 outpatients (53 males and 81 females, mean age 75.2 ± 11.2 years), 63% were diagnosed with oral hypofunction. Oral hypofunction prevalence increased significantly with age, and significant variations were observed in all tests. Furthermore, oral hygiene and swallowing function were not associated with oral hypofunction diagnosis. All examined factors decreased with increasing age, even after adjusting sex, except for oral hygiene and moisture. Occlusal force and masticatory function were higher in men after adjusting age. This study suggested that older outpatients were likely to be diagnosed with oral hypofunction, and that the test reference value and their selection for oral hypofunction should be reconsidered.
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75
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Guo R, Hama Y, Hosoda A, Kubota C, Minakuchi S. Age and sex differences in oral functions from junior high school to young adulthood: A cross-sectional study. J Oral Rehabil 2021; 48:1373-1379. [PMID: 34480807 DOI: 10.1111/joor.13253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/01/2021] [Accepted: 09/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND As oral function requires maintenance throughout life, it needs to be understood across age groups; however, few studies have investigated this in young individuals. OBJECTIVES To clarify age and sex differences in maximum occlusal force, maximum tongue pressure and tongue-lip motor function; and the relationship among these oral functions in junior high school students and young adults. METHODS This cross-sectional study investigated oral functions in students aged 12-13 years, 14-15 years old and 16-17 years old (S1, S2 and S3), and young adults aged 20-40 years (YA). We analysed age group differences in each sex and sex differences in each age group. Multiple linear regression analysis was performed for each sex using the maximum occlusal force as the dependent variable to investigate the associations among different oral functions. RESULTS In 522 children and 100 young adults, there were significant increases in oral functions with age in males and a significant decrease in maximum tongue pressure between S2 and S3 in females. Maximum occlusal force and tongue pressure were higher in males than in females in S3 and YA; tongue-lip motor function was higher in females than in males in S1. In multiple linear regression analysis, tongue-lip motor function and age group were significant factors in both sexes and in males, respectively. CONCLUSION Maximum occlusal force, maximum tongue pressure and tongue-lip motor function increased with increasing age groups in males. Our findings provide a basis for assessing oral function across age groups.
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Affiliation(s)
- Ruoyan Guo
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yohei Hama
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akemi Hosoda
- Division of Medical Nutrition, Faculty of Healthcare, Tokyo Healthcare University, Tokyo, Japan
| | - Chieko Kubota
- Major of Oral Health Sciences, Department of Health Sciences, Saitama Prefectural University, Koshigaya, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Matsuo K, Sekimoto Y, Okamoto M, Shibata S, Otaka Y. Association between oral health status and oral food intake level in subacute stroke patients admitted to a convalescent rehabilitation unit. Gerodontology 2021; 39:67-73. [PMID: 34448242 DOI: 10.1111/ger.12586] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Stroke patients often suffer from dysphagia during their recovery. We hypothesised that subacute stroke patients with dysphagia had more deteriorated oral health status including muscle strength and motor function. OBJECTIVE Quantitatively investigate oral health status and identify associations with oral feeding status in stroke patients admitted to a convalescent rehabilitation unit. METHODS We prospectively recruited 187 stroke patients admitted to a convalescent rehabilitation unit. Oral feeding status was examined using the Functional Oral Intake Scale (FOIS), and the cohort was divided into three groups based on FOIS score as non-oral feeding (FOIS-123; 22 patients), dysphagic diet (FOIS-45; 74 patients), and regular diet (FOIS-67; 91 patients) groups. Activities of daily living (ADL) were assessed with the Functional Independence Measure (FIM). Oral health status was measured quantitatively in six oral function parameters and Oral Health Assessment Tool (OHAT), and differences according to the FOIS, age and FIM were statistically tested. RESULTS In bivariate analysis, two parameters, tongue pressure and tongue-lip motor functions were significantly higher in the regular diet group than in the other groups (P < .01). Gross OHAT score was also significantly better in the regular diet group than in the other groups (P < .01). These significant associations mostly remained in the multiple model after adjusting for age and FIM. CONCLUSION This study suggests that, amongst oral health status, tongue strength and motor function, as well as OHAT score, may have strong associations with oral feeding status in subacute stroke patients at convalescent rehabilitation units regardless of ADL levels.
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Affiliation(s)
- Koichiro Matsuo
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan.,Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Sekimoto
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Mieko Okamoto
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
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Imamura Y, Chebib N, Ohta M, Maria Schulte-Eickhoff R, Mekki M, Schimmel M, Arakawa I, Graf C, Sato Y, Müller F. Validation of a novel diagnostic tool for decreased tongue pressure. J Oral Rehabil 2021; 48:1219-1225. [PMID: 34425018 PMCID: PMC9291622 DOI: 10.1111/joor.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Reduced tongue pressure may render eating and swallowing difficult. The purpose of this study was to investigate whether the tongue training device can also be used as a diagnostic device and whether its sensitivity and specificity are equal to the numerical tongue pressure measuring device. MATERIAL AND METHODS The target group is patients aged 70 years and over who are hospitalised for rehabilitation. Tongue pressure was measured by both, a tongue pressure measuring instrument and a tongue training tool. The diagnosis of the reduced tongue pressure was made with the tongue pressure measuring instrument and set the verified with the novel tongue training tool. RESULTS Sixty-two participants were included in the study. Forty-five were classified by the tongue pressure measuring device and 53 by the tongue training device as 'low tongue pressure'. Spearman correlation confirmed a positive correlation between the tongue pressure measuring device and the tongue training device rs = 0.800, p = 0.01 level (2-tailed). The tongue training device test identified sensitivity was 100%, and its specificity was 52.9%. The AUC of the ROC curve is 0.901. CONCLUSION The tongue training device seems a simple, safe and readily available alternative to the tongue pressure measuring device for the diagnosis of low tongue pressure, with an excellent sensitivity and very good specificity.
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Affiliation(s)
- Yoshiki Imamura
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Geriatric Dentistry, School of Dentistry, Showa University, Tokyo, Japan.,Yoshiki Imamura Meikai University, School of Dentistry, Division of Fixed Prosthodontics, Saitama, Japan
| | - Najla Chebib
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Midori Ohta
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Mustapha Mekki
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Itsuka Arakawa
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Comprehensive Dental Care, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, University Hospitals Geneva, Geneva, Switzerland
| | - Yuji Sato
- Department of Geriatric Dentistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Mitani A, Muramatsu M. Development of a Spoon Motion Navigation Algorithm for the Mealtime Assistant Simulator. JOURNAL OF ROBOTICS AND MECHATRONICS 2021. [DOI: 10.20965/jrm.2021.p0768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In aging society like Japan, maintaining the quality of life (QOL) is an important objective. The oral cavity has various significant functions that contribute to the QOL. Elderly people are susceptible to the swallowing disorders owing to various factors associated with advancing age. In such cases, mealtime assistance can provide elderly persons appropriate eating situations. Thus, mealtime assistance skills are essential for students in nursing and caregiver education. Recently, simulation education has attracted attention as an effective educational process for nursing and caregiver students before their clinical practice in a hospital or care house. In this educational process, a patient model that mimics specific symptoms called the simulation model, is used to learn the symptoms and its care process in the same clinical environment as actual. We have attempted to develop several oral care simulation models, and we have earlier developed a prototype of mealtime assistance simulation model. This simulation model had a tongue model with a sensor system to detect spoon motions, and its fundamental functions were evaluated via spoon detection experiments. Based on the earlier achievements, in this study, we develop an evaluation system of feeding skill using a spoon. The pressing force and position by spoon on the tongue model were estimated by transfer functions derived from experiments. In addition, we developed an algorithm that leads students’ spoon position and pressing force in the correct position.
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Umemoto G, Fujioka S, Arahata H, Sakae N, Sasagasako N, Toda M, Furuya H, Tsuboi Y. Longitudinal Changes of Tongue Thickness and Tongue Pressure in Neuromuscular Disorders. BMC Neurol 2021; 21:302. [PMID: 34353291 PMCID: PMC8340465 DOI: 10.1186/s12883-021-02225-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 05/06/2021] [Indexed: 12/03/2022] Open
Abstract
Background Swallowing dysfunction is related to major cause of adverse events and an indicator of shorter survival among patients with neuromuscular disorders (NMD). It is critical to assess the swallowing function during disease progression, however, there are limited tools that can easily evaluate swallowing function without using videofluoroscopic or videoendoscopic examination. Here, we evaluated the longitudinal changes in tongue thickness (TT) and maximum tongue pressure (MTP) among patients with amyotrophic lateral sclerosis (ALS), myotonic dystrophy type 1 (DM1), and Duchenne muscular dystrophy (DMD). Methods Between 2010 and 2020, TT and MTP were measured from 21 ALS, 30 DM1, and 14 DMD patients (mean ages of 66.9, 44.5, and 21.4 years, respectively) at intervals of more than half a year. TT was measured, by ultrasonography, as the distance from the mylohyoid muscle raphe to the tongue dorsum, and MTP was determined by measuring the maximum compression on a small balloon when pressing the tongue against the palate. Then we examined the relationship between these evaluations and patient background and swallowing function. Results Mean follow-up periods were 24.0 months in the ALS group, 47.2 months in the DM1group, and 61.1 months in the DMD group. The DMD group demonstrated larger first TT than the other groups, while the DM1 group had lower first MTP than the ALS group. The ALS group showed a greater average monthly reduction in mean TT than the DM1 group and greater monthly reductions in mean body weight (BW) and MTP than the other groups. Significant differences between the first and last BW, TT, and MTP measures were found only in the ALS group. Conclusions This study suggests that ALS is associated with more rapid degeneration of tongue function over several years compared to DMD and DM1.
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Affiliation(s)
- George Umemoto
- Swallowing Disorders Center, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. .,Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan.
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hajime Arahata
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Nobutaka Sakae
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Naokazu Sasagasako
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Mine Toda
- Department of Clinical Nutrition & Food services, NHO Omuta National Hospital, Fukuoka, Japan
| | - Hirokazu Furuya
- Department of Neurology, Faculty of Medicine, Kochi University, Kochi, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Onuki W, Magara J, Tsujimura T, Ito K, Sakai H, Kulvanich S, Nakajima Y, Saka N, Inoue M. Survey of oral hypofunction in older outpatients at a dental hospital. J Oral Rehabil 2021; 48:1173-1182. [PMID: 34346106 DOI: 10.1111/joor.13237] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/24/2021] [Accepted: 07/17/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Oral hypofunction is defined as the reversible stage preceding oral dysfunction. However, its assessment and management need further examination and consideration. OBJECTIVE The present study aimed to examine the current state of oral hypofunction among outpatients at the university hospital. METHODS New outpatients underwent medical interviews and detailed assessment of oral hypofunction at their initial visit to our dental department. Oral hypofunction was diagnosed if the results of three of the following seven assessment items were below cut-off values: poor oral hygiene, oral dryness, reduced occlusal force, decreased tongue-lip motor function, decreased tongue pressure, decreased masticatory function and deterioration of swallowing function. The relationships between factors used to diagnose oral hypofunction as well as the distributions of assessment values were clarified. RESULTS Seventy-five of 209 patients (35.9%) were finally diagnosed with oral hypofunction. Diagnosis of oral hypofunction was significantly related to patient age, Eichner index, a chief complaint of dental or periodontal disease or ill-fitting dentures and a history of neurodegenerative disease. The lowest quintile values for poor oral hygiene, oral dryness and decreased masticatory performance were all above current cut-off values. Reduced occlusal force contributed strongly to the diagnosis of oral hypofunction. CONCLUSION Oral hypofunction in dental outpatients at a university hospital was associated with patient age, medical history and chief complaint at presentation. Diagnosis of oral hypofunction can be closely related to reduced occlusal force. The validity of cut-off values for assessments of oral hypofunction needs further consideration.
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Affiliation(s)
- Wakana Onuki
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jin Magara
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takanori Tsujimura
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kayoko Ito
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruka Sakai
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sirima Kulvanich
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuta Nakajima
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Nobuaki Saka
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Yamaguchi K, Nakagawa K, Yoshimi K, Ariya C, Nakane A, Furuya J, Tohara H. Age-related changes in swallowing muscle intramuscular adipose tissue deposition and related factors. Exp Gerontol 2021; 153:111505. [PMID: 34343633 DOI: 10.1016/j.exger.2021.111505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To investigate age-related changes in the intramuscular adipose tissue (IAT) of the tongue and geniohyoid muscle (GHM) and associated factors. DESIGN Exploratory cross-sectional study. SETTING AND PARTICIPANTS This study included 89 participants recruited from a health survey, which included 38 younger adults (age range, 20-63 years) and 51 older adults (age range, 65-87 years). MEASUREMENTS Age, body mass index, body fat, lean body mass, skeletal muscle mass index, trunk muscle mass index, tongue pressure, jaw opening force, and oral diadochokinesis were assessed. The cross-sectional area (CSA) and echo intensity (EI) of the tongue and GHM were measured using ultrasonography. IAT was assessed according to EI values. The factors related to the IAT of each muscle were examined using multiple regression analysis. We also investigated the correlation of IAT with factors related to oral function and systemic and morphological factors. RESULTS Neither the EI of the tongue nor that of the GHM had a significant correlation with factors related to oral function and systemic factors. In the multiple regression analysis, significant explanatory variables for EI of the tongue and GHM were age (β = 0.14, P = 0.019; tongue and β = 0.13, P = 0.017; GHM) and the CSA of each muscle (β = -0.01, P = 0.042; tongue and β = -0.04, P = 0.003; GHM). EI was positively associated with age and negatively associated with muscle CSA. CONCLUSION Age-related changes in the IAT show the same trend for both the tongue and GHM, unlike age-related changes in muscle mass. The IATs of the tongue and GHM were not significantly correlated with oral function and systemic factors. Therefore, EI may not be a useful index for the functional evaluation of the tongue and GHM.
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Affiliation(s)
- Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Chantaramanee Ariya
- Department of Preventive Dentistry, Naresuan University, 99 Moo 9, Phitsanulok-Nakhon Sawan Road, Tha Pho, Mueang Phitsanulok 65000, Thailand
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Junichi Furuya
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
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Liu HY, Chen JH, Hsu KJ, Yao CT, Chen PH, Hsiao SY, Lin CL. Decreased Tongue Pressure Associated with Aging, Chewing and Swallowing Difficulties of Community-Dwelling Older Adults in Taiwan. J Pers Med 2021; 11:jpm11070653. [PMID: 34357120 PMCID: PMC8303908 DOI: 10.3390/jpm11070653] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/20/2022] Open
Abstract
Personalized tongue pressure (TP) training focuses on improving swallowing. This study aims to establish the TP values of different age levels and compare changes between different swallowing status among community-dwelling elders. In this cross-sectional study, 1000 participants, aged 60 years old and above, were recruited from community care centers. All participants were classified into non chewing and/or swallowing difficulties (NCSD) and with chewing and/or swallowing difficulties (CSD) groups and their diseases and dieting status were recorded using a structured questionnaire. A disposable oral probe was used to measure TP by asking participants to compress it against the hard palate with maximum voluntary effort. Among 1000 elders, 63.10% had CSD and their TP (from 31.76 to 18.20 kPa) was lower than the NCSD group (from 33.56 to 24.51 kPa). Both groups showed the same tendency for TP decline with increasing age. Decline of TP makes CSD elderly have a poor appetite, eat a soft or liquid diet, and take longer to eat a meal (all p < 0.050). The secondary risk factor dominating TP decline for NCSD and CSD elders is having an education level less than primary school and an abnormal eating assessment, respectively. Our results demonstrated that TP decline has a significant relationship with age changes. Education level and an abnormal eating assessment score are closely associated with TP decline. A series of TP values can be used as a reference indicator of personalized medicine during the aging process among community-dwelling older adults.
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Affiliation(s)
- Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-H.C.); (K.-J.H.); (P.-H.C.); (S.-Y.H.)
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Kun-Jung Hsu
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-H.C.); (K.-J.H.); (P.-H.C.); (S.-Y.H.)
- Department of Family Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
| | - Ching-Teng Yao
- Master Program of Long-Term Care in Aging, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-H.C.); (K.-J.H.); (P.-H.C.); (S.-Y.H.)
- Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Szu-Yu Hsiao
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-H.C.); (K.-J.H.); (P.-H.C.); (S.-Y.H.)
- Division of Pediatric Dentistry and Special Needs Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan
- Correspondence:
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Nakamori M, Ishikawa K, Imamura E, Yamamoto H, Kimura K, Ayukawa T, Mizoue T, Wakabayashi S. Relationship between tongue pressure and dysphagia diet in patients with acute stroke. PLoS One 2021; 16:e0252837. [PMID: 34086830 PMCID: PMC8177488 DOI: 10.1371/journal.pone.0252837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/23/2021] [Indexed: 11/25/2022] Open
Abstract
A dysphagia diet is important for patients with stroke to help manage their nutritional state and prevent aspiration pneumonia. Tongue pressure measurement is a simple, non-invasive, and objective method for diagnosing dysphagia. We hypothesized that tongue pressure may be useful in making a choice of diet for patients with acute stroke. Using balloon-type equipment, tongue pressure was measured in 80 patients with acute stroke. On admission, a multidisciplinary swallowing team including doctors, nurses, speech therapists, and management dietitians evaluated and decided on the possibility of oral intake and diet form; the tongue pressure was unknown to the team. Diet form was defined and classified as dysphagia diet Codes 0 to 4 and normal form (Code 5 in this study) according to the 2013 Japanese Dysphagia Diet Criteria. In multivariate analysis, only tongue pressure was significantly associated with the dysphagia diet form (p<0.001). Receiver operating characteristic analyses revealed that the optimal cutoff tongue pressure for predicting diet Codes 1, 2, 3, 4, and 5 was 3.6 (p<0.001, area under the curve [AUC] = 0.997), 9.6 (p<0.001, AUC = 0.973), 12.8 (p<0.001, AUC = 0.963), 16.5 (p<0.001, AUC = 0.979), and 17.3 kPa (p<0.001, AUC = 0.982), respectively. Tongue pressure is one of the sensitive indicators for choosing dysphagia diet forms in patients with acute stroke. A combination of simple modalities will increase the accuracy of the swallowing assessment and choice of the diet form.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Kenichi Ishikawa
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Haruna Yamamoto
- Department of Nursing, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Keiko Kimura
- Department of Nursing, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tomoko Ayukawa
- Department of Rehabilitation, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tatsuya Mizoue
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
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84
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Kugimiya Y, Iwasaki M, Ohara Y, Motokawa K, Edahiro A, Shirobe M, Watanabe Y, Obuchi S, Kawai H, Kera T, Fujiwara Y, Ihara K, Kim H, Igarashi K, Hoshino D, Hirano H. [The oral function of community-dwelling older adults complaining of an oral function deterioration: An examination using the oral function-related items of the Questionnaire for Latter-stage Elderly People]. Nihon Ronen Igakkai Zasshi 2021; 58:245-254. [PMID: 34039801 DOI: 10.3143/geriatrics.58.245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM The oral function-related items of the newly developed "Questionnaire for Latter-stage Elderly People" are based on two items of the Kihon checklist assessing the masticatory and swallowing functions. In this study, we estimated the questionnaire's application rate and investigated the oral function of the respondents. METHODS Included were 699 older adults (274 men/425 women, average age, 73.4±6.6 years old). Those who responded positively to the related items were considered to have decreased swallowing and masticatory functions. The specific oral function was assessed based on the number of present and functional teeth; oral hygiene; oral moisture; occlusal force; oral diadochokinesis /pa/, /ta/, /ka/; tongue pressure; mixing ability; shearing ability; and Eating Assessment Tool (EAT)-10 (reference, score ≥3). RESULTS The rates of decreased masticatory and swallowing functions were 21.5% and 26.6%, respectively, while 7.4% of participants had both. Those with a decreased masticatory function showed fewer present teeth; a lower occlusal force, oral diadochokinesis /pa/, mixing ability, shearing ability, and higher EAT-10 scores.Those with a decreased swallowing function only had higher EAT-10 scores. In the early- and latter-stage elderly, the decreased masticatory function rates were 15.6% and 29.4%, respectively, the decreased swallowing function rates were 27.8% and 25.0%, respectively, and the rates of both decreased masticatory and swallowing functions were 6.0% and 9.5%, respectively. CONCLUSION The older adults who responded positively to the related questionnaire items, especially for items related to masticatory function, had a decreased oral function in multiple respects. The items related to the oral function in the Questionnaire for Latter-stage Elderly People are considered useful for identifying older adults with a decreased oral function.
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Affiliation(s)
- Yoshihiro Kugimiya
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology
| | - Maki Shirobe
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology.,Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology
| | - Takeshi Kera
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology.,Faculty of Health Care, Takasaki University of Health and Welfare
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University School of Medicine
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology
| | - Kentaro Igarashi
- Removable Prosthodontics, Nihon University School of Dentistry at Matsudo
| | - Daichi Hoshino
- Division of Community-Based Comprehensive Dentistry, Department of Special Needs Dentistry, School of Dentistry, Showa University
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology
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85
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Sugiya R, Higashimoto Y, Shiraishi M, Tamura T, Kimura T, Chiba Y, Nishiyama O, Arizono S, Fukuda K, Tohda Y. Decreased Tongue Strength is Related to Skeletal Muscle Mass in COPD Patients. Dysphagia 2021; 37:636-643. [PMID: 34036401 PMCID: PMC8149139 DOI: 10.1007/s00455-021-10314-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/06/2021] [Indexed: 12/15/2022]
Abstract
Dysphagia is frequently observed in patients with chronic obstructive pulmonary disease (COPD). Decreased tongue strength is one of the causes of dysphagia, and it is often observed in patients with sarcopenia. Sarcopenia is also frequently observed in COPD patients. We hypothesized that tongue strength is lower in COPD patients compared to normal subjects. This was a single-center, observational, cross-sectional study. Maximum tongue pressure (MTP) was measured in 27 patients with COPD and 24 age-matched control subjects. We also evaluated handgrip strength, gait speed, and appendicular skeletal muscle mass to define subjects as having sarcopenia. We used bioelectrical impedance analysis to assess body composition. The eating assessment test-10 was used to diagnose dysphagia. MTP was significantly lower in COPD patients than in control subjects (33.8 ± 8.4 vs 38.0 ± 5.3; p = 0.032). All measures of muscle and fat free body mass, handgrip strength, and gait speed were also significantly lower in COPD patients compared to control subjects (p < 0.01). The prevalence of sarcopenia in COPD patients was higher than that in control subjects (6/27 versus 0/24; p = 0.007), but the prevalence of dysphagia was not different between groups (COPD: 5/27, versus control: 1/24; p = 0.112). MTP was moderately correlated with skeletal muscle mass index (r = 0.56, p = 0.003) and handgrip strength (r = 0.43, p = 0.027) in COPD patients. Tongue strength was lower in COPD patients compared to normal subjects, and decreased tongue strength may be correlated with sarcopenia in COPD patients.
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Affiliation(s)
- Ryuji Sugiya
- Department of Rehabilitation Medicine, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan. .,School of Rehabilitation Sciences, Seirei Christopher University, 3453 Mikatahara, Hamamatsu, Shizuoka, 4338558, Japan.
| | - Yuji Higashimoto
- Department of Rehabilitation Medicine, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan
| | - Masashi Shiraishi
- Department of Rehabilitation Medicine, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan
| | - Tomomi Tamura
- Department of Rehabilitation Medicine, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan
| | - Tamotsu Kimura
- Department of Rehabilitation Medicine, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kindai University hospital, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan
| | - Osamu Nishiyama
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan
| | - Shinichi Arizono
- School of Rehabilitation Sciences, Seirei Christopher University, 3453 Mikatahara, Hamamatsu, Shizuoka, 4338558, Japan
| | - Kanji Fukuda
- Department of Rehabilitation Medicine, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan
| | - Yuji Tohda
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 5898511, Japan
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86
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Shimizu A, Fujishima I, Maeda K, Wakabayashi H, Nishioka S, Ohno T, Nomoto A, Shigematsu T, Kayashita J. Effect of low tongue pressure on nutritional status and improvement of swallowing function in sarcopenic dysphagia. Nutrition 2021; 90:111295. [PMID: 34107332 DOI: 10.1016/j.nut.2021.111295] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/08/2021] [Accepted: 04/18/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effect of low tongue pressure on the improvement of swallowing function in people with sarcopenic dysphagia and ongoing dysphagia or physical rehabilitation. In addition, we investigated whether sarcopenic dysphagia at admission was associated with severity of malnutrition. METHODS This was a prospective cohort study of 146 people with sarcopenic dysphagia (mean age 84.6 ± 7.4 y; 68.4% women, 31.6% men) in a postacute rehabilitation hospital. Sarcopenic dysphagia was defined as the presence of both sarcopenia and dysphagia but not neurogenic dysphagia, such as dysphagia due to stroke. Low tongue pressure was classified as "probable" and normal tongue pressure as "possible" sarcopenic dysphagia. Swallowing function was assessed using the Food Intake Level Scale. Malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition criteria. Study outcomes included the amount of change in Food Intake Level Scale score during the rehabilitation period and the association between probable sarcopenic dysphagia and the severity of malnutrition on admission. Statistical significance was set at P < 0.05. RESULTS There were 83 participants (58.6%) with probable sarcopenic dysphagia. The severity of malnutrition (moderate malnutrition: adjusted odds ratio, 3.388; P = 0.042) and severe malnutrition (adjusted odds ratio, 3.663; P = 0.015) was a contributing factor to probable sarcopenic dysphagia. Probable sarcopenic dysphagia (regression coefficient, -0.384; P = 0.017) was negatively associated with the amount of change in Food Intake Level Scale score. CONCLUSIONS Probable sarcopenic dysphagia with low tongue pressure was associated with poorer improvement in swallowing function and severe malnutrition during postacute rehabilitation. Patients with probable sarcopenic dysphagia may require aggressive nutritional therapy.
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Affiliation(s)
- Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Tomohisa Ohno
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Akiko Nomoto
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Takashi Shigematsu
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan
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87
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Impact of Progression of Parkinson's Disease on Swallowing Ability and Oral Environment. PARKINSONS DISEASE 2021; 2021:5571556. [PMID: 33981405 PMCID: PMC8088364 DOI: 10.1155/2021/5571556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/10/2021] [Accepted: 04/17/2021] [Indexed: 01/22/2023]
Abstract
This study investigated the impact of the severity and treatment of Parkinson's disease (PD) on the swallowing ability and oral environment of patients. Swallowing dysfunction increases the aspiration risk and may lead to poor oral health among patients with PD. We investigated the influences of PD progression and drug treatment on the swallowing ability and oral environment using simple noninvasive screening measurements. We recruited 87 patients with PD (mean age, 71.9 ± 8.0 years; mean Hoehn and Yahr score, 2.9 ± 0.9). The PD condition was assessed in each patient using the unified Parkinson's disease rating scale (UPDRS) part III, diet type and oropharyngeal function using the swallowing disturbances questionnaire (SDQ), maximum bite force (MBF), tongue pressure (TP), and oral bacterial count (OBC). Levodopa equivalent daily dose (LEDD) was also calculated for 56 participants. Based on an SDQ score of ≥11, 29.5% of patients were dysphagic, but almost all were still on a regular diet. The SDQ score was positively correlated with disease duration (rho = 0.228, p=0.047) and UPDRS part III score (rho = 0.307, p=0.007) but was negatively correlated with OBC (rho = -0.289, p=0.012). OBC was significantly higher among patients with an SDQ score of <11 (nondysphagic) (p=0.01), and the SDQ score was lower in patients with higher OBC requiring professional oral care (p=0.03). However, OBC was also negatively correlated with LEDD (rho = -0.411, p=0.004). These results indicated low self-awareness of dysphagia among the participants and an association between dysphagia and PD progression. Moreover, the oral environment could have deteriorated with swallowing dysfunction. Patients and clinicians should be aware that higher LEDD can increase xerostomia and associated deficits in oral health.
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88
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Liu HY, Chen CH, Kuo CH, Feng MC, Chen JH, Wang HW, Chen KC, Lin CL. A Novel Tongue Pressure Measurement Instrument with Wireless Mobile Application Control Function and Disposable Positioning Mouthpiece. Diagnostics (Basel) 2021; 11:diagnostics11030489. [PMID: 33801947 PMCID: PMC8002047 DOI: 10.3390/diagnostics11030489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/16/2022] Open
Abstract
This study developed a novel chair-side tongue pressure (TP) measuring instrument with a disposable positioning mouthpiece controlled using a smartphone application (APP), denoted as the TP wireless application (TPWA). The mouthpiece was designed with a palate-shaped air balloon containing a tongue contact bump and a plastic bite positioning tube. Fatigue load testing was performed to evaluate mouthpiece durability by applying 700 displacement cycles (50 times a day for one week during training, with twice the safety factor) on the air balloon. The main component used in developing this instrument was a silicon pressure sensor equipped with wireless Bluetooth connection. Young (52 adults; mean age = 20.23 ± 2.17) and elderly (40 adults; mean age = 72.60 ± 7.03) individuals participated in the test with the new instrument, with the results compared to those of a commercial device. The TPWA mouthpiece fatigue test showed that mean response pressures were maintained at 12 kPa. No significant (p > 0.05) differences were found during testing repetitions 0–10 and 701–710. There were no significant differences in the maximum TP values presented between the test sequences using different instruments for young and elderly participants. The TPWA results showed that TP values gradually decreased with increasing age (40.77 kPa for young and 16.55 kPa for elderly participants). The maximum TP for males (43.51 kPa) was significantly larger than that for females (35.14 kPa) in the young group, but an opposite trend was seen in the elderly group (12.97 for males and 17.59 for females). Thus, this study developed a novel chair-side TP measurement instrument with Bluetooth wireless mobile application control. A durable positioning oral mouthpiece was approved for measuring pressure sufficiently, reliably, and precisely for TP screening.
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Affiliation(s)
- Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chun-Hung Chen
- Department of Neurology, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan;
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Chao-Hung Kuo
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Division of Internal Medicine, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung 81267, Taiwan
- Division of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Ming-Chu Feng
- Department of Nursing, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan;
- School of Nursing, Fooyin University, Kaohsiung 83102, Taiwan
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Hsuan-Wen Wang
- Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan; (H.-W.W.); (K.-C.C.)
| | - Kun-Chun Chen
- Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan; (H.-W.W.); (K.-C.C.)
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan; (H.-W.W.); (K.-C.C.)
- Correspondence: (C.-L.L.)
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89
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Kohyama K, Ishihara S, Nakauma M, Funami T. Fracture phenomena of soft gellan gum gels during compression with artificial tongues. Food Hydrocoll 2021. [DOI: 10.1016/j.foodhyd.2020.106283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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90
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Hijiya K, Masuda Y, Miyamoto T, Shimono R, Kato T, Kageyama T, Yamada K. Age-related differences in maximum voluntary lip-closing force and ability to control lip-closing force. J Oral Biosci 2021; 63:210-216. [PMID: 33652121 DOI: 10.1016/j.job.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/17/2021] [Accepted: 02/06/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Deterioration of lip function in the elderly is a form of oral hypofunction. It is important to understand age-related changes in lip function to improve oral health. This study aimed to quantitatively compare the maximum lip-closing force (LCF) and the ability to control LCF during voluntary lip-pursing movements between elderly and young adults and clarify the influence of aging on both measurements. METHODS Using a multidirectional LCF measurement system, we measured six-directional maximum LCFs (upper, upper right, lower right, lower, lower left, upper right) of 20 healthy elderly men (69.6 ± 4.2 years) and 20 healthy young men (25.1 ± 3.8 years). The ability to control the LCF in each direction was assessed based on the accuracy rate. The directional LCF and the ability to control LCF were compared between the elderly and young adults. RESULTS The maximum directional LCF in the elderly adults was significantly smaller than that in the young adults in three directions from the lower lip; moreover, the accuracy rate of the elderly adults was significantly lower than that of young adults in five of the six directions. CONCLUSIONS Our findings suggest that the influence of aging on the accuracy of LCF may be different from that on muscle strength. Hypofunction of the lips due to aging may result not only from decreased muscle strength but also from reduced LCF accuracy.
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Affiliation(s)
- Keiko Hijiya
- Department of Orthodontics, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Yuji Masuda
- Division of Oral and Maxillofacial Biology, Institute for Oral Science, Matsumoto Dental University, Shiojiri, Nagano, Japan; Department of Oral and Maxillofacial Biology, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri, Nagano, Japan.
| | - Takeshi Miyamoto
- Department of Orthodontics, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Ryosuke Shimono
- Department of Prosthodontics, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Toru Kageyama
- Department of Orthodontics, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Kazuhiro Yamada
- Department of Orthodontics, Matsumoto Dental University, Shiojiri, Nagano, Japan
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91
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Murakami K, Tokuda Y, Hori K, Minagi Y, Uehara F, Okawa J, Ishihara S, Nakauma M, Funami T, Maeda Y, Ikebe K, Ono T. Effect of fracture properties of gels on tongue pressure during different phases of squeezing and swallowing. J Texture Stud 2021; 52:303-313. [PMID: 33619744 DOI: 10.1111/jtxs.12593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 11/28/2022]
Abstract
To provide appropriate foods for elderly people with eating difficulties, it is necessary to take account of the ability of compensatory mastication such as tongue squeezing. However, the biomechanics of tongue squeezing is still unclear. The aim of present study is to investigate the effect of the initial mechanical properties of gels on the change in tongue pressure production during squeezing and swallowing. As test sample, nine kinds of gels with three fracture force and three fracture strain were prepared. Tongue pressure during squeezing and swallowing gels was measured by using an ultra-thin tongue pressure sensor with five measuring points attached on the hard palate in seven healthy participants, and analyzed at four phases; Initial squeeze, Middle squeeze, Last squeeze, and Swallowing. The maximal magnitude of tongue pressure was increased for gels with higher fracture force at most measuring points and was decreased for gels with higher fracture strain at some measuring points on the median line during Initial and Middle squeezing. However, no influence by fracture force and strain was found in magnitude during Last squeezing and Swallowing. The duration of tongue pressure increased for gels with higher force at most measuring points during Middle squeezing, although no influence by strain was found during each phase. The results clearly show how the initial fracture properties of gels influence on tongue pressure production during each phase of food oral processing, which clarified one aspect of squeezing with tongue, as the compensatory mastication.
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Affiliation(s)
- Kazuhiro Murakami
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Yoshitsugu Tokuda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Yoshitomo Minagi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Fumiko Uehara
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jumpei Okawa
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | | | | | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Suita, Japan
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92
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Stading M. Physical properties of a model set of solid, texture-modified foods. J Texture Stud 2021; 52:578-586. [PMID: 33599283 DOI: 10.1111/jtxs.12592] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 01/28/2023]
Abstract
Those suffering from swallowing disorders, or dysphagia, require texture-modified foods for safe swallowing. The texture is modified according to the severity of the disorder, as maintained by the guidelines outlining classes of texture-modified foods, ranging from viscous soups to soft, solid foods. As a basis for studies of bolus rheology and oral response of solid texture-modified foods, a set of well-defined, solid foods has been identified and characterized regarding texture and physical properties. Gelled food is compared to both the firmer timbale class and to the corresponding regular food. Foods eaten at room temperature were chosen to avoid temperature effects: bread, cheese, tomato, and the combination into a sandwich. All foods were tested as gel, timbale, and regular food. The texture was determined by compression and penetration tests, thereby showing a decrease in strength (compression stress), stiffness (modulus), and penetration force for increased degree of modification. The moisture content increased with increased degree of modification. The structural change from room to oral temperature was monitored by the complex shear modulus that showed a decrease with increasing temperature. Cheese and the gelatine-based tomato gel showed a distinct melting when the temperature was increased to 37°C. The texture-modified foods were softer and moister in all aspects as compared to the regular foods, which follows the intended modification. The classes for the texture-modified foods were qualitatively comparable to other national classification systems with regard to solid foods, but there is a lack of objective, physics-based classification of texture, especially for solid, texture-modified foods.
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Affiliation(s)
- Mats Stading
- RISE Research Institutes of Sweden, Gothenburg, Sweden.,Chalmers University of Technology, Gothenburg, Sweden
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93
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Tashiro K, Soutome S, Funahara M, Kawashita Y, Kitamura M, Fukuda H, Furugen R, Iwasaki T, Hayashida H, Kawasaki K, Higashi M, Nagayoshi M, Takamura N, Maeda T, Saito T. The Relationship between Dental Findings and Tongue Pressure: A Survey of 745 Community-Dwelling Adults and Elderly Persons in Japan. Gerontology 2021; 67:517-524. [PMID: 33596585 DOI: 10.1159/000513599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Reduced tongue pressure is one of the causes of dysphagia. The purpose of this study was to investigate the relationship between dental findings and tongue pressure, and whether prosthetic treatment prevents reduced tongue pressure. METHODS This was a cross-sectional study. Participants were 745 community-dwelling adults and elderly persons in the Goto Islands in Nagasaki, who underwent a health checkup for residents in 2015 and 2016. Data were collected on gender; age; grip strength; hemoglobin; Creatinine (Cr); glycated hemoglobin (HbA1c); history of stroke; smoking, drinking, exercise, and walking habits; number of teeth; wearing of removable dentures; functional units of natural teeth (n-FTUs), fixed prostheses (nif-FTUs), and removable dentures (t-FTUs); and tongue pressure. The associations between each variable and tongue pressure were examined using multiple regression analysis. Next, those with 3 or fewer n-FTUs were selected, and differences in tongue pressure were compared between those with 3 or fewer nif-FTUs and those with 4 or more nif-FTUs, using a propensity score matching method. RESULTS Male gender, weak grip strength, low HbA1c, no drinking, and a low number of teeth were independent factors significantly associated with lower tongue pressure. Among participants with 3 or fewer n-FTUs, the 43 with 4 or more nif-FTUs showed significantly higher tongue pressure than the 43 with 3 or fewer nif-FTUs after propensity score matching, although the number of t-FTUs was not associated with tongue pressure. DISCUSSION/CONCLUSION Tooth loss was significantly associated with lower tongue pressure. It was suggested that fixed prosthesis treatment might prevent the reduction of tongue pressure, but removable dentures did not have such an effect.
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Affiliation(s)
- Kensuke Tashiro
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Sakiko Soutome
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Madoka Funahara
- School of Oral Health Sciences, Kyushu Dental University, Fukuoka, Japan
| | - Yumiko Kawashita
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masayasu Kitamura
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Reiko Furugen
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Iwasaki
- Division of Dysphagia Rehabilitation, Department of Dentistry for the Disability and Oral Health, Asahi University, Gifu, Japan
| | | | - Koji Kawasaki
- Community Medical Network Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Takahiro Maeda
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshiyuki Saito
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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94
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Shimizu A, Fujishima I, Maeda K, Wakabayashi H, Nishioka S, Ohno T, Nomoto A, Kayashita J, Mori N. Nutritional Management Enhances the Recovery of Swallowing Ability in Older Patients with Sarcopenic Dysphagia. Nutrients 2021; 13:nu13020596. [PMID: 33670314 PMCID: PMC7917588 DOI: 10.3390/nu13020596] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 12/14/2022] Open
Abstract
This study assessed whether a high provided energy of ≥30 kcal/ideal body weight (IBW)/day (kg) for patients with sarcopenic dysphagia effectively improved swallowing ability and the activities of daily living (ADLs). Among 110 patients with sarcopenic dysphagia (mean age, 84.9 ± 7.4 years) who were admitted to a post-acute hospital, swallowing ability and the ADLs were assessed using the Food Intake LEVEL Scale (FILS) and the Functional Independence Measure (FIM), respectively. The primary outcome was the FILS at discharge, while the secondary outcome was the achievement of the FIM with a minimal clinically important difference (MCID) at discharge. We created a homogeneous probability model without statistically significant differences using the inverse probability of treatment weighting (IPTW) method with and without a mean provided energy of ≥30 kcal/IBW/day (kg) for a period of 1 week of hospitalization and compared the outcomes between groups. A mean provided energy of ≥30 kcal/IBW/day (kg) was achieved in 62.7% of patients. In the IPTW model, the FILS and the rates of achieved MCID of the FIM at discharge were significantly higher in the mean provided energy of ≥30 kcal/IBW/day (kg) group (p = 0.004 and p < 0.001, respectively). A high provided energy for patients with sarcopenic dysphagia may improve swallowing ability and produce clinically meaningful functional outcomes.
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Affiliation(s)
- Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8127, Japan
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (K.M.); (N.M.)
- Correspondence: ; Tel.: +81-53-471-8331; Fax: +81-53-474-8819
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8127, Japan;
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (K.M.); (N.M.)
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University, Shinjuku-ku 162-8666, Japan;
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan;
| | - Tomohisa Ohno
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8127, Japan; (T.O.); (A.N.)
| | - Akiko Nomoto
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8127, Japan; (T.O.); (A.N.)
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima 734-8558, Japan;
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (K.M.); (N.M.)
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95
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Kochi I, Takei E, Maeda R, Ito K, Magara J, Tsujimura T, Kulvanich S, Inoue M. Changes of bolus properties and the triggering of swallowing in healthy humans. J Oral Rehabil 2021; 48:592-600. [PMID: 33481324 DOI: 10.1111/joor.13151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
There is wide variation in chewing behaviours, even among healthy humans. Further, the way in which humans determine swallowing initiation when chewing solid foods remains unclear. The current study sought to investigate how the bolus properties change over time during chewing, and to clarify which factors affect chewing and swallowing behaviours, including swallowing initiation, in healthy humans. Twenty-four healthy volunteers were instructed to chew 8 g of steamed rice and spit it out at 50%, 100% and 150% of their own chewing duration, defined as the time of chewing from onset of the first chewing cycle to onset of the first swallow. Chewing and swallowing behaviours were monitored and determined by visual inspection of video recordings. The physical properties such as hardness, cohesiveness and adhesiveness as well as water content of the bolus were measured. In each subject, maximum bite force, tongue pressure and stimulated salivary flow rate were also measured. Hardness gradually decreased, and the cohesiveness and water content of the bolus did not change up to 50% of chewing duration, followed by a slight but significant increase. The adhesiveness of the bolus rapidly decreased at the beginning of chewing. Chewing duration was significantly related to stimulated salivary flow rate; greater salivary flow rate was associated with shorter chewing duration. Variation of chewing duration and swallowing initiation was not dependent on bolus properties during the chewing of steamed rice, but mainly depended on the surface lubrication of the bolus.
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Affiliation(s)
- Izumi Kochi
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Eri Takei
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Rumiko Maeda
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Rehabilitation, Faculty of Health Science, Kansai University of Welfare Sciences, Osaka, Japan
| | - Kayoko Ito
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Jin Magara
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takanori Tsujimura
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sirima Kulvanich
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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96
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Mancopes R, Gandhi P, Smaoui S, Steele CM. Which Physiological Swallowing Parameters Change with Healthy Aging? OBM GERIATRICS 2021; 5:10.21926/obm.geriatr.2101153. [PMID: 34350402 PMCID: PMC8330408 DOI: 10.21926/obm.geriatr.2101153] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Research suggests there are age-related changes in swallowing that do not constitute impairment ("presbyphagia"). The goal of this study was to explore the influence of age on quantitative measures of healthy swallowing by controlling for the effects of sex and sip volume in order to determine the specific characteristics of presbyphagia. Videofluoroscopy recordings of thin liquid swallows from 76 healthy adults (38 male), aged 21-82 were analysed. Blinded duplicate ratings of swallowing safety, efficiency, kinematics, and timing were made using the ASPEKT method. Hierarchical regression models were used to determine the effects of age, sex, and sip-volume on swallowing. There were no age-related changes in sip volume, number of swallows per bolus, frequency or severity of penetration-aspiration, duration of the hyoid-burst (HYB)-to-upper-esophageal-sphincter (UES) opening interval, time-to-laryngeal-vestibule-closure (LVC), peak hyoid position, hyoid speed, or pharyngeal residue. Significant changes seen with increasing age included: longer swallow reaction time, UES opening duration and LVC duration; larger pharyngeal area at rest and maximum constriction; and wider UES diameter. Male participants had larger sip volume and pharyngeal area at rest. Larger sip volumes were associated with multiple swallows per bolus and shorter hyoid-burst-to-UES opening intervals. These results help to define presbyphagic changes in swallowing that can be expected in healthy older adults up to 80 years of age, and distinguish them from changes that represent impairment. Certain parameters showed changes that were opposite in direction to changes that are usually considered to reflect impairment: longer UES opening, longer LVC duration and wider UES opening. These changes may reflect possible compensations for slower bolus transit. Further research is needed to determine the points along the age continuum where observed age-related changes in swallowing begin to emerge.
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Affiliation(s)
- Renata Mancopes
- Swallowing Rehabilitation Research Laboratory, KITE Research Institute — Toronto Rehabilitation Institute — University Health Network, 550 University Avenue, 12 floor, Toronto, Ontario, Canada, M5G 2A2
| | - Pooja Gandhi
- Swallowing Rehabilitation Research Laboratory, KITE Research Institute — Toronto Rehabilitation Institute — University Health Network, 550 University Avenue, 12 floor, Toronto, Ontario, Canada, M5G 2A2
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto,500 University Avenue, Suite 160, Toronto, ON, Canada, M5G 1V7
| | - Sana Smaoui
- Swallowing Rehabilitation Research Laboratory, KITE Research Institute — Toronto Rehabilitation Institute — University Health Network, 550 University Avenue, 12 floor, Toronto, Ontario, Canada, M5G 2A2
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto,500 University Avenue, Suite 160, Toronto, ON, Canada, M5G 1V7
| | - Catriona M. Steele
- Swallowing Rehabilitation Research Laboratory, KITE Research Institute — Toronto Rehabilitation Institute — University Health Network, 550 University Avenue, 12 floor, Toronto, Ontario, Canada, M5G 2A2
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto,500 University Avenue, Suite 160, Toronto, ON, Canada, M5G 1V7
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97
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Mori T, Wakabayashi H, Ogawa N, Fujishima I, Oshima F, Itoda M, Kunieda K, Shigematsu T, Nishioka S, Tohara H, Yamada M, Ogawa S. The Mass of Geniohyoid Muscle Is Associated with Maximum Tongue Pressure and Tongue Area in Patients with Sarcopenic Dysphagia. J Nutr Health Aging 2021; 25:356-360. [PMID: 33575728 DOI: 10.1007/s12603-020-1528-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We investigated the associations about the mass of geniohyoid and tongue muscle and the maximum tongue pressure in patients with sarcopenic dysphagia using ultrasonography. DESIGN Cross sectional study. SETTING 5 hospitals including 3 acute and 2 rehabilitation hospitals and 1 older facility. PARTICIPANTS 36 inpatients with sarcopenic dysphagia. MEASUREMENTS Ultrasonography was performed for geniohyoid muscle and tongue. The area for geniohyoid and tongue muscles in sagittal plane and the mean brightness level (0-255) in the muscle area were calculated. Maximum tongue pressure as strength of swallowing muscle were investigated. Partial correlation coefficient and multiple regression analysis adjusting for age and sex were performed. RESULTS The mean age was 81.1 ± 7.9. Men were 23. The mean BMI was 19.0 ± 4.1. The mean maximum tongue pressure was 21.3 ± 9.3 kPa. The mean cross sectional area for geniohyoid muscles was 140 ± 47 mm2. The mean brightness for geniohyoid muscle was 18.6 ± 9.0. The mean cross sectional area for tongue muscles was 1664.1 ± 386.0 mm2. The mean brightness for tongue muscles was 34.1 ± 10.6. There was a significant positive correlation between area of geniohyoid muscle and maximum tongue pressure (r = 0.38, p = 0.04). Geniohyoid muscle area was an explanatory factor for maximum tongue pressure (p = 0.012) and tongue muscle area (p = 0.031) in multivariate analysis. CONCLUSIONS Geniohyoid muscle mass was an independent explanatory factor for maximum tongue pressure and tongue muscle mass.
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Affiliation(s)
- T Mori
- Hidetaka Wakabayashi, MD, PhD, Dpt. of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Japan, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan. Code; 162-0054, , Tel: +81-3-3353-8111, FAX: +81-3-5269-7639
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98
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Morishita M, Ikeda T, Saito N, Sanou M, Yasuda M, Takao S. Relationship between oral function and life-space mobility or social networks in community-dwelling older people: A cross-sectional study. Clin Exp Dent Res 2020; 7:552-560. [PMID: 33325146 PMCID: PMC8404499 DOI: 10.1002/cre2.381] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES This study aimed to clarify the relationship between oral function and life-space mobility or social networks in order to explore approaches that prevent a decline in oral function. MATERIALS AND METHODS A total of 113 community-dwelling older people (mean age; 75.7 ± 7.3 years) who participated in preventive long-term care projects aimed at the maintenance or improvement of physical and mental functions were included in this study. The life-space assessment (LSA) was used to evaluate life-space mobility, while the Lubben Social Network Scale-6 (LSNS-6) was employed to assess social networks. Oral function was measured by maximum voluntary tongue pressure, oral diadochokinesis, the repetitive saliva swallowing test, and lip pressure. Indices of frailty were grip strength and the Kihon Checklist score. Multiple regression analysis was performed to clarify whether the LSA, LSNS-6, and frailty are associated with oral function. RESULTS The results of the Kihon Checklist showed that 63 participants (56%) were subjectively and at least slightly aware of a decline in oral function. LSA (B = 0.222, p < .001) and grip strength (B = 0.266, p = .003) associated with maximum voluntary tongue pressure. The goodness of fit of the predictive model was an adjusted R2 value of .486. Other oral functions were not associated with any factors and the goodness of fit of the model was poor (Adjusted R2 < .1). LSNS-6 was not associated with any oral function. CONCLUSIONS Life-space mobility and grip strength were independent factors associating maximum voluntary tongue pressure, while social networks did not directly association oral function. This study suggests the necessity of a program that approaches both oral and physical functions through guidance for securing a certain amount of daily activity for older people at risk of or exhibiting a decline in maximum voluntary tongue pressure.
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Affiliation(s)
- Motoyoshi Morishita
- Department of Physical Therapy, Kibi International University, Takahashi, Japan
| | - Taeka Ikeda
- Community General Support Center, Asakuchi City Office, Asakuchi, Japan
| | - Natsue Saito
- Community General Support Center, Asakuchi City Office, Asakuchi, Japan
| | - Mihoko Sanou
- Community General Support Center, Asakuchi City Office, Asakuchi, Japan
| | - Mayumi Yasuda
- Department of Health and Welfare, Asakuchi City Office, Asakuchi, Japan
| | - Shigeko Takao
- Department of Nursing, Kibi International University, Takahashi, Japan
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99
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Yoshimi K, Nakagawa K, Hara K, Yamaguchi K, Nakane A, Kubota K, Furuya J, Tohara H. Relationship between tongue pressure and back muscle strength in healthy elderly individuals. Aging Clin Exp Res 2020; 32:2549-2555. [PMID: 32006384 DOI: 10.1007/s40520-020-01484-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/13/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Aging is associated with a decrease in muscle mass and strength in swallowing muscles, as well as in whole-body muscles. A decrease in tongue pressure (TP) is related with whole-body function, and the trunk, including abdominal and back muscles, forms the core of the body. However, the direct relationship between TP and trunk muscle strength remains unclear. AIMS To clarify the association between back muscle strength, an indicator of trunk muscle strength, and TP in healthy elderly individuals. METHODS In all, 112 healthy community-dwelling individuals aged ≥ 60 years (men: 35, median age 74.0; women: 77, median age 69.0) were included. Body mass index (BMI), TP, and back muscle strength (BMS) were measured. Tooth loss pattern was evaluated by the Eichner classification. Participants were divided into two groups based on the median of the BMS and classified into three groups based on the Eichner index (Eichner A, B, and C). The effects of BMS and occlusal support on TP were analyzed. RESULTS In the low BMS group, there was a significant difference in TP between the Eichner B and Eichner C (p = 0.017) groups. However, in the high BMS group, occlusal support did not affect TP. Moreover, the explanatory factors for TP were BMS (β = 0.373, p = 0.001) and the Eichner index (β = 0.190, p = 0.036). CONCLUSIONS TP was correlated more with BMS than aging and occlusal support in healthy elderly individuals. This study indicated that the clinical evaluation of the whole body is important when assessing oral and swallowing function.
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100
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Relationship between Maximum Tongue Pressure Value and Age, Occlusal Status, or Body Mass Index among the Community-Dwelling Elderly. ACTA ACUST UNITED AC 2020; 56:medicina56110623. [PMID: 33227957 PMCID: PMC7699140 DOI: 10.3390/medicina56110623] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023]
Abstract
Background and objectives: In an aging society, the maintenance of the oral function of the elderly is of importance for the delay or prevention of frailty and long-term care. In the present study, we focused on the maximum tongue pressure (MTP) value and analyzed the relationship between MTP and age, occlusal status, or body mass index (BMI). Materials and Methods: This one-center observatory study was conducted using a cohort consisting of 205 community-dwelling outpatients over 65 years old. The MTP values of all subjects were measured using a commercially available tongue pressure measurement device and statistically analyzed. In addition, the correlation between MTP value and BMI was analyzed. Results: The MTP value decreased with age, especially in subjects classified as Eichner B and C. The difference in occlusal status did not show any statistically significant influence on MTP value. The correlation between BMI and MTP value was indicated in the tested groups other than an age of 65–74 and Eichner A groups. Conclusions: Although MTP value decreased with age, the difference in occlusal status did not have an impact on MTP value. The correlation between BMI and MTP value was not shown in the youngest group or a group with sufficient occlusal units. The results presented in the present study may imply that, even if MTP is low, younger age and/or better occlusal status compensate for the inferior MTP value in the cohort studied.
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