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Curtis JA, Diaz C, Lee T, Rameau A. Validation of a Low-Cost Manometer to Assess of Tongue, Lip, Cheek, and Respiratory Strength: A Laboratory-Based Study. Laryngoscope 2024. [PMID: 39177166 DOI: 10.1002/lary.31727] [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: 04/10/2024] [Revised: 07/15/2024] [Accepted: 08/08/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVE(S) The objective of this study was to characterize the level of agreement between three manometers: (1) Iowa Oral Performance Instrument (IOPI)-the reference standard for tongue, lip, and cheek strength assessments; (2) MicroRPM Respiratory Pressure Meter (MicroRPM)-the reference standard for respiratory strength assessments; and (3) Digital Pressure Manometer (DPM)-an alternative, low-cost pressure testing manometer. METHODS Manual pressures were simultaneously applied to the IOPI and DPM, and to the MicroRPM and DPM, within a controlled laboratory setting. Agreement in pressure readings were analyzed using descriptive statistics, Lin's concordance correlation, and Bland-Altman Plots. Agreement was interpreted as "poor" if ρc < 0.90, "moderate" if ρc = 0.90 - < 0.95, "substantial" if ρc = 0.95 - < 0.99, and "excellent" if ρc ≥ 0.99. RESULTS Differences in pressure readings between the DPM and clinical reference standards were consistently present yet highly predictable. There was a median absolute difference of 2.0-3.9 kPa between the IOPI and DPM, and 4.5-9.8 cm H2O between the MicroRPM and DPM. Lin's concordance revealed "substantial" agreement between the IOPI and DPM (ρc = 0.98) and the MicroRPM and DPM (ρc = 0.99). CONCLUSION The DPM revealed higher pressure readings when compared to the IOPI and MicroRPM. However, differences in pressure readings were relatively small, highly predictable, and yielded substantial overall agreement. These findings suggest the DPM may be a valid, lower-cost alternative for objective assessments of tongue, lip, cheek, and respiratory muscle strength. Future research should expand on the present findings in clinical patient populations. LEVEL OF EVIDENCE NA Laryngoscope, 2024.
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Affiliation(s)
- James A Curtis
- Aerodigestive Innovations Research lab (AIR), Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medical College of Cornell University, New York, New York, U.S.A
| | - Crystal Diaz
- Aerodigestive Innovations Research lab (AIR), Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medical College of Cornell University, New York, New York, U.S.A
- Communication Sciences and Disorders Program, Department of Biobehavioral Sciences, Teachers College of Columbia University, New York, New York, U.S.A
| | - Theresa Lee
- Aerodigestive Innovations Research lab (AIR), Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medical College of Cornell University, New York, New York, U.S.A
- Communication Sciences and Disorders Program, Department of Biobehavioral Sciences, Teachers College of Columbia University, New York, New York, U.S.A
| | - Anaïs Rameau
- Laryngology Innovation Lab, Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medical College of Cornell University, New York, New York, U.S.A
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Ito Y, Tanaka Y, Daidoji A, Al Khalili H, Hattori Y. Relationship between texture perception and oral function: A preliminary study in young, healthy adults. J Oral Rehabil 2024; 51:1229-1235. [PMID: 38641861 DOI: 10.1111/joor.13702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/05/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Oral frailty, characterised by reduced oral function, is associated with systemic health issues in older adults. Although the criteria for diminished oral function often focus on motor and secretory abilities, texture perception also plays a crucial role in health due to its impact on food intake and palatability. OBJECTIVE This study aimed to explore the relationship between thickness discrimination ability (TDA) and oral motor and secretory functions in healthy young individuals. METHODS Twenty-eight adults were assessed for texture perception using eight concentrations of aqueous xanthan gum solutions to determine TDA scores. Measurements of occlusal force, masticatory performance, tongue pressure, stimulated salivary flow rate and tongue-lip motor function were conducted. Spearman's correlation analysis was used to evaluate the relationship between TDA scores and oral functions. Participants were divided into high-sensitivity and low-sensitivity groups based on their TDA scores to compare oral function test results. RESULTS The TDA scores varied among the participants, with higher scores correlating with higher masticatory performance (r = 0.41, p < .05). Masticatory performance in the high-sensitivity group was significantly higher than in the low-sensitivity group (211.9 ± 59.2 mg/dL vs. 157.9 ± 43.0 mg/dL, p = .013), with no significant differences in other oral functions. CONCLUSION Masticatory performance was correlated with TDA, suggesting a link between the selection function of mastication and thickness discrimination. These findings highlight the potential relevance of texture perception in oral function and indicate the need for further exploration, particularly in older adults with declining oral health.
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Affiliation(s)
- Yuki Ito
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yasue Tanaka
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Akinari Daidoji
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Hala Al Khalili
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Nakamori M, Imamura E, Maetani Y, Yoshida M, Yoshikawa M, Nagasaki T, Masuda S, Kayashita J, Mizoue T, Wakabayashi S, Maruyama H, Hosomi N. Prospective Observational Study for the Comparison of Screening Methods Including Tongue Pressure and Repetitive Saliva Swallowing With Detailed Videofluoroscopic Swallowing Study Findings in Patients With Acute Stroke. J Am Heart Assoc 2024; 13:e032852. [PMID: 38293925 PMCID: PMC11056116 DOI: 10.1161/jaha.123.032852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Simple, noninvasive, and repeatable screening methods are essential for assessing swallowing disorders. We focused on patients with acute stroke and aimed to assess the characteristics of swallowing screening tests, including the modified Mann Assessment of Swallowing Ability score, tongue pressure, and repetitive saliva swallowing test (RSST), compared with detailed videofluoroscopic swallowing study (VFSS) findings to contribute as a helpful resource for their comprehensive and complementary use. METHODS AND RESULTS We enrolled first-ever patients with acute stroke conducting simultaneous assessments, including VFSS, modified Mann Assessment of Swallowing Ability score, tongue pressure measurement, and RSST. VFSS assessed aspiration, laryngeal penetration, oral cavity residue, vallecular residue, pharyngeal residue, and swallowing reflex delay. Screening tests were compared with VFSS findings, and multiple logistic analysis determined variable importance. Cutoff values for each abnormal VFSS finding were assessed using receiver operating characteristic analyses. We evaluated 346 patients (70.5±12.6 years of age, 143 women). The modified Mann Assessment of Swallowing Ability score was significantly associated with all findings except aspiration. Tongue pressure was significantly associated with oral cavity and pharyngeal residue. The RSST was significantly associated with all findings except oral cavity residue. Receiver operating characteristic analyses revealed that the minimum cutoff value for all VFSS abnormal findings was RSST ≤2. CONCLUSIONS The modified Mann Assessment of Swallowing Ability is useful for broadly detecting swallowing disorders but may miss mild issues and aspiration. The RSST, with a score of ≤2, is valuable for indicating abnormal VFSS findings. Tongue pressure, especially in oral and pharyngeal residues, is useful. Combining these tests might enhance accuracy of the swallowing evaluation.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and TherapeuticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
- Department of NeurologySuiseikai Kajikawa HospitalHiroshimaJapan
| | - Eiji Imamura
- Department of NeurologySuiseikai Kajikawa HospitalHiroshimaJapan
| | - Yuta Maetani
- Department of Clinical Neuroscience and TherapeuticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
- Department of NeurologySuiseikai Kajikawa HospitalHiroshimaJapan
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeAichiJapan
- Department of Advanced ProsthodonticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
| | - Mineka Yoshikawa
- Department of Advanced ProsthodonticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial RadiologyHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
| | - Shin Masuda
- Department of Children SensoryHiroshima Prefectural HospitalHiroshimaJapan
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and SciencesPrefectural University of HiroshimaHiroshimaJapan
| | - Tatsuya Mizoue
- Department of NeurosurgerySuiseikai Kajikawa HospitalHiroshimaJapan
| | | | - Hirofumi Maruyama
- Department of Clinical Neuroscience and TherapeuticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
| | - Naohisa Hosomi
- Department of NeurologyChikamori HospitalKochiJapan
- Department of Disease Model, Research Institute of Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
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Nakamori M, Shimizu Y, Takahashi T, Toko M, Yamada H, Hayashi Y, Ushio K, Yoshikawa K, Hiraoka A, Yoshikawa M, Nagasaki T, Mikami Y, Maruyama H. Swallowing sound index analysis using electronic stethoscope and artificial intelligence for patients with Parkinson's disease. J Neurol Sci 2023; 454:120831. [PMID: 37837871 DOI: 10.1016/j.jns.2023.120831] [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: 08/22/2023] [Revised: 09/20/2023] [Accepted: 10/08/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND AND PURPOSE Several noninvasive tools assess swallowing disorders, including electronic stethoscope artificial intelligence (AI) analysis for remote diagnosis, with the potential for telemedicine. This study investigated the swallowing sound index in patients with Parkinson's disease (PD). METHODS This single-arm, open-label trial assessed the impact of cervical percutaneous interferential current stimulation on swallowing in patients with PD classified as Hoehn-Yahr stages 2-4. Stimulation was conducted for 8 weeks. Baseline data were used to examine the link between the swallowing sound index and indicators such as videofluoroscopy (VF). Furthermore, we examined changes in the swallowing sound index after the intervention. RESULTS Twenty-five patients were included. The swallowing sound index in patients with PD was higher than that in those with amyotrophic lateral sclerosis but considerably lower than that in healthy controls. The number of patients with normal EAT-10 scores positively correlated with the swallowing sound index, whereas elevated C-reactive protein levels were negatively correlated with the swallowing sound index. However, the index displayed no correlation with other indicators, including the VF results. Despite the intervention, the index remained unchanged throughout the study. CONCLUSION In patients with PD, a decrease in the swallowing sound index suggests a potential association between swallowing disorders and the risk of aspiration pneumonia. TRIAL REGISTRATION NUMBER jRCTs062220013.
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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.
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tamayo Takahashi
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Kohei Yoshikawa
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Nakamori M, Ishikawa R, Watanabe T, Toko M, Naito H, Takahashi T, Simizu Y, Yamazaki Y, Maruyama H. Swallowing sound evaluation using an electronic stethoscope and artificial intelligence analysis for patients with amyotrophic lateral sclerosis. Front Neurol 2023; 14:1212024. [PMID: 37602264 PMCID: PMC10435850 DOI: 10.3389/fneur.2023.1212024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/11/2023] [Indexed: 08/22/2023] Open
Abstract
Background and purpose Non-invasive, simple, and repetitive swallowing evaluation is required to prevent aspiration pneumonia in neurological care. We investigated the usefulness of swallowing sound evaluation in patients with amyotrophic lateral sclerosis (ALS) using our new electronic stethoscope artificial intelligence (AI) analysis tool. Methods We studied patients with ALS who provided written informed consent. We used an electronic stethoscope, placed a Bluetooth-enabled electronic stethoscope on the upper end of the sternum, performed a 3-mL water swallow three times, and remotely identified the intermittent sound components of the water flow caused at that time by AI, with the maximum value as the swallowing sound index. We examined the correlation between the swallowing sound index and patient background, including swallowing-related parameters. Results We evaluated 24 patients with ALS (age 64.0 ± 11.8 years, 13 women, median duration of illness 17.5 months). The median ALS Functional Rating Scale-Revised (ALSFRS-R) score was 41 (minimum 18, maximum 47). In all cases, the mean swallowing sound index was 0.209 ± 0.088. A multivariate analysis showed that a decrease in the swallowing sound index was significantly associated with a low ALSFRS-R score, an ALSFRS-R bulbar symptom score, % vital capacity, tongue pressure, a Mann Assessment of Swallowing Ability (MASA) score, and a MASA pharyngeal phase-related score. Conclusion Swallowing sound evaluation using an electronic stethoscope AI analysis showed a correlation with existing indicators in swallowing evaluation in ALS and suggested its usefulness as a new method. This is expected to be a useful examination method in home and remote medical care.
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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
| | - Ruoyi Ishikawa
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomoaki Watanabe
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroyuki Naito
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tamayo Takahashi
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoshitaka Simizu
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yu Yamazaki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Liu J, Yu S, Xu Y, Li J, Liu B, Liu S, Ning H, Xu D, Low SS. In situ quantitative assessment of food oral processing parameters: A review of feasible techniques and devices. J Texture Stud 2023; 54:3-20. [PMID: 36222444 DOI: 10.1111/jtxs.12728] [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: 06/24/2022] [Revised: 09/25/2022] [Accepted: 10/01/2022] [Indexed: 11/30/2022]
Abstract
Oral processing is a combination of various actions, the detailed description of which has always been the subject of relevant research. By means of imaging technology and sensory evaluation, more knowledge of oral processing have been accumulated. Presently, the advances in sensory technology have added quantitative parameters to the qualitative description of oral processing, which also enriched the specifics of each action. Previous studies have shown that oral processing includes lip closure, dental occlusion, masticatory muscles activity, tongue movement, and swallowing, whose processing contains rich information such as the movement of organ and the intensity of organ contacts. "Quantification" was taken in this review as the basic feature of in situ detection information, the relevant parameters and feasible methods for the quantitative description of each activity was recorded in detail. In addition, basic problems and feasible optimization schemes of the existing in situ detection device are also proposed in the hope of promoting the development of in situ detection device thus providing available information for the description of oral processing.
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Affiliation(s)
- Jingjing Liu
- College of Automation Engineering, Northeast Electric Power University, Jilin, China
| | - Shixin Yu
- College of Automation Engineering, Northeast Electric Power University, Jilin, China
| | - Yifei Xu
- College of Automation Engineering, Northeast Electric Power University, Jilin, China
| | - Jiangyong Li
- College of Automation Engineering, Northeast Electric Power University, Jilin, China
| | - Boyu Liu
- College of Automation Engineering, Northeast Electric Power University, Jilin, China
| | - Shikun Liu
- College of Automation Engineering, Northeast Electric Power University, Jilin, China
| | - Haohao Ning
- College of Automation Engineering, Northeast Electric Power University, Jilin, China
| | - Dongfu Xu
- College of Automation Engineering, Northeast Electric Power University, Jilin, China
| | - Sze Shin Low
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo, China
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Kamimura T, Nakamori M, Naito H, Aoki S, Nezu T, Imamura E, Mizoue T, Wakabayashi S, Masuda T, Hattori N, Maruyama H, Hosomi N. Peak expiratory flow, but not tongue pressure, can predict pneumonia development in older adults. Eur Geriatr Med 2023; 14:211-217. [PMID: 36640229 DOI: 10.1007/s41999-023-00744-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/04/2023] [Indexed: 01/15/2023]
Abstract
PURPOSE Pneumonia is the leading cause of mortality and morbidity in aging populations. Major causes of pneumonia in older adults are swallowing dysfunction and decreased airway clearance capacity, including an impaired cough reflex. Maximal tongue pressure is useful for evaluating swallowing function, and peak expiratory flow indirectly reflects cough strength. However, it is unclear whether they can predict pneumonia development in older adults. In this study, we investigated whether tongue pressure and peak expiratory flow could predict pneumonia development in older adults. METHODS This two-center prospective observational study included older adults aged 65 years or older without respiratory disease or head and neck cancer. We enrolled 383 consenting participants, many of whom had a history of stroke, and followed them for 2 years. The association between time to pneumonia development and tongue pressure or peak expiratory flow at enrollment was examined in a Cox proportional hazards model. RESULTS The mean age of the participants was 77.1 ± 6.2 years, and 36.0% of them were women. The mean tongue pressure was 35.4 ± 10.5 kPa and median peak expiratory flow was 218 L/min at enrollment. Six patients developed pneumonia during the study period. A low peak expiratory flow at enrollment was significantly associated with pneumonia development in the multivariate Cox proportional hazards model, but this association was not observed for tongue pressure. CONCLUSION Decreased peak expiratory flow may predict pneumonia development in older adults. Future studies should investigate interventions for peak expiratory flow improvement.
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Affiliation(s)
- Teppei Kamimura
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi, Minami-ku, Hiroshima-City, Hiroshima, Japan
| | - Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi, Minami-ku, Hiroshima-City, Hiroshima, Japan.
| | - Hiroyuki Naito
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi, Minami-ku, Hiroshima-City, Hiroshima, Japan
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi, Minami-ku, Hiroshima-City, Hiroshima, Japan
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi, Minami-ku, Hiroshima-City, Hiroshima, Japan
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tatsuya Mizoue
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | | | - Takeshi Masuda
- Department of Respiratory Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Noboru Hattori
- Molecular and Internal Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi, Minami-ku, Hiroshima-City, Hiroshima, Japan
| | - Naohisa Hosomi
- Department of Neurology, Chikamori Hospital, Kochi, Japan.,Department of Disease Model, Research Institute of Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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Nakao-Kato M, Izumi SI, Maeno Y, Steele CM. A Case of Progressive Ataxia, Dysphagia, and Dysarthria Caused by a Rare Disease, and Treatment with Lingual Resistance Training. Dysphagia 2023; 38:1001-1003. [PMID: 36670318 DOI: 10.1007/s00455-022-10551-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/28/2022] [Indexed: 01/21/2023]
Affiliation(s)
- Mari Nakao-Kato
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan.
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Yutaka Maeno
- Rehabilitation Department, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Catriona M Steele
- KITE Research Institute - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Canada Research Chair (Tier 1) in Swallowing and Food Oral Processing, Ottawa, ON, Canada
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Effect of Tongue-Pressure Resistance Training in Poststroke Dysphagia Patients With Oral Motor Dysfunction: A Randomized Controlled Trial. Am J Phys Med Rehabil 2022; 101:1134-1138. [PMID: 35320813 DOI: 10.1097/phm.0000000000001998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aims of the study were to investigate the effect of tongue-pressure resistance training in poststroke dysphagia patients with oral motor dysfunction and to examine the therapeutic value of tongue-pressure resistance training in the oral and pharyngeal phases. DESIGN Patients were divided into an experimental and a control group. Both groups received 30 mins of traditional swallowing rehabilitation treatment every day for 4 wks. In addition, the experimental group received tongue-pressure resistance training for an extra 20 mins/d. Maximum tongue pressure and fiberoptic endoscopic examination of swallowing were assessed before and after treatments. RESULTS Compared with the control group, the experimental group showed significant improvement in Functional Communication Measure for swallowing, Oral Motor Function Scale, maximum tongue pressure, Murray Secretion Scale, Rosenbek Penetration-Aspiration Scale, and food residue in pyriform sinuses ( P < 0.05). There was no significant difference in food residue in epiglottic vallecula between both groups ( P > 0.05). CONCLUSIONS This study demonstrated that tongue-pressure resistance training is an effective approach to improve the overall swallowing function in patients with oral motor dysfunction. The improvement of oral motor function could facilitate the recovery of pharyngeal motor function. Tongue-pressure resistance training seems to have more clearance of residue in piriform sinus than epiglottic vallecula.
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Improvement in Tongue Pressure Precedes Improvement in Dysphagia in Dermatomyositis. Clin Pract 2022; 12:797-802. [PMID: 36286069 PMCID: PMC9600123 DOI: 10.3390/clinpract12050083] [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: 07/07/2022] [Revised: 09/24/2022] [Accepted: 09/28/2022] [Indexed: 11/23/2022] Open
Abstract
Dysphagia is known to occur in patients with dermatomyositis. However, the sudden-onset dysphagia without other symptoms can make diagnosis and treatment challenging. Two patients who did not have a severe muscle weakness complained of the sudden inability to swallow solids and liquids. The muscle biopsy results showed the perifascicular atrophy, and the patients were diagnosed with dermatomyositis. Videofluoroscopy revealed an inadequate pharyngeal contraction and a decreased upper esophageal sphincter opening with silent aspiration. Both patients showed low tongue pressures. Patient 1 received intravenous and oral methylprednisolone, and patient 2 received intravenous immunoglobulin in addition to intravenous and oral methylprednisolone. Several months after the onset of the dysphagia, the swallowing function of both patients improved. The improvement in tongue pressure preceded an improvement in the subjective and objective measurements of dysphagia. In conclusion, tongue pressure may be useful for predicting early improvement in swallowing function.
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11
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Fukuoka T, Ono T, Hori K, Kariyasu M. Effects of Tongue-Strengthening Exercise on Tongue Strength and Effortful Swallowing Pressure in Young Healthy Adults: A Pilot Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1686-1696. [PMID: 35363546 DOI: 10.1044/2022_jslhr-21-00331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to investigate the effects of tongue-strengthening exercise (TSE) on tongue strength and effortful swallowing pressure in young healthy adults. METHOD Thirteen young healthy volunteers (six men, seven women; M age = 20.5 ± 0.5 years) performed 8 weeks of isometric TSE 3 days per week. A tongue pressure measurement device was used to measure maximum isometric tongue pressure (MITP) and conduct the TSE, and a tactile sensor system attached to the hard palate was used to measure effortful swallowing pressure. MITP and effortful swallowing pressure were measured at baseline, after 4 and 8 weeks of training, and at 4 and 8 weeks after the last training session to examine the detraining effects. RESULTS The results indicated that both MITP and effortful swallowing pressure increased significantly from baseline to 8 weeks after training. Although the improved MITP significantly decreased at 4 and 8 weeks after training cessation, no detraining effect was observed for effortful swallowing pressure. CONCLUSIONS TSE is an effective method for increasing tongue pressure in wide tongue-palate contact areas during effortful swallow. The effortful swallowing pressure gained with TSE appears to be maintained for at least eight nontraining weeks.
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Affiliation(s)
- Tatsuyuki Fukuoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Japan
| | - Makoto Kariyasu
- Human Communication Science Laboratories, Nobeoka, Japan
- Institute of Junwa Rehabilitation Foundation, Miyazaki, Japan
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12
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Gonzalez-Martinez JF, Boyd H, Gutfreund P, Welbourn RJ, Robertsson C, Wickström C, Arnebrant T, Richardson RM, Prescott SW, Barker R, Sotres J. MUC5B mucin films under mechanical confinement: A combined neutron reflectometry and atomic force microscopy study. J Colloid Interface Sci 2022; 614:120-129. [DOI: 10.1016/j.jcis.2022.01.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/05/2022] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
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13
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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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14
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Alvarado C, Arminjon A, Damieux-Verdeaux C, Lhotte C, Condemine C, Cousin AS, Sigaux N, Bouletreau P, Mateo S. Impaired tongue motor control after temporomandibular disorder: A proof-of-concept case-control study of tongue print. Clin Exp Dent Res 2022; 8:529-536. [PMID: 35220688 PMCID: PMC9033548 DOI: 10.1002/cre2.549] [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: 12/18/2021] [Accepted: 02/11/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) perturbs the tongue motor control and consequently impairs oral function, but strength training reduces this impairment. However, tongue motor control is widely reduced to a matter of strength. OBJECTIVES To investigate the accuracy of the tongue placement as a measure of tongue motor control in patients with TMD compared with age- and sex-matched healthy participants. MATERIAL AND METHODS This proof-of-concept case-control study was prospective, observational, and part of the TMIQ study (NCT04102306). After pointing against a wood stick while maintaining the tongue as sharp as possible, the examinator drew the contour of the tongue print on the wood stick, which was then scanned for image analyses to compute the area for each participant using ImageJ. RESULTS A total of 94 participants were included, all patients with TMD (n = 47) diagnosed with myalgia, 61% with intra-articular joint disorder accordingly to the DC/TMD. The median (IQR) tongue print area was 117 (111) mm2 for the TMD group and 93.5 (76.2) mm2 for the control group (V = 352, p = .04) and the median [95% confidence interval] difference was 25.4 [1.3; 51.0] mm². Overlapping of the 95% confidence intervals of the area evidenced no significant difference between the categories of the DC/TMD. The corrected each area-total correlation (r = .24) suggests a reasonably homogenous thus valid measure. CONCLUSION The results suggest that TMD impairs the motor control of the tongue. Therefore, the sharpest tongue pointing test may constitute a simple and accessible clinical tool to assess the accuracy of tongue placement in TMD patients. The study was registered on ClinicalTrial.gov with identification number NCT04102306.
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Affiliation(s)
| | | | | | - Claire Lhotte
- Cabinet de kinésithérapie Saint-Alexandre, Lyon, France
| | - Chloé Condemine
- Cabinet de kinésithérapie Saint-Alexandre, Lyon, France.,Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Anne-Sabine Cousin
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Nicolas Sigaux
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Pierre Bouletreau
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Sébastien Mateo
- Lyon Neuroscience Research Center, Trajectoires Team, CNRS UMR5292, INSERM U1028, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Hôpital Henry Gabrielle, Plate-forme Mouvement et Handicap, Lyon, France
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15
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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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16
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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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17
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Characteristics and Prognostic Factors of Swallowing Dysfunction in Patients with Lateral Medullary Infarction. J Stroke Cerebrovasc Dis 2021; 30:106122. [PMID: 34583216 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106122] [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: 06/25/2021] [Revised: 08/30/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Lateral medullary infarction mainly impairs the pharyngeal phase of swallowing. We aimed to investigate the utility of the assessment tools of swallowing function in patients with lateral medullary infarction and to determine the factors that could predict the outcomes of swallowing function. MATERIALS AND METHODS 15 patients with lateral medullary infarction who were admitted to Suiseikai Kajikawa Hospital between August 1, 2016, and March 31, 2020 (age 62.7 ± 14.8 years, 5 women) were enrolled in this prospective study. The diagnosis was made using brain magnetic resonance imaging. We analyzed the factors associated with severe swallowing dysfunction, which was defined as the necessity for tube feeding on the 90th day from admission, with multiple logistic regression analysis. RESULTS Multivariate analyses identified the repetitive saliva swallowing test, modified water swallowing test, and vertical spread of stroke lesions as independent significant factors affecting severe swallowing dysfunction (p = 0.002, 0.016, and 0.011, respectively). The sub-scores of the pharyngeal phase of the Mann Assessment of Swallowing Ability were also significantly associated with severe swallowing dysfunction (p < 0.001). However, tongue pressure, severe passage pattern abnormality on videofluoroscopic examination, and vertebral artery dissection were not significantly associated with swallowing dysfunction. CONCLUSIONS Since lateral medullary infarction presents with swallowing dysfunction mainly in the pharyngeal phase, tools that can be used to evaluate the pharyngeal phase of swallowing, such as repetitive saliva swallowing test and modified water swallowing test, are moreuseful than tongue pressure measurement.
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18
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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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19
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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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20
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Noninvasive Measurement of Tongue Pressure and Its Correlation with Swallowing and Respiration. SENSORS 2021; 21:s21082603. [PMID: 33917263 PMCID: PMC8068065 DOI: 10.3390/s21082603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/17/2022]
Abstract
Tongue pressure plays a critical role in the oral and pharyngeal stages of swallowing, contributing considerably to bolus formation and manipulation as well as to safe transporting of food from the mouth to the stomach. Smooth swallowing relies not only on effective coordination of respiration and pharynx motions but also on sufficient tongue pressure. Conventional methods of measuring tongue pressure involve attaching a pressure sheet to the hard palate to monitor the force exerted by the tongue tip against the hard palate. In this study, an air bulb was inserted in the anterior oral cavity to monitor the pressure exerted by the extrinsic and intrinsic muscles of the tongue. The air bulb was integrated into a noninvasive, multisensor approach to evaluate the correlation of the tongue pressure with other swallowing responses, such as respiratory nasal flow, submental muscle movement, and thyroid cartilage excursion. An autodetection program was implemented for the automatic identification of swallowing patterns and parameters from each sensor. The experimental results indicated that the proposed method is sensitive in measuring the tongue pressure, and the tongue pressure was found to have a strong positive correlation with the submental muscle movement during swallowing.
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21
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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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22
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Rodríguez-Alcalá L, Martín-Lagos Martínez J, O´Connor-Reina C, Plaza G. Assessment of muscular tone of the tongue using a digital measure spoon in a healthy population: A pilot study. PLoS One 2021; 16:e0245901. [PMID: 33600465 PMCID: PMC7891707 DOI: 10.1371/journal.pone.0245901] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/03/2021] [Indexed: 12/16/2022] Open
Abstract
The study of the muscles of the tongue forms part of a basic evaluation of upper airway function that includes swallowing, speaking and chewing. It is important because the upper airway presents a region of collapse during sleep. Through the action of the dilator muscles, mainly the genioglossus, such collapse can be prevented. In this study, we present a simple tool that can be used to measure the strength of the tongue. This tool may provide an easy way to measure tongue function and allow a simple evaluation of pathologies that affect the tone of the tongue. We have carried out 20 tongue strength measurements using the Tongue Digital Spoon (TDS) in a healthy adult population, using the Iowa Oral Performance Instrument (IOPI) as the gold standard. To validate the procedure, we performed replicate measurements on 20 individuals aged 20-70 years. We found a mean TDS measurement of 115.99 g/cm2 in young subjects, 98.47 g/cm2 in middle-aged subjects and 84.23 g/cm2 in the elderly. There was a significant difference in the measurements between young and elderly participants. There was also a significant correlation between TDS and IOPI measurements (Pearson correlation coefficient, r = 0.69, P < 0.001). We found the TDS to be a useful tool in daily clinical practice for the measurement of the strength of the tongue in the healthy population. It has potential application in oropharyngeal monitoring and rehabilitation.
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Affiliation(s)
- Laura Rodríguez-Alcalá
- Department of Otorhinolaryngology, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | - Carlos O´Connor-Reina
- Department of Otorhinolaryngology, Hospital Quirón Marbella, Marbella, Spain
- Department of Otorhinolaryngology, Hospital Quirón Campo de Gibraltar, Marbella, Spain
| | - Guillermo Plaza
- Department of Otorhinolaryngology, Hospital Universitario Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain
- Department of Otorhinolaryngology, Hospital Sanitas La Zarzuela, Madrid, Spain
- * E-mail:
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23
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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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Zaghi S, Shamtoob S, Peterson C, Christianson L, Valcu-Pinkerton S, Peeran Z, Fung B, Kwok-Keung Ng D, Jagomagi T, Archambault N, O'Connor B, Winslow K, Lano M, Murdock J, Morrissey L, Yoon A. Assessment of posterior tongue mobility using lingual-palatal suction: Progress towards a functional definition of ankyloglossia. J Oral Rehabil 2021; 48:692-700. [PMID: 33386612 PMCID: PMC8247966 DOI: 10.1111/joor.13144] [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: 11/18/2020] [Accepted: 12/21/2020] [Indexed: 12/22/2022]
Abstract
Background A functional definition of ankyloglossia has been based on assessment of tongue mobility using the tongue range of motion ratio (TRMR) with the tongue tip extended towards the incisive papilla (TIP). Whereas this measurement has been helpful in assessing for variations in the mobility of the anterior one‐third of the tongue (tongue tip and apex), it may be insufficient to adequately assess the mobility of the posterior two‐thirds body of the tongue. A commonly used modification is to assess TRMR while the tongue is held in suction against the roof of the mouth in lingual‐palatal suction (LPS). Objective This study aims to explore the utility and normative values of TRMR‐LPS as an adjunct to functional assessment of tongue mobility using TRMR‐TIP. Study Design Cross‐sectional cohort study of 611 subjects (ages: 3‐83 years) from the general population. Methods Measurements of tongue mobility using TRMR were performed with TIP and LPS functional movements. Objective TRMR measurements were compared with subjective self‐assessment of resting tongue position, ease or difficulty elevating the tongue tip to the palate, and ease or difficulty elevating the tongue body to the palate. Results There was a statistically significant association between the objective measures of TRMR‐TIP and TRMR‐LPS and subjective reports of tongue mobility. LPS measurements were much more highly correlated with differences in elevating the posterior body of the tongue as compared to TIP measurements (R2 0.31 vs 0.05, P < .0001). Conclusions This study validates the TRMR‐LPS as a useful functional metric for assessment of posterior tongue mobility.
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Affiliation(s)
| | | | | | | | | | - Zahra Peeran
- The Breathe Institute, Los Angeles, CA, USA.,Happy Kids Dental Planet, Agoura Hills, CA, USA
| | | | | | - Triin Jagomagi
- Institute of Dentistry and Unimed United Clinics, University of Tartu, Tartu, Estonia
| | | | | | | | - Miche' Lano
- South County Pediatric Speech, Mission Viejo, CA, USA
| | | | | | - Audrey Yoon
- Division of Growth and Development, Section of Pediatric Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA
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26
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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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Liu YCG, Lan SJ, Hirano H, Lin LM, Hori K, Lin CS, Zwetchkenbaum S, Minakuchi S, Teng AYT. Update and review of the gerodontology prospective for 2020's: Linking the interactions of oral (hypo)-functions to health vs. systemic diseases. J Dent Sci 2020; 16:757-773. [PMID: 33854730 PMCID: PMC8025188 DOI: 10.1016/j.jds.2020.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/03/2020] [Indexed: 02/07/2023] Open
Abstract
New lines of evidence suggest that the oral-systemic medical links and oral hypo-function are progressively transcending beyond the traditional clinical signs and symptoms of oral diseases. Research into the dysbiotic microbiome, host immune/inflammatory regulations and patho-physiologic changes and subsequent adaptations through the oral-systemic measures under ageism points to pathways leading to mastication deficiency, dysphagia, signature brain activities for (neuro)-cognition circuitries, dementia and certain cancers of the digestive system as well. Therefore, the coming era of oral health-linked systemic disorders will likely reshape the future of diagnostics in oral geriatrics, treatment modalities and professional therapies in clinical disciplines. In parallel to these highlights, a recent international symposium was jointly held by the International Association of Gerontology and Geriatrics (IAGG), Japanese Society of Gerodontology (JSG), the representative of USA and Taiwan Academy of Geriatric Dentistry (TAGD) on Oct 25th, 2019. Herein, specific notes are briefly addressed and updated for a summative prospective from this symposium and the recent literature.
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Affiliation(s)
- Yen Chun G. Liu
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Corresponding author. Dept. of Oral Hygiene & COBR, College of Dental Medicine, Kaohsiung Medical University; No. 100, Shih-Chun 1st Rd, Kaohsiung 807, Taiwan. Fax: +886 07 3223141.
| | - Shou-Jen Lan
- Dept. of Healthcare Administration, Asia University, Tai-Chung, Taiwan
| | - Hirohiko Hirano
- Research Team for Promoting Independence & Mental Health, and Dentistry & Oral Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Li-min Lin
- Div. of Oral Pathology & Oral Maxillo-facial Radiology, School of Dentistry, Kaohsiung Medical University & KMU-Hospital, Kaohsiung, Taiwan
| | - Kazuhiro Hori
- Div. of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Chia-shu Lin
- Dept. of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Samuel Zwetchkenbaum
- Rhode Island Dept. of Health, Rhode Island, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - Shunsuke Minakuchi
- Gerodontology & Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Andy Yen-Tung Teng
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Center for Osteoimmunology & Biotechnology Research (COBR) and School of Dentistry, College of Dental Medicine, Kaohsiung Medical University and KMU-Hospital, Kaohsiung, Taiwan
- Corresponding author. Center for Osteoimmunology and Biotechnology Research (COBR), College of Dental Medicine, Kaohsiung Medical University (KMU) & KMU-Hospital, Kaohsiung, Taiwan.
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Association between stroke lesions and videofluoroscopic findings in acute stroke patients. J Neurol 2020; 268:1025-1035. [PMID: 32979098 DOI: 10.1007/s00415-020-10244-4] [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: 07/25/2020] [Revised: 09/20/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE We aimed to assess stroke lesions, which play a key role in determining swallowing dysfunction, and findings of videofluoroscopy (VF), which provides the most accurate instrumental assessment for evaluating swallowing function, in patients with acute stroke. METHODS We enrolled 342 patients with first-time acute stroke (age 70.4 ± 12.6 years, 142 female). Patients with dementia and altered mental status due to severe stroke were excluded. All patients underwent cranial magnetic resonance imaging to identify the location of stroke lesion, VF, and tongue pressure measurement. RESULTS Aspiration was detected in 45 (13.2%) patients. Multivariate analysis identified parietal lobe lesion and the National Institutes of Health Stroke Scale (NIHSS) score as independent significant factors for aspiration (odds ratio 6.33, 95% confidence interval [CI] 2.25-17.84, p < 0.001; odds ratio 1.12, 95% CI 1.03-1.20, p = 0.004, respectively). Swallowing reflex delay was detected in 58 (17.0%) patients. Multivariate analysis identified habitual drinking, basal ganglia lesion, and the NIHSS score as independent significant factors for swallowing reflex delay (odds ratio 0.51, 95% CI 0.26-0.99, p = 0.047; odds ratio 1.91, 95% CI 1.09-3.67, p = 0.041; odds ratio 1.12, 95% CI 1.05-1.20, p < 0.001, respectively). Additionally, oral cavity and pharyngeal residues were independently associated with tongue pressure. CONCLUSION Parietal lobe lesions are associated with aspiration and basal ganglia lesions with swallowing reflex delay.
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Arakawa I, Igarashi K, Imamura Y, Müller F, Abou-Ayash S, Schimmel M. Variability in tongue pressure among elderly and young healthy cohorts: A systematic review and meta-analysis. J Oral Rehabil 2020; 48:430-448. [PMID: 32799377 DOI: 10.1111/joor.13076] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/14/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Tongue pressure (TP) is used for the diagnosis of oral hypofunction; however, the impact of several variables on TP is unclear. Therefore, the current systematic review and meta-analysis aimed to analyse the variability in tongue pressure among healthy individuals aged ≥60 years vs <60 years. Secondary outcomes were the influence of gender and the type of measuring device (Iowa Oral Performance Instrument (IOPI) vs JMS tongue pressure measurement device (JMS)). METHODS PubMed and the Japanese database Ichushi-Web were searched systematically by two independent reviewers for studies reporting TP values in healthy populations. Clinical studies published between 1959 and June 2020 with more than 10 participants, written in English, German or Japanese, were included. A random-effects meta-regression for aggregate-level data was applied (α < 0.05). RESULTS Sixty-eight studies reported TP for a total of 13 773 subjects aged <60 years (n = 3265) and ≥60 years (n = 10 508). TP was significantly higher in subjects <60 years (estimated weighted mean (EWM) ± standard error = 51.9 ± 1.28 kPa; 95% CI = 49.4-54.4) relative to those ≥60 (EWM = 34.7 ± 0.94 kPa; 95% CI = 32.8-36.5) (P < .001), men (EWM = 45.9 ± 2.09 kPa; 95% CI = 41.8-50.0) relative to women (EWM = 39.3 ± 1.68 kPa; 95% CI = 36.0-42.6) (P = .015) and when assessed with the IOPI (EWM = 51.9 ± 1.32 kPa; 95% CI = 49.3-54.5) compared to the JMS (EWM = 33.5 ± 0.63 kPa; 95% CI = 32.2-34.7) (P < .001). In terms of gender, there was no significant difference in TP among subjects ≥60 years (P = .282). However, in subjects younger than 60, a significant difference was observed (P = .004). CONCLUSIONS Healthy populations aged <60 years showed significantly higher TP than those aged ≥60 years. TP values ascertained by the IOPI are significantly higher than those obtained with the JMS.
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Affiliation(s)
- 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
| | - Kensuke Igarashi
- Department of Dental Materials Science, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
| | - 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
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - 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
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Yoshikawa M, Nagakawa K, Tanaka R, Yamawaki K, Mori T, Hiraoka A, Higa C, Nishikawa Y, Yoshida M, Tsuga K. Improper sitting posture while eating adversely affects maximum tongue pressure. J Dent Sci 2020; 16:467-473. [PMID: 33384836 PMCID: PMC7770356 DOI: 10.1016/j.jds.2020.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/23/2020] [Indexed: 11/30/2022] Open
Abstract
Background/purpose Although many studies have examined the efficacy of neck and trunk positioning during eating, few studies have examined how the positioning of the lower extremities affects swallowing function. The purpose of this study was to examine how tongue pressure, which is an important factor during swallowing, is affected by eating postures in bed and wheelchair. Materials and methods A total of 43 healthy adults (13 men and 30 women; 29.0 ± 5.9 years) and 33 elderly individuals requiring long-term care (14 men and 19 women; 83.6 ± 7.8 years) participated. In both healthy and elderly participants, tongue pressure was measured in four different postures: a good and poor postures in bed (postures 1 and 2, respectively), and a good and poor postures in a reclining wheelchair (posture 3 and 4, respectively). Results Among the healthy participants, the mean tongue pressure was significantly higher in posture 1 (40.2 ± 7.24 kPa) than in posture 2 (37.6 ± 8.68 kPa) or posture 4 (38.2 ± 8.14 kPa) (P < 0.05). Tongue pressure was also significantly higher in posture 3 (41.3 ± 7.75 kPa) than in either posture 2 or 4 (P < 0.05). Among the elderly participants, the median tongue pressure in posture 1 (16.9 kPa; interquartile range [IQR], 9.4–21.6 kPa) was significantly higher than that in posture 2 (14.1 kPa; IQR, 9.2–21.6 kPa). Tongue pressure in posture 3 (18.5 kPa; IQR, 14.2–26.0 kPa) was significantly higher than that in either posture 1 or 2, and posture 4 (15.9 kPa; IQR, 10.6–22.9 kPa). Conclusion Posture during eating can potentially affect tongue pressure.
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Affiliation(s)
- Mineka Yoshikawa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Corresponding author. Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | | | | | - Kanako Yamawaki
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- PIA Nakamura Hospital, Hiroshima, Japan
| | - Takahiro Mori
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chiaki Higa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuichi Nishikawa
- College of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Nakamori M, Imamura E, Fukuta M, Tachiyama K, Kamimura T, Hayashi Y, Matsushima H, Ogawa K, Nishino M, Hirata A, Mizoue T, Wakabayashi S. Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly. PLoS One 2020; 15:e0230224. [PMID: 32764766 PMCID: PMC7413413 DOI: 10.1371/journal.pone.0230224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 07/11/2020] [Indexed: 11/18/2022] Open
Abstract
The term "oral frailty" reflects the fact that oral health is associated with physical frailty and mortality. The gold standard methods for evaluating the swallowing function have several problems, including the need for specialized equipment, the risk of radiation exposure and aspiration, and general physicians not possessing the requisite training to perform the examination. Hence, several simple and non-invasive techniques have been developed for evaluating swallowing function, such as those for measuring tongue pressure and tongue thickness. The aim of this study was to investigate the relationship between tongue thickness ultrasonography and tongue pressure in the Japanese elderly. We evaluated 254 elderly patients, who underwent tongue ultrasonography and tongue pressure measurement. To determine tongue thickness, we measured the vertical distance from the surface of the mylohyoid muscle to the tongue dorsum using ultrasonography. The results of the analyses revealed that tongue thickness was linearly associated with tongue pressure in both sexes. In male participants, dyslipidemia, lower leg circumference, and tongue pressure were independently and significantly associated with tongue thickness. In female participants, body mass index and tongue pressure were independently and significantly associated with tongue thickness. The optimal cutoff for tongue thickness to predict the tongue pressure of < 20 kPa was 41.3 mm in males, and 39.3 mm in females. In the Japanese elderly, tongue thickness using ultrasonography is associated with tongue pressure. Tongue thickness and tongue pressure, which are sensitive markers for oral frailty, decrease with age. We conclude that tongue ultrasonography provides a less invasive technique for determining tongue thickness and predicts oral frailty for elderly patients.
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Affiliation(s)
- Masahiro Nakamori
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- * E-mail:
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Masako Fukuta
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Keisuke Tachiyama
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Teppei Kamimura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hayato Matsushima
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Kanami Ogawa
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Masami Nishino
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Akiko Hirata
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tatsuya Mizoue
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
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Sunada Y, Magara J, Tsujimura T, Ono K, Inoue M. Endurance measurement of hyoid muscle activity and hyoid-laryngeal position during tongue lift movement. J Oral Rehabil 2020; 47:967-976. [PMID: 32350874 DOI: 10.1111/joor.12988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/11/2020] [Accepted: 04/16/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Tongue lift movement (TLM) is used as a therapy to improve tongue pressure against the hard palate for dysphagic patients. OBJECTIVE The present study aimed to characterize the time-dependent endurance changes in hyoid muscle activity and hyoid-laryngeal displacement during TLM in different ways. METHODS Sixteen young healthy volunteers were instructed to perform TLM at maximum effort (100%) against the anterior and posterior parts of the hard palate using a balloon-type tongue pressure instrument, followed by a 10-second recording during anterior 80% TLM, anterior 100% TLM, posterior 80% TLM and posterior 100% TLM with visual feedback. Electromyography (EMG) of suprahyoid (S-Hyo) and infrahyoid (I-Hyo) muscles and videofluorography were simultaneously recorded. To evaluate temporal changes, the recording period was divided into three substages: early, middle and late. Tongue pressure, integrated EMG (iEMG), power frequency of EMG burst and hyoid-laryngeal position were compared among the conditions (80% vs 100%, anterior vs posterior and early vs middle vs late). RESULTS Tongue pressure was stably maintained for 10 seconds in all conditions. S-Hyo iEMG and I-Hyo iEMG were significantly greater at 100% than at 80%, while no significant difference was observed between positions. S-Hyo iEMG and I-Hyo iEMG significantly increased at the late stage, while power frequency of EMG burst gradually decreased. Significant temporal changes in laryngeal elevation were observed only in posterior 100% TLM. CONCLUSION The current results suggested that isometric posterior TLM may be more useful compared with anterior TLM in clinical situations for dysphagic patients to elevate the hyolaryngeal complex.
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Affiliation(s)
- Yukako Sunada
- 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
| | - Kazuhiro Ono
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, 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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Yoshikawa M, Fukuoka T, Mori T, Hiraoka A, Higa C, Kuroki A, Takeda C, Maruyama M, Yoshida M, Tsuga K. Comparison of the Iowa Oral Performance Instrument and JMS tongue pressure measurement device. J Dent Sci 2020; 16:214-219. [PMID: 33384800 PMCID: PMC7770307 DOI: 10.1016/j.jds.2020.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 06/04/2020] [Indexed: 11/17/2022] Open
Abstract
Background/purpose Tongue pressure measurement conveys important information about eating and swallowing function. The Iowa Oral Performance Instrument® (IOPI) and KAY Swallowing Workstation® are internationally used for tongue pressure measurement, but for legal reasons cannot be used in Japan; rather the JMS tongue pressure measurement device® has been approved for use in Japan. However, it is not clear whether measurement obtained with these devices are directly comparable. Materials and methods This study investigated the correlation between the maximum tongue pressure data measured by the IOPI and the JMS tongue pressure measurement device in young healthy participants (34 males; 23.2 ± 2.0 years old, and 40 females; 21.4 ± 1.3 years old). Results Measurements obtained with these two devices showed significant correlations in the total cohort, and in male and female participants, separately (P < 0.05). Conclusion These findings demonstrate that the measurements obtained with the JMS device is comparable to those obtained with the IOPI. In Japan, JMS tongue pressure measurement device is used not only in dysphagia research field, but also geriatrics field, and extensive and detailed investigations has been carried out.
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Affiliation(s)
- Mineka Yoshikawa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
- Corresponding author. 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8553, Japan. Fax: +81 92 257 5679.
| | - Tatsuyuki Fukuoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Takahiro Mori
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Chiaki Higa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Azusa Kuroki
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Chiho Takeda
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Mariko Maruyama
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
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Nishinari K, Ishihara S, Hori K, Fang Y. Tongue-palate squeezing of soft gels in food oral processing. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.02.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Arakawa I, Abou-Ayash S, Genton L, Tsuga K, Leles CR, Schimmel M. Reliability and comparability of methods for assessing oral function: Chewing, tongue pressure and lip force. J Oral Rehabil 2020; 47:862-871. [PMID: 32275327 DOI: 10.1111/joor.12976] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/07/2020] [Accepted: 03/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Quantitative clinical assessment tests for oral function have become popular in patient assessment; however, their comparability remains unclear. OBJECTIVE To assess the reliability and comparability of pairs of different instruments for measuring maximum tongue pressure (MTP), chewing function (CF) and maximum lip force (MLF), and to analyse the influence of subjects' characteristics on the applied instruments. METHODS Each pair of instruments, as well as a single device measuring the maximum voluntary bite force (MBF), was assessed across 26 healthy volunteers. The respective pairs of devices were compared using Bland-Altman plots and linear regression analysis. Furthermore, the influence of age, occlusal support zones, number of functional occlusal units, MBF, MTP and MLF were investigated as predictors on CF using a generalised estimating equation model. RESULTS Neither the two assessments of CF, nor of MLF were correlated to each other, but there was a significant correlation between the assessments of MTP. Hue-Check Gum was able to demonstrate a significantly higher CF in younger compared to older individuals (P = .004) and individuals with high numbers compared to low numbers of occlusal units (P < .001). Those differences could not be demonstrated with the Vivident chewing gum. CONCLUSION The absolute values of MTP assessed by the two applied devices cannot directly be compared, although normalised values may be directly comparable. Moreover, our observations suggest that the Hue-Check Gum was able to discriminate the effects of age and the number of occlusal units on CF. Our observations suggest that the two gums cannot be used interchangeably.
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Affiliation(s)
- Itsuka Arakawa
- Comprehensive Dental Care Unit, The Nippon Dental University Niigata Hospital, Niigata, Japan.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Laurence Genton
- Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Cláudio Rodrigues Leles
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
| | - 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
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Supplied Food Consistency and Oral Functions of Institutionalized Elderly. Int J Dent 2020; 2020:3463056. [PMID: 32148501 PMCID: PMC7031709 DOI: 10.1155/2020/3463056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/14/2020] [Accepted: 01/21/2020] [Indexed: 12/04/2022] Open
Abstract
Background Maintaining good oral function is one of the goals of dental treatment. The Japanese national insurance system newly introduced the concept of management of oral function according to the life stage. For the application of management of oral functions of the elderly, seven kinds of examination is a must for the diagnosis: xerostomia, oral hygiene status, maximum occlusal pressure, tongue and labium function, tongue pressure, chewing ability, and swallowing function. We analyzed the relationship between oral functions and supplied food consistency. Methods Oral functions and supplied food consistency of sixty-nine institutionalized elderly were investigated. There were 13 men and 56 women, and their mean age was 86.23 ± 7.02. Oral functions were measured and evaluated according to the Japanese insurance system. Data were analyzed by item response theory analysis, ROC analysis, and decision analysis. Results By the item response theory analysis, tongue pressure and swallowing functions had high discrimination ability. The subjects who had malfunction of the tongue and labium all had processed food. The subjects with difficulty in swallowing, even without malfunction of the tongue and labium, all had processed food. Conclusion Supplied food consistency may depend on the oral functions. However, as oral function has some dimension, a systematic evaluation system is necessary to decide the supplied food consistency.
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Ogawa M, Kagaya H, Nagashima Y, Mori S, Shibata S, Inamoto Y, Aoyagi Y, Toda F, Ozeki M, Saitoh E. Repetitive Peripheral Magnetic Stimulation for Strengthening of the Suprahyoid Muscles: A Randomized Controlled Trial. Neuromodulation 2019; 23:778-783. [PMID: 31667935 DOI: 10.1111/ner.13057] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 08/21/2019] [Accepted: 08/29/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Head lift exercise is a widely known form of training in the rehabilitation of patients with dysphagia. This study aimed to compare muscular strength reinforcement training of the suprahyoid muscles using repetitive peripheral magnetic stimulation (rPMS) with head lift exercises in a randomized controlled trial. MATERIALS AND METHODS Twenty-four healthy adults were randomly assigned to either the magnetic stimulation group (M group) or the head lift exercise group (H group). Both groups underwent training five days a week for two weeks. The primary outcome was the cervical flexor strength, and secondary outcomes were jaw-opening force, tongue pressure, muscle fatigue of the hyoid and laryngeal muscles, displacement of the hyoid bone and opening width of the upper esophageal sphincter (UES) while swallowing 10 mL of liquid, training performance rate, and pain. RESULTS No dropouts were reported during the two-week intervention period. Cervical flexor strength significantly increased solely in the M group. Tongue pressure significantly improved in both groups. There were no significant differences in the jaw-opening force, median frequency rate of the anterior belly of the digastric muscle, sternohyoid muscle, sternocleidomastoid muscle, anterior and superior hyoid bone displacement, and UES opening width in both groups. CONCLUSIONS Two-week rPMS of the suprahyoid muscles increased the strength of these muscles compared with the head lift exercise during the same period.
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Affiliation(s)
- Mao Ogawa
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yuki Nagashima
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.,Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan
| | - Shino Mori
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Fumi Toda
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Megumi Ozeki
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
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Barikroo A, Hegland K, Carnaby G, Bolser D, Manini T, Crary M. The Effects of Electrical Stimulation Pulse Duration on Lingual Palatal Pressure Measures During Swallowing in Healthy Older Adults. Dysphagia 2019; 34:529-539. [PMID: 30820657 DOI: 10.1007/s00455-019-09991-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 02/23/2019] [Indexed: 11/28/2022]
Abstract
Limited research in swallowing physiology has suggested that the most common existing transcutaneous electrical stimulation (TES) protocol (VitalStim) may not penetrate to layers of tissue to affect deep swallowing muscles. TES amplitude is the primary parameter that determines the depth of electrical current penetration (DECP). Preliminary work suggests that replacing a long-pulse duration with a short-pulse duration can increase maximum amplitude tolerance (MAT) within subjects' comfort level. Increasing MAT may indicate a higher DECP. The current study evaluates this premise in reference to the effects of varying pulse duration on lingual-palatal pressure during swallowing. Thirty healthy older adults (60-70 years of age) participated in this study. Each subject swallowed three trials of 10 mL pudding under three TES conditions: no stimulation, short-pulse duration, and long-pulse duration. TES was delivered using two pairs of surface electrodes on the submental muscles. MAT and perceived discomfort levels were identified separately for short and long-pulse TES conditions. Lingual-palatal peak pressure, pressure integral, and pressure duration were measured under each condition. Two-way repeated measures ANOVAs were conducted to identify within subject effects of TES condition and tongue bulb location. Lingual-palatal pressure and pressure integral were significantly reduced in the short-pulse duration condition. MAT was significantly higher in the short-pulse duration versus the long-pulse duration condition. Furthermore, MAT was significantly correlated with lingual-palatal pressure. Changing pulse duration had no significant impact on tongue pressure duration. Results suggest that a short-pulse duration may penetrate deeper into muscles involved in swallowing. The specific impact is reflected in a reduced upward pressure of the tongue on the palate during swallowing. This 'restrictive' effect of TES on tongue pressure may have the potential to be used during a resistive exercise paradigm for tongue elevation during swallowing.
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Affiliation(s)
- Ali Barikroo
- Speech Pathology and Audiology Program, Swallowing Physiology & Rehabilitation Research Laboratory, School of Health Sciences, Kent State University, PO Box 5190, Kent, OH, 44242-0001, USA.
| | - Karen Hegland
- Department of Speech, Language, and Hearing Sciences, Upper Airway Dysfunction Lab, Gainesville, FL, USA
| | - Giselle Carnaby
- Department of Communication Sciences and Disorders, Swallowing Research Laboratory, University of Central Florida, Orlando, USA
| | - Donald Bolser
- Department of Physiological Sciences, University of Florida, Gainesville, USA
| | - Todd Manini
- Institute on Aging and the Department of Aging and Geriatric Research, University of Florida, Gainesville, USA
| | - Michael Crary
- Department of Communication Sciences and Disorders, Swallowing Research Laboratory, University of Central Florida, Orlando, USA
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Manda Y, Kodama N, Maeda N, Minagi S. Effect of food properties and chewing condition on the electromyographic activity of the posterior tongue. J Oral Rehabil 2019; 46:511-517. [DOI: 10.1111/joor.12774] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 01/27/2019] [Accepted: 01/30/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yousuke Manda
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan
| | - Naoki Kodama
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan
| | - Naoto Maeda
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan
| | - Shogo Minagi
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan
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40
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Yano J, Yamamoto-Shimizu S, Yokoyama T, Kumakura I, Hanayama K, Tsubahara A. Effects of anterior tongue strengthening exercises on posterior tongue strength in healthy young adults. Arch Oral Biol 2019; 98:238-242. [DOI: 10.1016/j.archoralbio.2018.11.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/21/2018] [Accepted: 11/27/2018] [Indexed: 12/17/2022]
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Minakuchi S, Tsuga K, Ikebe K, Ueda T, Tamura F, Nagao K, Furuya J, Matsuo K, Yamamoto K, Kanazawa M, Watanabe Y, Hirano H, Kikutani T, Sakurai K. Oral hypofunction in the older population: Position paper of the Japanese Society of Gerodontology in 2016. Gerodontology 2018; 35:317-324. [PMID: 29882364 DOI: 10.1111/ger.12347] [Citation(s) in RCA: 256] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is growing international interest in identifying the effects of ageing on oral health and on appropriate strategies for managing oral disorders. The Japanese Society of Gerodontology (JSG), as the official representative of researchers and clinicians interested in geriatric dentistry in Japan, makes several recommendations on the concept of "oral hypofunction." AIMS This study proposes diagnostic criteria and management strategies to reduce the risk of oral hypofunction among older people. CONCEPTUAL FRAMEWORK We define oral hypofunction as a presentation of 7 oral signs or symptoms: oral uncleanness; oral dryness; decline in occlusal force; decline in motor function of tongue and lips; decline in tongue pressure; decline in chewing function; and decline in swallowing function. The criteria of each symptom were determined based on the data of previous studies, and oral hypofunction was diagnosed if the criteria for 3 or more signs or symptoms were met. CONCLUSIONS We recommend that more evidence should be gathered from clinical studies and trials to clarify our diagnostic criteria and management strategies.
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Affiliation(s)
- Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Fumiyo Tamura
- Tama Oral Rehabilitation Clinic, The Nippon Dental University, Tokyo, Japan
| | - Kan Nagao
- Department of Oral & Maxillofacial Prosthodontics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Junichi Furuya
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichiro Matsuo
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Ken Yamamoto
- Department of Community Dentistry, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yutaka Watanabe
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Dentistry and Oral Surgery, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takeshi Kikutani
- Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
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42
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Checklin M, Pizzari T. Impaired Tongue Function as an Indicator of Laryngeal Aspiration in Adults with Acquired Oropharyngeal Dysphagia: A Systematic Review. Dysphagia 2018; 33:778-788. [DOI: 10.1007/s00455-018-9902-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/19/2018] [Indexed: 01/03/2023]
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43
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Nishinari K, Fang Y. Perception and measurement of food texture: Solid foods. J Texture Stud 2018; 49:160-201. [PMID: 29437224 DOI: 10.1111/jtxs.12327] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 01/22/2018] [Indexed: 11/28/2022]
Abstract
There is still a gap between instrumental measurement and sensory evaluation because of the complexity of food texture in spite of many efforts. In sensory evaluation, the terms describing the texture should be well understood by panelists, which poses a problem of establishing lexicons and training panelists. In the instrumental measurement, more efforts are required to understand the large deformation and fracture behavior of foods. The texture profile analysis (TPA) proposed by Alina Szczesniak, Malcolm Bourne, and Sherman has been applied to many foods, and was useful to develop the understanding of textures. But sometimes confusion of the interpretation of TPA parameters appeared. Many new techniques have been introduced to quantify TPA parameters. Recent efforts to fill the gap between sensory evaluation and instrumental measurements, human measurements, or physiological measurements have been introduced. This endeavor is an effort of synthesizing the dentistry and biomedical approach, sensory and psychological approach, and material science approach, and therefore, the collaboration among these disciplines is necessary. This manuscript mainly discusses texture studies for solid foods. PRACTICAL APPLICATIONS To fill the gap between the sensory evaluation and the instrumental measurement of texture, it is necessary to examine the physical change of foods during the oral processing. This will give us the designing principle of palatable and safe foods.
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Affiliation(s)
- Katsuyoshi Nishinari
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Technology & Business University (BTBU), Beijing, China.,Department of Food and Pharmaceutical Engineering, School of Light Industry, Glyn O. Phillips Hydrocolloids Research Centre, Hubei University of Technology, Wuhan, Wuchang, China
| | - Yapeng Fang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Technology & Business University (BTBU), Beijing, China.,Department of Food and Pharmaceutical Engineering, School of Light Industry, Glyn O. Phillips Hydrocolloids Research Centre, Hubei University of Technology, Wuhan, Wuchang, China
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Nagayoshi M, Higashi M, Takamura N, Tamai M, Koyamatsu J, Yamanashi H, Kadota K, Sato S, Kawashiri SY, Koyama Z, Saito T, Maeda T. Social networks, leisure activities and maximum tongue pressure: cross-sectional associations in the Nagasaki Islands Study. BMJ Open 2017; 7:e014878. [PMID: 29217718 PMCID: PMC5728263 DOI: 10.1136/bmjopen-2016-014878] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Social environment is often associated with health outcomes, but epidemiological evidence for its effect on oral frailty, a potential risk factor for aspiration, is sparse. This study aimed to assess the association between social environment and tongue pressure, as an important measure of oral function. The study focused on family structure, social networks both with and beyond neighbours, and participation in leisure activities. DESIGN A population-based cross-sectional study. SETTING Annual health check-ups in a rural community in Japan. PARTICIPANTS A total of 1982 participants, all over 40 years old. Anyone with missing data for the main outcome (n=14) was excluded. OUTCOME MEASURES Tongue pressure was measured three times, and the maximum tongue pressure was used for analysis. A multivariable adjusted regression model was used to calculate parameter estimates (B) for tongue pressure. RESULTS Having a social network involving neighbours (B=2.43, P=0.0001) and taking part in leisure activities (B=1.58, P=0.005) were independently associated with higher tongue pressure, but there was no link with social networks beyond neighbours (B=0.23, P=0.77). Sex-specific analyses showed that for men, having a partner was associated with higher tongue pressure, independent of the number of people in the household (B=2.26, P=0.01), but there was no association among women (B=-0.24, P=0.72; P-interaction=0.059). CONCLUSIONS Having a social network involving neighbours and taking part in leisure activities were independently associated with higher tongue pressure. Marital status may be an important factor in higher tongue pressure in men.
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Affiliation(s)
- Mako Nagayoshi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koichiro Kadota
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shimpei Sato
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Zenya Koyama
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshiyuki Saito
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Jeong DM, Shin YJ, Lee NR, Lim HK, Choung HW, Pang KM, Kim BJ, Kim SM, Lee JH. Maximal strength and endurance scores of the tongue, lip, and cheek in healthy, normal Koreans. J Korean Assoc Oral Maxillofac Surg 2017; 43:221-228. [PMID: 28875136 PMCID: PMC5583196 DOI: 10.5125/jkaoms.2017.43.4.221] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 06/05/2017] [Indexed: 11/18/2022] Open
Abstract
Objectives The purpose of this study was to establish normative data for healthy Korean adults by measuring the maximal strength and endurance scores of the tongue, lip, and cheek, and to examine correlations between these measurements. Materials and Methods This study included 120 subjects that were divided into three groups according to age: young (20-39 years), middle-aged (40-59 years), and older (over 60 years); and by gender. Measurements were taken using the Iowa Oral Performance Instrument (IOPI). Results The mean maximal tongue strengths were as follows: young men (46.7±10.2 kPa) and women (32.1±7.9 kPa), middle-aged men (40.9±9.3 kPa) and women (36.9±8.6 kPa), and older men (35.2±9.0 kPa) and women (34.5±6.9 kPa). The mean tongue endurance scores were: young men (28.8±12.6 seconds) and women (20.8±13.5 seconds), middle-aged men (17.0±8.5 seconds) and women (15.3±5.2 seconds), and older men (15.8±6.7 seconds) and women (17.9±8.1 seconds). The mean maximal lip strengths were: young men (11.6±3.0 kPa) and women (11.4±3.8 kPa), middle-aged men (11.4±4.2 kPa) and women (11.1±5.1 kPa), and older men (14.5±3.9 kPa) and women (11.7±2.6 kPa). The mean lip endurance scores were: young men (41.1±23.9 seconds) and women (22.4±21.7 seconds), middle-aged men (24.3±10.3 seconds) and women (30.5±13.4 seconds), and older men (24.9±11.0 seconds) and women (12.8±7.6 seconds). The mean maximal cheek strengths were: young men (24.5±4.6 kPa) and women (20.5±4.3 kPa), middle-aged men (25.2±6.4 kPa) and women (21.2±5.5 kPa), and older men (22.4±5.3 kPa) and women (18.0±4.8 kPa). The mean cheek endurance scores were: young men (47.8±24.4 seconds) and women (43.9±25.0 seconds), middle-aged men (27.3±11.3 seconds) and women (20.0±14.6 seconds), and older men (21.7±14.5 seconds) and women (17.2±11.4 seconds). Conclusion The data collected in this study will provide an important database of standardized measurements for maximal strength and endurance scores of the tongue, lip and cheek in healthy, normal Koreans.
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Affiliation(s)
- Dong-Min Jeong
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yoo-Jin Shin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Na-Ra Lee
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea
| | - Ho-Kyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Han-Wool Choung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kang-Mi Pang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea
| | - Bong-Ju Kim
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Soung-Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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46
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Hiraoka A, Yoshikawa M, Nakamori M, Hosomi N, Nagasaki T, Mori T, Oda M, Maruyama H, Yoshida M, Izumi Y, Matsumoto M, Tsuga K. Maximum Tongue Pressure is Associated with Swallowing Dysfunction in ALS Patients. Dysphagia 2017; 32:542-547. [DOI: 10.1007/s00455-017-9797-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 04/08/2017] [Indexed: 12/11/2022]
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Hasegawa Y, Sugahara K, Fukuoka T, Saito S, Sakuramoto A, Horii N, Sano S, Hasegawa K, Nakao Y, Nanto T, Kadoi K, Moridera K, Noguchi K, Domen K, Kishimoto H. Change in tongue pressure in patients with head and neck cancer after surgical resection. Odontology 2017; 105:494-503. [PMID: 28197773 DOI: 10.1007/s10266-016-0291-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 12/20/2016] [Indexed: 12/13/2022]
Abstract
Tongue pressure is reportedly associated with dysphagia. This study investigated relationships among characteristics of head and neck cancer, tongue pressure and dysphagia screening tests performed in patients with head and neck cancer during the acute phase after surgical resection. Fifty-seven patients (36 men, 21 women; age range 26-95 years) underwent surgical resection and dysphagia screening tests (Repetitive Saliva Swallowing Test, Water Swallowing Test, Modified Water Swallowing Test and Food Test) and pre- and postoperative measurement of tongue pressure at 5 time points (preoperatively, and 1-2 weeks and 1, 2, and 3 months postoperatively). Progression of cancer (stage), tracheotomy, surgical reconstruction, chemotherapy, radiotherapy and neck dissection were factors associated with postoperative tongue pressure. Data were analyzed by linear mixed-effect model, Spearman correlation coefficient and receiver operating characteristic (ROC) curve. Tongue pressure was significantly reduced 1-2 weeks after surgery, and recovered over time. Changes in tongue pressure were significantly associated with stage, radiotherapy and reconstruction. All screening tests showed a significant relationship with tongue pressure. Analysis of ROC and area under the effect curve suggested that a tongue pressure of 15 kPa can be used as a cut-off value to detect dysphagia after surgery for head and neck cancer. Our results suggest that tongue pressure evaluation might offer a safe, useful and objective tool to assess dysphagia immediately postoperatively in patients with head and neck cancer.
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Affiliation(s)
- Yoko Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
| | - Kazuma Sugahara
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Tatsuyuki Fukuoka
- Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan
| | - Shota Saito
- Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan
| | - Ayumi Sakuramoto
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Nobuhide Horii
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Saori Sano
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Kana Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Yuta Nakao
- Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan
| | - Tomoki Nanto
- Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan
| | - Kanenori Kadoi
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Kuniyasu Moridera
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Kazuma Noguchi
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Hiromitsu Kishimoto
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan
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Hosotsubo M, Magota T, Egusa M, Miyawaki T, Matsumoto T. Fabrication of Artificial Food Bolus for Evaluation of Swallowing. PLoS One 2016; 11:e0168378. [PMID: 27977775 PMCID: PMC5158057 DOI: 10.1371/journal.pone.0168378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/30/2016] [Indexed: 11/19/2022] Open
Abstract
Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy). The results indicated that Young's modulus of bolus before swallowing was below 150 kPa. The bolus volume before swallowing was below 400 mm3. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa•s. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Thus, this artificial food bolus would be a promising tool for evaluation of swallowing.
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Affiliation(s)
- Miyu Hosotsubo
- Center for the Special Needs Dentistry, Okayama University Hospital, Shikata-cho, Kita-ku, Okayama, Japan
- Department of Dental Anesthesiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kita-ku, Okayama, Japan
- Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kita-ku, Okayama, Japan
| | - Tetsuro Magota
- Center for the Special Needs Dentistry, Okayama University Hospital, Shikata-cho, Kita-ku, Okayama, Japan
- Department of Dental Anesthesiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kita-ku, Okayama, Japan
- Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kita-ku, Okayama, Japan
| | - Masahiko Egusa
- Center for the Special Needs Dentistry, Okayama University Hospital, Shikata-cho, Kita-ku, Okayama, Japan
| | - Takuya Miyawaki
- Department of Dental Anesthesiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kita-ku, Okayama, Japan
| | - Takuya Matsumoto
- Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kita-ku, Okayama, Japan
- * E-mail:
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49
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Nakamori M, Hosomi N, Ishikawa K, Imamura E, Shishido T, Ohshita T, Yoshikawa M, Tsuga K, Wakabayashi S, Maruyama H, Matsumoto M. Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements. PLoS One 2016; 11:e0165837. [PMID: 27802333 PMCID: PMC5089549 DOI: 10.1371/journal.pone.0165837] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/18/2016] [Indexed: 01/12/2023] Open
Abstract
Swallowing dysfunction caused by stroke is a risk factor for aspiration pneumonia. Tongue pressure measurement is a simple and noninvasive method for evaluating swallowing dysfunction. We have hypothesized that low tongue pressure may be able to predict pneumonia occurrence in acute stroke patients. Tongue pressure was measured using balloon-type equipment in 220 acute stroke patients. The modified Mann Assessment of Swallowing Ability (MASA) score was evaluated independently on the same day. Tongue pressure was measured every week thereafter. An improvement in tongue pressure was observed within the first 2 weeks. Receiver operating curve analysis was performed to determine the ability of tongue pressure to predict modified MASA score <95, which suggests swallowing dysfunction. The optimal cutoff for tongue pressure was 21.6 kPa (χ2 = 45.82, p<0.001, sensitivity 95.9%, specificity 91.8%, area under the curve = 0.97). The tongue pressure was significantly lower in patients with pneumonia than in those without pneumonia. Using a Cox proportional hazard model for pneumonia onset with a cutoff tongue pressure value of 21.6 kPa and adjustment for age, sex, and National Institutes of Health Stroke Scale score at admission, the tongue pressure had additional predictive power for pneumonia onset (hazard ratio, 7.95; 95% confidence interval, 2.09 to 52.11; p = 0.0013). In the group with low tongue pressure, 27 of 95 patients showed improvement of tongue pressure within 2 weeks. Pneumonia occurred frequently in patients without improvement of tongue pressure, but not in patients with improvement (31/68 and 2/27, p<0.001). Tongue pressure is a sensitive indicator for predicting pneumonia occurrence in acute stroke patients.
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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
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- * E-mail:
| | - Kenichi Ishikawa
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Takeo Shishido
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomohiko Ohshita
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | | | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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50
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Nakamori M, Hosomi N, Takaki S, Oda M, Hiraoka A, Yoshikawa M, Matsushima H, Ochi K, Tsuga K, Maruyama H, Izumi Y, Matsumoto M. Tongue thickness evaluation using ultrasonography can predict swallowing function in amyotrophic lateral sclerosis patients. Clin Neurophysiol 2016; 127:1669-1674. [DOI: 10.1016/j.clinph.2015.07.032] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/22/2015] [Accepted: 07/29/2015] [Indexed: 12/12/2022]
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