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Chen YH, Shieh WY, Huang YF, Cheng HYK, Wang CM. Development of a tool for monitoring the jaw-opening pace and preliminary comparison the pace between young and old ages. J Formos Med Assoc 2024; 123:942-949. [PMID: 38185618 DOI: 10.1016/j.jfma.2024.01.009] [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: 07/31/2023] [Revised: 11/13/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Studies have demonstrated that high-speed jaw-opening exercises are effective in improving swallowing function. However, there has been no objective tool available for monitoring jaw-opening pace. This study aimed to develop an objective tool for monitoring and validating jaw-opening pace and compare it between young and old ages from different age groups. MATERIALS AND METHODS A load cell plug-in jaw pad connected to an automatic recording and analysis system was used to record jaw-opening motions for offline analysis. We recruited 58 healthy volunteers from different age groups (20-39 y/o; 40-59y/o; 60-79y/o). During a 2-min recording session, each participant was instructed to fully open and close their jaw as quickly as possible while wearing a sensor. Bland-Altman plot, paired t-test and Pearson's correlation test were used to compare the number of jaw-opening motions between manual counting and automatic software analysis. The number of jaw-opening motions during the 2-min recording was compared between the three age groups. RESULTS Automated analysis of jaw-opening pace was efficient and equally comparable with the traditional manual counting method across the three age groups. A declining trend in jaw-opening pace among the old age group was found but with no statistically significant difference. CONCLUSION A jaw-opening motion monitoring tool with reliable automatic pace analysis software was validated in young and old ages The jaw-opening pace demonstrated a tendency to decline with age.
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Affiliation(s)
- Yu-Hsin Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan
| | - Wann-Yun Shieh
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan; Department of Computer Science and Information Engineering, Chang Gung University, Tao-Yuan, 33302, Taiwan
| | - Yi-Fang Huang
- Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan; School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan; Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Tao-Yuan, 33302, Taiwan
| | - Hsin-Yi Kathy Cheng
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan; Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, TaoYuan, 33302, Taiwan
| | - Chin-Man Wang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, 33302, Taiwan.
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Greenbaum T, Kalichman L, Kedem R, Emodi-Perlman A. The mouth-opening muscular performance in adults and elderlies with and without dysphagia: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 124:105448. [PMID: 38653018 DOI: 10.1016/j.archger.2024.105448] [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: 02/20/2024] [Revised: 04/07/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES To characterize mouth-opening muscular performance (MOMP) in adults and elderly individuals with dysphagia and healthy controls. METHODS We searched the PubMed, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science databases from inception to Jan. 26, 2023. Two independent researchers considered the titles, abstracts, and full texts of potentially eligible papers from 1451 search results. Twenty-five studies that evaluated mouth-opening maximal strength (MOMS) in healthy adults, elderly individuals, and patients with dysphagia met the inclusion criteria. RESULTS We found comparable, reliable values with significant sex differences in maximal mouth opening strength (MMOS) in the meta-analysis for healthy elderly patients (females 5.31 ± 0.47 kg vs. males 7.04 ± 0.70 kg; mean difference of 0.84 kg). Age has also emerged as an essential factor in reducing strength. There was a significant reduction in the MMOS score in the only study that compared dysphagic individuals to healthy elderly individuals. In another study, the MMOS score was comparable to the meta-analysis of healthy elderly individuals. CONCLUSIONS Both sex and age play significant roles in the MMOS. There is no reliable data on the normal mouth-opening strength and endurance of healthy adults, patients with dysphagia, or individuals with other relevant clinical problems.
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Affiliation(s)
- Tzvika Greenbaum
- Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - Leonid Kalichman
- Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ron Kedem
- Academic Branch, Medical Corps, IDF, Tel Aviv, Israel
| | - Alona Emodi-Perlman
- The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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3
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Yoon TH, Morishita M, Han NM, Park JS. Effect of home-based tongue-strengthening exercise using a portable tool on oropharyngeal muscles in older adults with sarcopenic dysphagia: A randomised controlled study. J Oral Rehabil 2024. [PMID: 39073062 DOI: 10.1111/joor.13818] [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: 06/25/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Tongue-strengthening exercises may be used at home to strengthen swallowing-related oropharyngeal muscles in community-dwelling older adults with sarcopenic dysphagia; however, evidence of their effectiveness remains unclear. OBJECTIVE This study aimed to investigate the effects of a home-based tongue-strengthening exercise (hTSE) using portable tool on swallowing-related oropharyngeal muscles in community-dwelling older adults with sarcopenic dysphagia. METHODS Forth community-dwelling older adults with sarcopenic dysphagia were enrolled in the study. The participants were randomly assigned to the experimental and control groups. 1-Repetition Maximum (1-RM) of tongue muscle was measured in the experimental group using the Iowa Oral Performance Instrument, and hTSE was performed using a portable tool with an intensity corresponding to approximately 70%-80% of the range based on the 1-RM value (90 times/day, 5 days/week, for 8 weeks). The control group did not perform any tongue exercises. The primary outcome measures were tongue strength and thickness. The secondary outcome measure was suprahyoid muscle strength (digastric and mylohyoid muscles). RESULTS The experimental group showed significantly greater increases in suprahyoid muscle (mylohyoid and digastric) thickness (p = .01 and .011, d = 1.0 and .55), as well as tongue strength and thickness (p < .001 and .029, d = 2.2 and .6) than the control group. CONCLUSION This study confirmed that hTSE using a portable tool is effective in increasing swallowing-related oropharyngeal muscle activity in older adults with sarcopenic dysphagia. Therefore, hTSE is recommended as an inexpensive, safe, and easy-to-use therapy for sarcopenic dysphagia in older adults.
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Affiliation(s)
- Tae-Hyung Yoon
- Department of Occupational Therapy, Dongseo University, Busan, Korea
| | - Motoyoshi Morishita
- Department of Physical Therapy, Faculty of Rehabilitation, Reiwa Health Sciences University, Fukuoka, Japan
| | - Na-Mi Han
- Department of Rehabilitation Medicine, Busan Paik Hospital, Busan, Korea
| | - Ji-Su Park
- Research Institute for Korean Medicine, Pusan National University, Yangsan, Korea
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Okamoto M, Yoshida M, Tsuga K, Matsuo K, Ikebe K, Ueda T, Minakuchi S. Associations of sex, age, and number of remaining teeth with performance on oral hypofunction tests. Gerodontology 2024. [PMID: 38874012 DOI: 10.1111/ger.12770] [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] [Accepted: 06/03/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Oral hypofunction comprises seven aspects of oral condition, including oral hygiene, oral dryness, bite strength, tongue-lip motor function, tongue pressure, masticatory function, and swallowing function. Each of these seven has a single diagnostic criterion; however, the use of a single indicator without consideration of sex, age, or other factors is controversial. The purpose of this study was to evaluate the association between the oral hypofunction test and sex, age, and number of remaining teeth. METHODS The study was conducted at 12 facilities by the members of the Japanese Society of Geriatric Dentistry during April to December 2019. The participants comprised 181 healthy older adults aged 65 years and over (56.9% female; age range 65-95 years) who regularly visited these facilities. All tests of oral function and oral status available in Japan were performed on the participants, and the association between these tests and sex, age, and number of remaining teeth was examined. RESULTS Sex differences were observed in masticatory function, bite force, lip closure force, jaw-opening force, oral diadochokinesis "ka," and tongue coating index (p < .05). In men, age was weakly (r = 0.20-0.40) associated with masticatory function, jaw-opening force, maximum tongue pressure, oral diadochokinesis, and swallowing function. In women, the number of remaining teeth, masticatory function, jaw-opening force, and oral diadochokinesis "ta" and "ka" was also weakly associated with age. CONCLUSIONS Performance on the oral hypofunction test differs by sex, age, and number of remaining teeth. This means that the current single criterion for evaluation requires caution in its interpretation.
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Affiliation(s)
- Mieko Okamoto
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koichiro Matsuo
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Ogawa N, Ohno T, Kunieda K, Watanabe M, Fujishima I. A Novel Exercise to Improve Suprahyoid Muscle Area and Intensity as Evaluated by Ultrasonography. Dysphagia 2024:10.1007/s00455-024-10667-5. [PMID: 38324169 DOI: 10.1007/s00455-024-10667-5] [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: 08/14/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
Insufficient suprahyoid muscle strength with poor opening of the upper esophageal sphincter can cause dysphagia. This study investigated whether an exercise of the suprahyoid muscle, named forehead exercise for suprahyoid muscles (FESM, "Enge-Odeko-Taiso" in Japanese), improves the geniohyoid muscle area and intensity using ultrasonography. Sixty-four participants (15 men and 49 women, 82.8 ± 6.0 years) living independently with no symptoms of swallowing difficulties were enrolled. The participants were divided into the FESM and the control group. The FESM is an isometric exercise involving repetitions of looking into the navel as if the chin is pulled back with little neck motion using a hand pushed against the forehead for resistance. This exercise is performed five times in 10 courses a day (total 50 times) for 8 weeks. Participants in the control group did not conduct any exercises. Body mass index, hand grip strength, gait speed, calf circumference, Mini Nutritional Assessment short-form, eating assessment tool, repetitive saliva swallowing test (RSST), and Food Intake LEVEL Scale scores were examined. The ultrasonographic geniohyoid muscle area, intensity, and RSST were investigated before and after the program. In the FESM group, the geniohyoid muscle area increased from 2.24 to 2.52 cm2 (P < 0.05), intensity decreased from 34.6 to 32.0 (P < 0.05), and the median RSST increased from 5 to 6 (P < 0.05) significantly. Conversely, no significant differences were observed in the control group. The FESM was effective to increase the area and decrease the intensity of the geniohyoid muscle and may improve swallowing function.
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Affiliation(s)
- Nami Ogawa
- Department of Dentistry, Sakaue Dental Office, 3F-3-14-8, Tamagawa, Setagaya-Ku, Tokyo, 158-0094, Japan.
| | - Tomohisa Ohno
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, 1-6-1, Wagou, Hamamatsu City, Shizuoka, 433-8511, Japan
| | - Kenjiro Kunieda
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, 1-6-1, Wagou, Hamamatsu City, Shizuoka, 433-8511, Japan
- Department of Neurology, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu-City, Gifu, 501-1194, Japan
| | - Masato Watanabe
- Department of Internal Medicine and Respiratory Medicine, Ohisamagenki Clinic, 2F-5-2-5, Futako, Takatsu-Ku, Kawasaki-Shi, Kanagawa, 213-0002, Japan
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, 1-6-1, Wagou, Hamamatsu City, Shizuoka, 433-8511, Japan
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Ishimura K, Sakaniwa R, Shirai K, Aida J, Takeuchi K, Kondo K, Iso H. Frequency of Going Outdoors and Risk of Poor Oral Health Among Older Japanese Adults: A Longitudinal Cohort From the Japan Gerontological Evaluation Study. J Epidemiol 2024; 34:63-69. [PMID: 36967120 PMCID: PMC10751189 DOI: 10.2188/jea.je20220221] [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: 08/08/2022] [Accepted: 01/09/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND The association between the frequency of going outdoors and the risk of poor oral health has been reported in several studies; however, the findings have been inconclusive. METHODS We conducted a 3-year longitudinal study of 19,972 Japanese adults aged ≥65 years who reported no poor oral condition at baseline in 2013. The respondents rated their frequency of going outdoors in three categories (≤1, 2-3, or ≥4 times/week), and the oral conditions reported in 2016 included tooth loss, chewing difficulty, swallowing difficulty, dry mouth, and composite outcomes. The associations between the frequency of going outdoors and the risk of poor oral health were examined as relative risk ratios (RRs) and 95% confidence intervals (CIs) using multivariable Poisson regression, while mediation analysis was performed to investigate indirect effects. RESULTS During the follow-up, 32.5% of participants developed poor oral health. In the mediation analysis, indirect effects were observed through low instrumental activities of daily living, depressive symptoms, little social network diversity, and underweight. Compared to going outdoors ≥4 times/week, the multivariable RRs of composite poor oral health conditions were 1.12 (95% CI, 1.05-1.20) for 2-3 times/week and 1.22 (95% CI, 1.07-1.39) for ≤1 time/week (P-trend < 0.001). Similar associations were observed for tooth loss, chewing difficulty, and swallowing difficulty; the corresponding RRs were 1.07 (95% CI, 0.97-1.19) and 1.36 (95% CI, 1.13-1.64) (P-trend = 0.002), 1.18 (95% CI, 1.06-1.32) and 1.30 (95% CI, 1.05-1.60) (P-trend < 0.001), and 1.15 (95% CI, 1.01-1.31) and 1.38 (95% CI, 1.08-1.77) (P-trend = 0.002), respectively. CONCLUSION The frequency of going outdoors was inversely associated with the risk of poor oral health through several modifiable risk factors in the older population.
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Affiliation(s)
- Keiko Ishimura
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryoto Sakaniwa
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kokoro Shirai
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Science, Tokyo, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hiroyasu Iso
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Healthcare Center Medicine, Tokyo, Japan
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Moynihan P, Teo JL. Exploring Oral Function, Protein Intake, and Risk of Sarcopenia: A Scoping Review. JDR Clin Trans Res 2024; 9:4-20. [PMID: 36883673 PMCID: PMC10725128 DOI: 10.1177/23800844231157259] [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] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Sarcopenia is loss of both muscle mass and function with age and is associated with inadequate protein intake. However, evidence to suggest an association with oral health is less clear. OBJECTIVE To scope peer-reviewed published evidence (2000-2022) pertaining to oral function in relation to sarcopenia and/or protein intake in older people. METHODS CINAHL, Embase, PubMed, and Scopus were searched. Included were peer-reviewed studies measuring oral function (e.g., tooth loss, salivary flow masticatory function, strength of muscles of mastication, and tongue pressure) and a measure of protein intake and/or a measure of sarcopenia (appendicular muscle mass and function). Full article screening was conducted by 1 reviewer with a random 10% screened in duplicate by a second reviewer. Relevant content pertaining to study type, country of origin, measures of exposure, and outcomes and key findings was mapped and the balance of data showing a positive versus null association of oral health with outcomes charted. RESULTS Of 376 studies identified, 126 were screened in full, yielding 32 included texts, of which 29 were original articles. Seven reported intake of protein and 22 reported measures of sarcopenia. Nine distinct oral health exposures were identified, with ≤4 studies relating to any one of these measures. Most data were cross-sectional in nature (27 studies) and from Japan (20 studies). The balance of data showed associations between tooth loss and measures of sarcopenia and protein intake. However, the balance of data pertaining to any association between chewing function, tongue pressure, or indices of oral hypofunction and sarcopenia was mixed. CONCLUSION A broad range of oral health measures have been studied in relation to sarcopenia. The balance of data suggests that tooth loss is associated with risk, but data pertaining to the oral musculature and indices of oral hypofunction are mixed. KNOWLEDGE TRANSFER STATEMENT The findings of this research will increase awareness among clinicians of the amount and nature of evidence pertaining to the relationship between oral health and risk of compromised muscle mass and function, including data showing that loss of teeth is associated with increased risk of sarcopenia in older people. The findings highlight to researchers the gaps in the evidence and where further research and clarification of the relationship between oral health and risk of sarcopenia is warranted.
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Affiliation(s)
- P.J. Moynihan
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - J-L. Teo
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Korčok M, Calle J, Veverka M, Vietoris V. Understanding the health benefits and technological properties of β-glucan for the development of easy-to-swallow gels to guarantee food security among seniors. Crit Rev Food Sci Nutr 2023; 63:11504-11521. [PMID: 35766942 DOI: 10.1080/10408398.2022.2093325] [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] [Indexed: 11/03/2022]
Abstract
The world's population is growing rapidly and the number of elderly people with undernutrition and malnutrition is increasing. Common health problems among seniors are cardiovascular, inflammatory, gastrointestinal, and cognitive disorders, cancer, diabetes, psychological and dental problems. The food industry is trying to meet the demands of an aging society, but these efforts are not sufficient. New strategies are needed, and they demand foods development with modified textures that are easy to swallow, such as gels suitable for seniors. Depending on the specific needs of the elderly, bioactive compounds with health benefits should be included in food systems. Novel foods may play an important role in the prevention, maintenance, and treatment of age-related diseases. One of the most studied bioactive compound is β-glucan, a polysaccharide with approved health claims confirmed by clinical trials, such as "β-glucan contributes to the maintenance of normal blood cholesterol levels" and "the consumption of β-glucan from oats or barley contributes to the reduction of postprandial glucose spikes." In this review, the health benefits, and technological properties of β-glucan for the development of senior-friendly ready-to-swallow gels were described. In addition, some patents and studies conducted in connection with the development of the gel systems were collected.
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Affiliation(s)
- Melina Korčok
- Institute of Food Sciences, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture, Nitra, Slovakia
| | - Jehannara Calle
- Institute of Food Sciences, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture, Nitra, Slovakia
- Food Research Institute for the Food Industry (IIIA), Havana, Cuba
| | | | - Vladimir Vietoris
- Institute of Food Sciences, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture, Nitra, Slovakia
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Kakehi S, Isono E, Wakabayashi H, Shioya M, Ninomiya J, Aoyama Y, Murai R, Sato Y, Takemura R, Mori A, Masumura K, Suzuki B. Sarcopenic Dysphagia and Simplified Rehabilitation Nutrition Care Process: An Update. Ann Rehabil Med 2023; 47:337-347. [PMID: 37907225 PMCID: PMC10620494 DOI: 10.5535/arm.23101] [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: 07/25/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
Sarcopenic dysphagia is characterized by weakness of swallowing-related muscles associated with whole-body sarcopenia. As the number of patients with sarcopenia increases with the aging of the world, the number of patients with sarcopenic dysphagia is also increasing. The prevalence of sarcopenic dysphagia is high in the institutionalized older people and in patients hospitalized for pneumonia with dysphagia in acute care hospitals. Prevention, early detection and intervention of sarcopenic dysphagia with rehabilitation nutrition are essential. The diagnosis of sarcopenic dysphagia is based on skeletal and swallowing muscle strength and muscle mass. A reliable and validated diagnostic algorithm for sarcopenic dysphagia is used. Sarcopenic dysphagia is associated with malnutrition, which leads to mortality and Activities of Daily Living (ADL) decline. The rehabilitation nutrition approach improves swallowing function, nutrition status, and ADL. A combination of aggressive nutrition therapy to improve nutrition status, dysphagia rehabilitation, physical therapy, and other interventions can be effective for sarcopenic dysphagia. The rehabilitation nutrition care process is used to assess and problem solve the patient's pathology, sarcopenia, and nutrition status. The simplified rehabilitation nutrition care process consists of a nutrition cycle and a rehabilitation cycle, each with five steps: assessment, diagnosis, goal setting, intervention, and monitoring. Nutrition professionals and teams implement the nutrition cycle. Rehabilitation professionals and teams implement the rehabilitation cycle. Both cycles should be done simultaneously. The nutrition diagnosis of undernutrition, overnutrition/obesity, sarcopenia, and goal setting of rehabilitation and body weight are implemented collaboratively.
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Affiliation(s)
- Shingo Kakehi
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Eri Isono
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Moeka Shioya
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Junki Ninomiya
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Yohei Aoyama
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Ryoko Murai
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Yuka Sato
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Ryohei Takemura
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Amami Mori
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Kei Masumura
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Bunta Suzuki
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
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Martins FAG, Motta AR, Neves LS, Furlan RMMM. Evaluation of the maximum tongue and lip pressure in individuals with Class I, II, or III Angle malocclusions and different facial types. Codas 2023; 35:e20220102. [PMID: 37436259 PMCID: PMC10449092 DOI: 10.1590/2317-1782/20232022102] [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: 04/13/2022] [Accepted: 09/14/2022] [Indexed: 07/13/2023] Open
Abstract
PURPOSE To compare the maximum anterior and posterior tongue pressure, tongue endurance, and lip pressure in Class I, II, and III malocclusions and different facial types. METHODS A cross-sectional observational analytical study was carried out in 55 individuals (29 men and 26 women) aged between 18 and 55 years. The participants were divided into groups according to Angle malocclusion (Class I, II, and III) and facial type. The maximum anterior and posterior tongue pressure, tongue endurance, and maximum lip pressure were measured using the IOPI (Iowa Oral Performance Instrument). To determine the facial type, the cephalometric analysis was accomplished using Ricketts VERT analysis as a reference. RESULTS There was no statistically significant difference when comparing the maximum pressure of the anterior and posterior regions of the tongue, the maximum pressure of the lips, or the endurance of the tongue in the different Angle malocclusion types. Maximum posterior tongue pressure was lower in vertical individuals than in mesofacial individuals. CONCLUSION Tongue and lips pressure, as well as tongue endurance in adults was not associated with the type of malocclusion. However, there is an association between facial type and the posterior pressure of the tongue.
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Affiliation(s)
| | - Andréa Rodrigues Motta
- Departamento de Fonoaudiologia, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Leniana Santos Neves
- Departamento de Odontologia Restauradora, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
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Lee HJ, Park YS, Choi KJ, Kim YH, Choi YH, Lee EB, Kang BK, Shin WS. Impact of varying food hardness on mastication/swallowing. Food Sci Biotechnol 2023; 32:959-967. [PMID: 37123073 PMCID: PMC10130275 DOI: 10.1007/s10068-022-01237-2] [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: 07/14/2022] [Revised: 11/17/2022] [Accepted: 12/26/2022] [Indexed: 02/25/2023] Open
Abstract
The purpose of this study was to analyze mastication and swallowing in the elderly and confirm the association with dysphagia characteristics. A questionnaire was developed to evaluate the masticating and swallowing functions of the elderly. Mastication was analyzed using electromyography, and tongue/lip pressures were measured using Iowa Oral Performance Instrument. The results of the questionnaire showed that statistical difference in the number of teeth between the group without and with, decreased ability to swallow, and there was a correlation with lip pressure. Additionally, the higher number of teeth, the higher muscle activity, and there is a positive correlation between the number of chews and the lip pressure. Consequently, our findings suggested oral health parameters are closely associated with mastication/swallowing ability. Finally, based on the results obtained for different foods tested, we suggested that texture-modified foods are necessary to enhance swallowing ability.
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Affiliation(s)
- Hyun-Jung Lee
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
| | - Young-Sook Park
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
| | - Kui-Jeong Choi
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
| | - Yoon-Ha Kim
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
| | - Yun-Hye Choi
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
| | - Eun-Bee Lee
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
| | - Bo-Kyong Kang
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
| | - Weon-Sun Shin
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
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12
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Yamaguchi K, Nakagawa K, Yoshimi K, Ariya C, Nakane A, Ishii M, Hasegawa S, Tohara H. Association between characteristics of swallowing-related muscles and trunk muscle mass. Sci Rep 2023; 13:7814. [PMID: 37188715 DOI: 10.1038/s41598-023-34905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/09/2023] [Indexed: 05/17/2023] Open
Abstract
Swallowing function is associated with systemic factors. Whether trunk or appendicular skeletal muscle mass is a better indicator of swallowing-related muscle characteristics in community-dwelling older adults is not clear. Hence, we investigated the association between the characteristics of swallowing-related muscles (e.g., mass and quality) and trunk muscle mass. Community-dwelling older adults aged ≥ 65 years (n = 141; men: n = 45, women: n = 96) were recruited for this cross-sectional observational study via a health survey conducted in 2018. Trunk muscle mass index (TMI) and appendicular skeletal muscle mass index (SMI) were measured using bioelectrical impedance analysis. Cross-sectional areas (CSAs) and echo intensity (EI) of the geniohyoid muscle (GHM) and tongue were evaluated using an ultrasonic diagnostic apparatus. Multiple regression analysis was used to examine the relationship of the characteristics of swallowing-related muscle with TMI and SMI. Multiple regression analysis showed that CSA of the GHM was positively associated with both TMI (B = 24.9, p < 0.001) and SMI (B = 13.7, p = 0.002). EIs of swallowing-related muscles were not associated with TMI and SMI. Trunk muscle mass was associated with swallowing-related muscle mass and not muscle quality. The results of this study shed light on the elucidation of association of dysphagia with TMI and SMI.
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Affiliation(s)
- Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Chantaramanee Ariya
- Department of Preventive Dentistry, Naresuan University, 99 Moo 9 Tambon Tha Pho, Mueang Phitsanulok, 65000, Thailand
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Miki Ishii
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Shohei Hasegawa
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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13
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Kugimiya Y, Iwasaki M, Ohara Y, Motokawa K, Edahiro A, Shirobe M, Watanabe Y, Taniguchi Y, Seino S, Abe T, Obuchi S, Kawai H, Kera T, Fujiwara Y, Kitamura A, Ihara K, Kim H, Shinkai S, Hirano H. Association between sarcopenia and oral functions in community-dwelling older adults: A cross-sectional study. J Cachexia Sarcopenia Muscle 2023; 14:429-438. [PMID: 36470807 PMCID: PMC9891969 DOI: 10.1002/jcsm.13145] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/13/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Few studies have examined the state of oral function in older adults with sarcopenia. We assessed the oral functions of community-dwelling older adults with sarcopenia from multiple perspectives to clarify their potentially low oral function. METHODS A total of 1517 (86.2%; 990 women, 527 men; mean age 76.1 ± 7.6 years) participants were included in this study. Grip strength, gait speed and skeletal muscle mass index were assessed, and sarcopenia was evaluated according to the criteria of the Asian Working Group for Sarcopenia 2019. The degree of tongue coating, oral moisture, occlusal force, tongue-lip motor function, tongue pressure, masticatory function and swallowing function were assessed. The criteria for oral hypofunction (a disease that is a combination of multiple low oral functions) were used to assess oral function. Statistical analyses were performed using Kolmogorov-Smirnov test, unpaired t-test, Mann-Whitney U test, χ2 test, and univariate and multivariable logistic regression analyses, with each oral function as the dependent variable and sarcopenia as one of the independent variables. The significance level was set at P < 0.05. RESULTS The prevalence rates of sarcopenia and severe sarcopenia were 14.2% and 3.8%, respectively. The prevalence of oral hypofunction was 39.9%. Compared with the robust group, the sarcopenia and severe sarcopenia groups tended to have a higher frequency of the following components (all P < 0.01): low occlusal force, low tongue-lip motor function, low tongue pressure, low masticatory function, low swallowing function and oral hypofunction. Univariate logistic regression analysis showed that sarcopenia was associated with low occlusal force, low tongue-lip motor function, low tongue pressure, low masticatory function, low swallowing function and oral hypofunction. The odds ratios and 95% confidence intervals of sarcopenia for each oral function were 2.62 [2.00, 3.43], 2.21 [1.69, 2.89], 3.66 [2.79, 4.81], 3.23 [2.46, 4.25], 1.66 [1.26, 2.20] and 3.59 [2.72, 4.72], respectively. Multivariable logistic regression analysis showed that sarcopenia was associated with low occlusal force (1.63 [1.10, 2.40]), low tongue pressure (2.28 [1.65, 3.15]), low masticatory function, (1.94 [1.27, 2.97]), low swallowing function (1.64 [1.17, 2.28]) and oral hypofunction (2.17 [1.52, 3.09]). CONCLUSIONS This study demonstrated that multiple aspects of oral function were low among community-dwelling older adults with sarcopenia. The potential decline in oral functions in older adults with sarcopenia may have been overlooked until now. This study indicates the need for dental perspectives in intervening with older adults with sarcopenia and the need to encourage them to see dental professionals.
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Affiliation(s)
- Yoshihiro Kugimiya
- Department of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yu Taniguchi
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takeshi Kera
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Faculty of Health Care, Takasaki University of Health and Welfare, Gunma, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University School of Medicine, Aomori, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Graduate School of Nutrition and Health Science, Kagawa Nutrition University, Sakato, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
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14
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Kitamura K, Watanabe T, Yamamoto M, Ishikawa N, Kasahara N, Abe S, Yamamoto H. A Newly Discovered Tendon Between the Genioglossus Muscle and Epiglottic Cartilage Identified by Histological Observation of the Pre-Epiglottic Space. Dysphagia 2023; 38:315-329. [PMID: 35678869 PMCID: PMC9873719 DOI: 10.1007/s00455-022-10469-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/16/2022] [Indexed: 01/28/2023]
Abstract
Epiglottic retroversion is difficult to explain anatomically. One reason is inadequate structural identification of the ligaments in the submucosal tissue anterior to the epiglottis (pre-epiglottic space, PES). Although studies have shown that tongue root movement plays a role in epiglottic retroversion, few morphological reports have investigated the attachment of the lingual muscles to the epiglottis. This study reconstructed the fiber structure of the PES by comprehensively analyzing fiber alignment in the PES focusing on the hyoepiglottic ligament, which runs between the lingual muscles and the epiglottis. Gross and microscopic observations of the submucosal structures from the tongue to the larynx of 20 cadavers (10 men, 10 women; mean age 79 years) were performed. A tendon continuing from the posterior part of the genioglossus muscle and attaching to the center of the epiglottic cartilage was identified in the midline area of the epiglottis. We named this tendon the glossoepiglottic tendon. In contrast, the hyoepiglottic ligament is found between the hyoid bone and the epiglottis and is attached from the lateral margin of the epiglottic cartilage to its base. Furthermore, the glossoepiglottic tendon consists of a high-density fiber bundle that is thicker than the hyoepiglottic ligament. These results show that the conventional hyoepiglottic ligament has a two-layer structure consisting of an upper fiber bundle connected to the genioglossus muscle and a lower fiber bundle connected to the hyoid bone. Sustained contraction of the posterior part of the genioglossus muscle therefore places the epiglottis under persistent traction, suggesting that its relaxation may cause epiglottic retroversion.
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Affiliation(s)
- Kei Kitamura
- Department of Histology and Developmental Biology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan.
| | - Tae Watanabe
- Department of Histology and Developmental Biology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Masahito Yamamoto
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Noboru Ishikawa
- Department of Forensic Odontology and Anthropology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Norio Kasahara
- Department of Histology and Developmental Biology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Hitoshi Yamamoto
- Department of Histology and Developmental Biology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
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15
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Iwasaki M, Ohara Y, Motokawa K, Hayakawa M, Shirobe M, Edahiro A, Watanabe Y, Awata S, Okamura T, Inagaki H, Sakuma N, Obuchi S, Kawai H, Ejiri M, Ito K, Fujiwara Y, Kitamura A, Nofuji Y, Abe T, Iijima K, Tanaka T, Son BK, Shinkai S, Hirano H. Population-based reference values for tongue pressure in Japanese older adults: A pooled analysis of over 5,000 participants. J Prosthodont Res 2023; 67:62-69. [PMID: 35082226 DOI: 10.2186/jpr.jpr_d_21_00272] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To establish age- and sex-specific population reference values for tongue pressure (TP) in community-dwelling Japanese older adults. METHODS For this analysis, we pooled four population-based studies on community-dwelling adults aged ≥65 years that measured TP using a JMS tongue pressure measuring device. We calculated the means and deciles of TP per 5-year age group for each sex. We also estimated age trends in TP for men and women. RESULTS In total, 5,083 individuals (2,150 men and 2,933 women, with a mean [standard deviation] age of 75.2 [6.5] years) were included in the present analysis. In male participants, the mean (standard deviation) TPs for ages 65-69, 70-74, 75-79, 80-84, and ≥85 years were 34.0 (8.4), 32.2 (8.1), 30.8 (8.3), 28.4 (8.9), and 24.4 (8.2) kPa, respectively. In female participants, the corresponding values were 31.5 (7.1), 30.5 (7.5), 29.6 (7.3), 28.4 (8.0), and 26.4 (7.6) kPa, respectively. For both sexes, there were significant declining trends in TP with advanced age. In addition, the interaction between age and sex had a significant effect on TP (regression coefficient [95% confidence interval] = -0.18 [-0.25 to -0.11] when age was modeled as a continuous variable and sex was modeled as a categorical variable [coded as 0=women, 1=men]). CONCLUSIONS This study determined age- and sex-specific reference values for TP, presented as means and deciles, in community-dwelling Japanese older adults aged ≥65 years. This study also demonstrated sex differences in age-related declines in TP.
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Affiliation(s)
- Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Misato Hayakawa
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Maki Shirobe
- The Tokyo Metropolitan Support Center for Preventative Long-Term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Gerodontology, Department of Oral Health Science, Hokkaido, Japan
| | - Shuichi Awata
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Naoko Sakuma
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Manami Ejiri
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kumiko Ito
- Health Promotion Management Office, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan.,Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Bo-Kyung Son
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan.,Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Shoji Shinkai
- The Tokyo Metropolitan Support Center for Preventative Long-Term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Graduate School of Nutrition Sciences, School of Nutritional Sciences, Kagawa Nutrition University, Saitama, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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16
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Abstract
BACKGROUND The oropharyngeal dysphagia is an underestimated symptom with various causes in the geriatric population. Clinical presentation is often insidious and dysphagia symptoms are seldomly mentioned by elderly patients although causing many life-threatening complications. The aim of this work was to introduce an easy applicable tool to be used by the caregivers and general practitioners for screening of dysphagia in geriatrics for early detection of at risk individuals. METHODS A sample of 200 Egyptian Arabic-speaking elderly patients (65 years or older) not complaining of dysphagia was recruited from nursing homes in Greater Cairo Area. They or their caregivers completed the designed screening tool, including; the designed questionnaires of dysphagia manifestations and eating habits. General, oral motor and bedside evaluation were also performed. In addition to filling in the EAT10 questionnaire and FEES that was performed for only suspected cases for the purpose of validation of the screening tool. RESULTS The dysphagia manifestations questionnaire was significantly correlated with EAT 10 with p value of 0.001. It was correlated in some of its aspects with FEES showing quite reliability with p values' range between 0.012 and 0.044. The Questionnaire of eating habits reliability of r- value of 0.568 slightly exceeding EAT10 reliability of r -value of 0.721 in the subjects under study. The cutoff point of total score of the dysphagia manifestations was > 5, with a sensitivity of 17.65% & a specificity of 94.20%. The cutoff point of total score of the bedside evaluation was ≤ 1 with a sensitivity of 66.9% & a specificity of 56.9%. CONCLUSION the use of this easy applicable screening tool managed to suspect and later on diagnose cases with oropharyngeal dysphagia in non-complaining aging subjects.
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17
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Thu Hien NT, Thong TH, Tung LT, Khoi VH, Thu Hoai DT, Tinh TT, Van Huy N, Kien VD. Dysphagia and associated factors among patients with acute ischemic stroke in Vietnam. Ann Med Surg (Lond) 2022; 84:104887. [DOI: 10.1016/j.amsu.2022.104887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/24/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022] Open
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18
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Nanto T, Ono T, Hori K, Murakami K, Uchiyama Y, Maeda Y, Domen K. The Effects of Tongue Elevation using a Weighted Plastic Bottle on the Tongue Pressure and Activity of Suprahyoid Muscles. J Oral Rehabil 2022; 49:1041-1048. [PMID: 36029125 DOI: 10.1111/joor.13365] [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: 10/04/2021] [Revised: 06/30/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND A rise in tongue pressure coincides with an increase in the suprahyoid muscles activity. OBJECTIVES The aim was to investigate the effects of holding a weighted plastic bottle on tongue pressure and the suprahyoid muscles activity. METHODS Eighteen participants (8 men and 10 women; mean age 42 ± 16 years) participated in this study. All participants had no history of speech, language, hearing, or swallowing disorders and no tooth loss, and they did not require dentures. Healthy participants held gauzes connected with a plastic bottle with increasing resistive loads of 0 g, 250 g, 500 g, and 750 g, between their palate and tongue. The maximum tongue pressure and average tongue pressure were measured during a 5-second hold. The average tongue pressure was defined as the mean tongue-pressure data in each task. The suprahyoid muscles activity was measured using the electromyogram (EMG). The root mean square of the EMG signals measured while lifting different loads and while performing the head lifting exercises were compared. All variables were examined using the Friedman's test and Wilcoxon signed-rank test. RESULTS The maximum tongue pressure (p < .05) and average tongue pressure values (p < .05) increased gradually in the anterior-median region with increasing resistive loads, and the root mean square amplitudes for 250 g, 500 g, and 750 g were not significant compared to head lifting exercises. CONCLUSION These results indicated that Plastic bottle holding could be a potential strength-training tool for the tongue and the suprahyoid muscles.
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Affiliation(s)
- Tomoki Nanto
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan.,Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Niigata University Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuhiro Murakami
- Division of Comprehensive Prosthodontics, Niigata University Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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19
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Tamai T, Hara K, Nakagawa K, Namiki C, Yamaguchi K, Yoshimi K, Yanagida R, Hasegawa S, Nakane A, Okumura T, Ishii M, Tohara H. Strength and morphology of a suprahyoid muscle and their relationship to forward head posture in healthy older adults. Geriatr Gerontol Int 2022; 22:779-784. [DOI: 10.1111/ggi.14457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Tomoe Tamai
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Koji Hara
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry Kanagawa Dental University Kanagawa Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Chizuru Namiki
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Ryosuke Yanagida
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Shohei Hasegawa
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Takuma Okumura
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Miki Ishii
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology Tokyo Medical and Dental University Tokyo Japan
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20
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Namiki C, Hara K, Yanagida R, Nakagawa K, Yamaguchi K, Okumura T, Tamai T, Kurosawa Y, Komatsu T, Tohara H. Association between Tongue Pressure and Jaw-Opening Force in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9825. [PMID: 36011461 PMCID: PMC9407805 DOI: 10.3390/ijerph19169825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Tongue pressure (TP) is used to assess tongue muscle strength and is related to function and frailty. While performing TP, it is necessary to elevate the tongue and oral floor by contracting the suprahyoid muscles. However, the association between TP and suprahyoid muscle strength remains unclear. Accordingly, this study investigated the relationship between TP and jaw-opening force (JOF), an indicator of suprahyoid muscle strength. This cross-sectional study included 88 independent community-dwelling participants aged ≥65 years. Age, sex, and the number of remaining teeth were recorded. Ultrasonography was used to evaluate the cross-sectional area of the tongue and geniohyoid muscle, as representatives of the suprahyoid muscles. Sarcopenia was diagnosed based on appendicular skeletal muscle mass index, handgrip strength, and gait speed. Multiple regression analysis was performed with TP as the dependent variable. TP was significantly associated with JOF (β = 0.371, p = 0.003). This study revealed that decreased TP was associated with a decline in JOF and suprahyoid muscle mass in older adults. Thus, low TP may be associated with decreased JOF. Prevention of the weakness of the suprahyoid muscles and maintaining TP may also contribute to the prevention of frailty associated with TP.
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Affiliation(s)
- Chizuru Namiki
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 2388580, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Koji Hara
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 2388580, Japan
| | - Ryosuke Yanagida
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Takuma Okumura
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Tomoe Tamai
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Yukiko Kurosawa
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 2388580, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Tomoko Komatsu
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 2388580, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
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Sakai K, Nakayama E, Yoneoka D, Sakata N, Iijima K, Tanaka T, Hayashi K, Sakuma K, Hoshino E. Association of Oral Function and Dysphagia with Frailty and Sarcopenia in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Cells 2022; 11:2199. [PMID: 35883642 PMCID: PMC9316124 DOI: 10.3390/cells11142199] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 12/11/2022] Open
Abstract
Studies investigating the associations of oral function and dysphagia with frailty and sarcopenia in community-dwelling older adults are increasing; however, they have not been systematically summarized. We conducted a systematic review to investigate these associations. We searched electronic databases and synthesized relevant data using conventional (frequentist-style) and Bayesian meta-analyses. Twenty-four studies were found to be eligible for our review, including 20 cross-sectional and four prospective cohort studies. Older adults with frailty or sarcopenia had lower tongue pressure, according to the results of conventional meta-analysis (mean difference [95% confidence interval or credible interval]: -6.80 kPa [-10.22 to -3.38] for frailty and -5.40 kPa [-6.62 to -4.17] for sarcopenia) and Bayesian meta-analysis (-6.90 kPa [-9.0 to -4.8] for frailty, -5.35 kPa [-6.78 to -3.89] for sarcopenia). People with frailty had a higher odds ratio (OR) for dysphagia according to the results of conventional meta-analysis (3.99 [2.17 to 7.32]) and Bayesian meta-analysis (1.38 [0.77 to 1.98]). However, the results were inconclusive for people with sarcopenia. A prospective association could not be determined because of the lack of information and the limited number of studies. Decreased oral function and dysphagia can be important characteristics of frailty and sarcopenia in community-dwelling older adults.
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Affiliation(s)
- Kotomi Sakai
- Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Research Organization of Science and Technology, Ritsumeikan University, Kyoto 600-8815, Japan;
- Heisei Medical Welfare Group Research Institute, Tokyo 151-0053, Japan;
| | - Enri Nakayama
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo 101-8310, Japan;
| | - Daisuke Yoneoka
- Infectious Disease Surveillance Center at the National Institute of Infectious Diseases, Tokyo 162-8640, Japan;
- Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo 160-8582, Japan
- Tokyo Foundation for Policy Research, Tokyo 106-6234, Japan
| | - Nobuo Sakata
- Heisei Medical Welfare Group Research Institute, Tokyo 151-0053, Japan;
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo 113-8654, Japan; (K.I.); (T.T.)
- Institute for Future Initiatives, The University of Tokyo, Tokyo 113-8654, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo 113-8654, Japan; (K.I.); (T.T.)
| | - Kuniyoshi Hayashi
- Institute of Religion and Culture, Kyoto Women’s University, Kyoto 605-8501, Japan;
| | - Kunihiro Sakuma
- Institute for Liberal Arts, Environment and Society, Tokyo Institute of Technology, Tokyo 152-8550, Japan;
| | - Eri Hoshino
- Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Research Organization of Science and Technology, Ritsumeikan University, Kyoto 600-8815, Japan;
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Factors Predicting Tongue Pressure Decline among Community-Dwelling Older Adults: The Takashimadaira Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137850. [PMID: 35805508 PMCID: PMC9265909 DOI: 10.3390/ijerph19137850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/18/2022] [Accepted: 06/23/2022] [Indexed: 11/17/2022]
Abstract
A limited number of longitudinal studies have explored factors contributing to decreases in tongue pressure (TP). This longitudinal study aimed to clarify the factors affecting TP decline among community-dwelling older adults. We followed the Takashimadaira Study participants with a baseline TP ≥ 30 kPa for 2 years. A TP of <30 kPa at follow-up was defined as TP decline. We used Poisson regression with robust standard errors to explore the factors related to TP decline. The studied baseline variables were dental status, sociodemographic characteristics, health behaviors, appetite, medical conditions, physical function, cognitive status, and anthropometric and body composition characteristics. Inverse probability weighting (IPW) was used to adjust for selection bias. Overall, 357 individuals (159 men and 198 women) with a mean (standard deviation) age of 75.9 (4.1) years were included in the analyses. Of these, 59 study participants (16.5%) exhibited TP decline. After adjusting for baseline TP and applying IPW, poor appetite (incident rate ratio [95% confidence interval] = 1.58 [1.01−2.48]), low skeletal muscle mass index (1.66 [1.02−2.70]), and cognitive impairment (1.93 [1.12−3.33]) were associated with TP decline. In conclusion, we demonstrated that baseline appetite, body composition, and cognitive status could predict future TP decline among community-dwelling older adults.
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Kusunoki H, Hasegawa Y, Tsuji S, Wada Y, Tamaki K, Nagai K, Mori T, Matsuzawa R, Kishimoto H, Shimizu H, Shinmura K. Relationships between cystatin C and creatinine‐based eGFR with low tongue pressure in Japanese rural community‐dwelling older adults. Clin Exp Dent Res 2022; 8:1259-1269. [PMID: 35749633 PMCID: PMC9562798 DOI: 10.1002/cre2.619] [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: 04/08/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Sarcopenia is prevalent in patients with chronic kidney disease (CKD), which is defined as a low estimated glomerular filtration rate (eGFR). It has been reported that oral hypofunction characterized by decreased tongue pressure is related to sarcopenia. Although there are several previous reports regarding the association of renal dysfunction with oral hypofunction characterized by low tongue pressure, the association between tongue pressure and renal function is not fully understood. Methods This cross‐sectional study included 68 men aged 79.0 ± 4.8 years and 145 women aged 77.3 ± 5.4 years from a rural area in Hyogo Prefecture, Japan. We examined the relationships between cystatin C‐based CKD (CKDcys), creatinine‐based CKD (CKDcre), ratio of cystatin C‐based GFR (eGFRcys) divided by creatinine‐based GFR (eGFRcre): eGFRcys/eGFRcre, and tongue pressure in community‐dwelling older adults. Results Tongue pressure was significantly lower in participants with CKDcys than in those without CKDcys in men and women. However, there were no significant differences in tongue pressure with or without CKDcre. Tongue pressure was significantly lower in participants with eGFRcys/eGFRcre <1.0, than in those with eGFRcys/eGFRcre ≧ 1.0 in men. According to the receiver operating characteristic analysis, the optimal cut‐off value of tongue pressure for the presence of CKDcys was 36.6kPa, area under the curve (AUC) 0.74 (specificity 54.8%, sensitivity 84.6%) in men and 31.8kPa, AUC 0.65 (specificity 67.3%, sensitivity 60.5%) in women. Conclusions CKDcys but not CKDcre is associated with low tongue pressure. In addition, a lower eGFRcys/eGFRcre ratio is a useful screening marker of low tongue pressure in community‐dwelling older adults.
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Affiliation(s)
- Hiroshi Kusunoki
- Division of General Medicine, Department of Internal Medicine Hyogo College of Medicine Nishinomiya Hyogo Japan
- Department of Internal Medicine Osaka Dental University Hirakata Osaka Japan
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics Niigata University Graduate School of Medical and Dental Sciences Niigata Niigata Japan
- Amagasaki Medical COOP Honden Clinic Amagasaki Hyogo Japan
| | - Shotaro Tsuji
- Department of Orthopaedic Surgery Hyogo College of Medicine Nishinomiya Hyogo Japan
| | - Yosuke Wada
- Division of General Medicine, Department of Internal Medicine Hyogo College of Medicine Nishinomiya Hyogo Japan
| | - Kayoko Tamaki
- Division of General Medicine, Department of Internal Medicine Hyogo College of Medicine Nishinomiya Hyogo Japan
| | - Koutatsu Nagai
- School of Rehabilitation Hyogo University of Health Sciences Kobe Hyogo Japan
| | - Takara Mori
- Division of General Medicine, Department of Internal Medicine Hyogo College of Medicine Nishinomiya Hyogo Japan
- Amagasaki Medical COOP Honden Clinic Amagasaki Hyogo Japan
| | - Ryota Matsuzawa
- School of Rehabilitation Hyogo University of Health Sciences Kobe Hyogo Japan
| | - Hiromitsu Kishimoto
- Department of Dentistry and Oral Surgery Hyogo College of Medicine Nishinomiya Hyogo Japan
| | - Hideo Shimizu
- Department of Internal Medicine Osaka Dental University Hirakata Osaka Japan
| | - Ken Shinmura
- Division of General Medicine, Department of Internal Medicine Hyogo College of Medicine Nishinomiya Hyogo Japan
- Department of Orthopaedic Surgery Hyogo College of Medicine Nishinomiya Hyogo Japan
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Riolo V, Pizzorni N, Guanziroli E, Agostinis B, Confortola M, Schettino N, Gilardone G, Schindler A, Molteni F. Cross-cultural adaptation into Italian and validation of the Frenchay dysarthria assessment - 2. Eur J Phys Rehabil Med 2022; 58:342-351. [PMID: 34498832 PMCID: PMC9980487 DOI: 10.23736/s1973-9087.21.07029-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND A comprehensive evaluation of dysarthria is required to make an accurate differential diagnosis with other communication disorders and plan effective rehabilitation programs. The Frenchay Dysarthria Assessment-2 (FDA-2) is a valid, reliable and widely used protocol for the assessment of dysarthria. An Italian version of the FDA-2 is currently lacking. AIM To perform a cross-cultural adaptation of the FDA-2 in Italian and to validate the Italian version of the FDA-2. DESIGN Validation study. SETTING Inpatient rehabilitation center. POPULATION 69 patients with dysarthria and 112 healthy controls. METHODS The FDA-2 was translated and cross-culturally adapted to Italian. The validation study was carried out in 4 steps: (1) 42 audio-recorded samples of FDA-2 items from 11 patients with dysarthria were independently assessed by 7 speech and language pathologists for interrater reliability and re-assessed after 6 weeks for intrarater reliability; (2) 11 patients were simultaneously assessed by 3 speech and language therapists for interrater reliability of the whole Italian version of the FDA-2 and re-assessed within 24 hours for test-retest reliability; (3) the Italian version of the FDA-2 was administered to 112 healthy volunteers to gain normative data; (4) 49 patients with different types of dysarthria were assessed using the Italian version of the FDA-2, the Therapy Outcome Measure impairment scale and the Robertson Profile for the validity analysis. RESULTS Interrater and intrarater reliability ranged from good to excellent (ICC >0.75) except for 3 audio-recorded items. The overall protocol demonstrated excellent (ICC >0.9) inter-rater and test-retest reliability for all the sections and the total score. Normative data were gained for 6 age groups. For the validity analysis, a statistically significant difference was found between dysarthric patients and healthy subjects for all sections and the total score. The FDA-2 significantly correlated to the therapy outcome measure (r=0.75) and the Robertson Profile (r=0.81). CONCLUSIONS The Italian version of the FDA-2 yield satisfactory reliability and validity, comparable to the psychometric properties of the original version. CLINICAL REHABILITATION IMPACT Speech and language pathologists can rely on a valid and reliable tool in Italian for the assessment of dysarthria in both clinical and research practice.
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Affiliation(s)
- Valentina Riolo
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy
| | - Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "Luigi Sacco, " University of Milan, Milan, Italy -
| | - Eleonora Guanziroli
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy
| | | | - Megghi Confortola
- Unit of Childhood and Adolescent Neuropsychiatry, ASST Valtellina e Alto Lario, Sondrio, Italy
| | | | - Giulia Gilardone
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "Luigi Sacco, " University of Milan, Milan, Italy
| | - Franco Molteni
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy
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Tongue Pressure Declines Early on in Patients with Malocclusion. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
(1) Background: The tongue plays a key role in the stomatognathic system in carrying out oral functions. The aim of this study was to identify the association between tongue pressure and orthodontic parameters. (2) Methods: This study is a cross-sectional multicentered cohort study with IRB approval. During routine orthodontic initial examinations, the following data were recorded: age, sex, angle classification, overjet (OJ), overbite (OB), arch sizes, tongue width, and maximum tongue pressure (MTP). The association between MTP and orthodontic parameters was analyzed using Pearson’s correlation analysis and the Student’s t-test. (3) Results: There is a positive correlation between MTP and age between ages 10 and 20 (R = 0.47, p < 0.01). There is a negative correlation with MTP and age between 20 and 40 (R = −0.30, p < 0.05). There are negative correlations between MTP and OJ (R = −0.278, p < 0.01)) and OB (R = −0.374, p < 0.01). While there is no statistical significance between MTP and tongue width, there is a statistically significant difference between age and tongue width (R = 0.22482, p < 0.05). There is no statistical significance between MTP and sex, angle classification, arch length, intercanine width, and intermolar width. (4) Conclusion: An earlier decline in MTP is observed with patients with malocclusion. This implies that patients with malocclusion should seek early treatment for the malocclusion.
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Effect of decreased tongue pressure on dysphagia and survival rate in elderly people requiring long-term care. J Dent Sci 2022; 17:856-862. [PMID: 35756815 PMCID: PMC9201529 DOI: 10.1016/j.jds.2021.09.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/21/2021] [Indexed: 12/11/2022] Open
Abstract
Background/purpose Tongue pressure plays an important role in swallowing function. The purpose of this study is to investigate whether decreased tongue pressure is associated with dysphagia and the development of pneumonia in the elderly requiring long-term care. Materials and methods Tongue pressure measurement and swallowing videoendoscopic (VE) examination were performed in 60 hospitalized elderly people (33 males and 27 females, with an average age of 84.3 years) to investigate the relationship with the clinical course. Factors related with dysphagia was analyzed by Fisher's exact test and one-way ANOVA, followed by multivariate logistic regression. The relationship between each variable and survival were analyzed by cox regression. Results Twenty-one patients had dysphagia by VE examination. Multivariate analysis showed that smaller BMI and reduced tongue pressure were significantly correlated with dysphagia. Smaller number of remaining teeth and dysphagia were significantly related to pneumonia-related death. No patients with tongue pressure of larger than 20 kpa died by pneumonia within one year, while in those with tongue pressure of smaller than 20 kpa, one-year cumulative survival rate by pneumonia was 44.3%. Conclusion Decreased tongue pressure was significantly associated with dysphagia and may increase the risk of pneumonia-related death in the elderly requiring long-term care.
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Kumar A, Munirji L, Nayif S, Almotairy N, Grigoriadis J, Grigoriadis A, Trulsson M. Motor Performance and Skill Acquisition in Oral Motor Training With Exergames: A Pilot Study. Front Aging Neurosci 2022; 14:730072. [PMID: 35309890 PMCID: PMC8924593 DOI: 10.3389/fnagi.2022.730072] [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: 06/24/2021] [Accepted: 02/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To investigate the effects of oral-motor training with exergames on motor performance and motor skill acquisition in two different age groups. Methods Thirty-two healthy participants were recruited in the current pilot study and divided equally into two groups (Gen Z and Baby Boomers) according to their age. A pair of electromyographic (EMG) electrodes were placed on the participants’ masseter muscles. The EMG device communicated via Bluetooth with a mobile video game in response to the electromyographic activity of the masseter muscles during clenching. During the experimental session, participants were asked to play a video game in five blocks of 5 min each, with a 3-min break between each time block. The goal of the game was to collect as many coins (game points) as possible and to dodge/avoid upcoming obstacles (game life). Motor performance was assessed by performance scores and the number of game lives. Skill acquisition was measured by task efficiency (ratio of performance scores and number of game lives) across time blocks. Results The results of the study showed significantly lower performance scores (p < 0.001), a higher number of game lives (p < 0.001), and lower task efficiency in the Baby Boomer group compared to the Gen Z group. Specifically, the results showed that there was a significant difference in task efficiency between the first and second, third and fourth, fourth- and fifth-time blocks in the Gen Z group (p < 0.002). However, there was only a significant difference between first- and second-time blocks in the Baby Boomer group (p = 1.012), suggesting that skill acquisition in the Baby Boomer group did not change significantly over the course of the time blocks. Conclusion The study showed higher motor performance and superior motor skill acquisition with novel exergame training in the Gen Z group compared to the Baby Boomer group. The results of the study indicate that there is an improvement in oral motor skills with short-term training, yet the differences in oral motor skills between the two groups are still evident. The Baby Boomer group, unlike the Gen Z group, did not show robust improvement in task efficiency over the course of the series.
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Affiliation(s)
- Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- *Correspondence: Abhishek Kumar,
| | - Linda Munirji
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sam Nayif
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Nabeel Almotairy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | - Joannis Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Anastasios Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Mats Trulsson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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A simplified method for evaluating swallowing ability and estimating malnutrition risk: A pilot study in older adults. PLoS One 2022; 17:e0263896. [PMID: 35171950 PMCID: PMC8849596 DOI: 10.1371/journal.pone.0263896] [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: 07/03/2021] [Accepted: 01/29/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives The aim of this pilot study was to develop a Thai-version of a simple swallowing questionnaire, called the T-SSQ, and to evaluate the association between malnutrition risk and swallowing ability, determined objectively by tongue strength and subjectively by the T-SSQ. Sensitivity analysis was also performed to determine which swallowing indices better estimate malnutrition in older adults. Methods This cross-sectional study comprised two phases: Phase I, development and cross-cultural translation of the T-SSQ; and Phase II, application of the T-SSQ in 60 older adults. In Phase I, content and face validity of the T-SSQ was evaluated by 10 experts and 15 older adults. In Phase II, the convergent validity of the T-SSQ was evaluated by determining its association with objective tongue strength. Nutritional status was evaluated using the Thai-version of the Mini-Nutritional Assessment. Covariates included sociodemographic characteristics, and oral and health-related status. Adjusting for covariates, the associations between the two swallowing indices and malnutrition risk were determined using multivariable regression analyses. A cut-off value for low tongue strength was determined using a receiver operating characteristic (ROC) curve, and sensitivity analysis between the swallowing indices and malnutrition risk was performed. Results The T-SSQ comprised 4-items of common signs and symptoms of a swallowing problem. Its content and face validity were verified. Older adults were considered as having a swallowing problem when at least one item was reported. Convergent validity of the subjective index was shown by significantly different tongue strength values between the participants with and without a swallowing problem (p for independent t-test = 0.014). Based on the highest area under the ROC curve, an 18-kPa cut-off value was chosen to classify low tongue strength. Having a swallowing problem and low tongue strength was significantly associated with malnutrition risk. The positive predictive value of the subjective swallowing index was 1.8-fold higher than objective tongue strength. Conclusions Self-reported swallowing problems determined by the T-SSQ can be used as a subjective index for evaluating swallowing ability in older adults. Subjective swallowing problems and objective tongue strength were associated with malnutrition risk. However, the T-SSQ estimated malnutrition risk better than the objective index.
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Murakami T, Kamide N, Ando M, Hata W, Sakamoto M. Association between tongue pressure and skeletal muscle mass and muscle function in community-dwelling older people without sarcopenia. Eur Geriatr Med 2022; 13:649-653. [PMID: 35122216 DOI: 10.1007/s41999-022-00608-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/30/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to cross-sectionally investigate relationships between maximum tongue pressure (MTP) and whole-body muscle mass and strength for non-sarcopenic older adults. METHODS Study participants comprised 341 adults (105 men, 236 women) ≥ 65 years old (mean age, 72.7 ± 4.8 years). Participants were measured for MTP, grip strength, five-time chair stand test (FCST), gait speed, and skeletal muscle mass index (SMI). Multiple regression analysis adjusted for confounding factors was used to analyze relationships between MTP and each other variable. RESULTS MTP was significantly related to SMI (r = 0.15, p < 0.001), grip strength (r = 0.12, p < 0.05), FCST (r = - 0.14, p < 0.05), and age (r = 0.25, p < 0.001). Multiple regression analysis showed a positive association between MTP and SMI, even after accounting for the influence of age, sex, physical performance, and other potential confounding factors. CONCLUSION Whole-body muscle mass was suggested to be decreasing with tongue pressure decline before sarcopenia diagnosis in community-dwelling older adults.
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Affiliation(s)
- Takeshi Murakami
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.
- Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan.
| | - Naoto Kamide
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
| | - Masataka Ando
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Wakana Hata
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
| | - Miki Sakamoto
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
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30
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Greenbaum T, Pitance L, Kedem R, Emodi-Perlman A. The mouth-opening muscular performance in adults with and without temporomandibular disorders: A systematic review. J Oral Rehabil 2022; 49:476-494. [PMID: 35020217 PMCID: PMC9303535 DOI: 10.1111/joor.13303] [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: 08/14/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
Background The mouth‐opening muscular performance in patients with temporomandibular disorders (TMDs) is unclear. Understanding the impairments of this muscle group within specific TMDs is important to develop proper management strategies. Objective To characterise the mouth‐opening muscular performance in adults with and without TMDs. Methods PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane databases were searched from inception to 12 November 2020. Bibliographies were searched for additional articles, including grey literature. Case‐control, cross‐sectional and interventional studies reporting mouth‐opening muscular strength and/or endurance were included. Risk of bias was assessed by the SIGN checklist for case‐control studies and by the NIH quality assessment tool for cross‐sectional studies. Results were pooled with a random‐effects model. Confidence in cumulative evidence was determined by means of the GRADE guidelines. Results Fourteen studies were included; most were rated as having a moderate risk of bias. Only three studies assessed patients with TMDs and the other 11 assessed healthy adults. Significant sex differences in muscular performance were found for healthy adults in the review (strength deficit for females versus males). There was a significant reduction in maximal mouth opening performance (strength and endurance) in the three studies that assessed patients with temporomandibular disorders. Conclusion Sex plays a significant role in maximal mouth opening strength. There is a lack of reliable data on the normal mouth‐opening strength and endurance of healthy adults as well as for patients with TMDs. Implications Lack of reliable TMDs patient data and comparable healthy adult data highlight future direction for research.
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Affiliation(s)
- Tzvika Greenbaum
- Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Laurent Pitance
- Institute of Experimental and Clinical Research, Health Sciences division, Neuro-Musculo-Skeletal-Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium
| | - Ron Kedem
- Academic Branch, Medical Corps, IDF, Tel Aviv, Israel
| | - Alona Emodi-Perlman
- The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Inamoto Y, Kaneoka A. Swallowing Disorders in the Elderly. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-021-00339-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Relationship between Oral Hypofunction, and Protein Intake: A Cross-Sectional Study in Local Community-Dwelling Adults. Nutrients 2021; 13:nu13124377. [PMID: 34959928 PMCID: PMC8705970 DOI: 10.3390/nu13124377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 01/09/2023] Open
Abstract
Few studies have investigated the relationship between nutritional status and comprehensive assessment of oral hypofunction, especially protein intake-related sarcopenia. Thus, we explored these relationships in a large-scale cross-sectional cohort study using the seven-item evaluation for oral hypofunction and Diet History Questionnaire for nutritional assessment. We used the data from 1004 individuals who participated in the 2019 health survey of the residents of Tarumizu City, Kagoshima Prefecture, Japan for analysis. We found that individuals with oral hypofunction were significantly older with a lower skeletal muscle index. Although there were few foods that had a significant difference between the groups with and without oral hypofunction, the consumption of beans and meats was significantly lower in women and men in the oral hypofunction group, respectively. According to the lower limit of the tentative dietary goal defined in Japan, comprehensive evaluation of oral hypofunction was significantly and independently associated with protein intake in both men and women (odds ratio, 1.70; 95% confidence interval, 1.21-2.35). In conclusion, we found that oral hypofunction was associated with targeted protein intake for sarcopenia and frailty prevention in middle-aged and older community-dwelling adults. Comprehensive evaluation of oral function with intervention in cases of hypofunction could inform clinicians to better prevent sarcopenia.
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Nakao Y, Uchiyama Y, Honda K, Yamashita T, Saito S, Domen K. Age-related composition changes in swallowing-related muscles: a Dixon MRI study. Aging Clin Exp Res 2021; 33:3205-3213. [PMID: 33904143 DOI: 10.1007/s40520-021-01859-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/07/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dysphagia is considered a social problem in the super-aging society. However, age-related changes in swallowing-related muscles have not been fully deciphered. AIMS We aimed to identify intramuscular fatty infiltration and muscle atrophy in multiple swallowing-related muscles on magnetic resonance imaging (MRI). Moreover, an appropriate muscle strength parameter for the evaluation of swallowing-related muscle mass was examined. METHODS We analyzed the Dixon MRI results of 20 elderly and 20 young adults without head and neck cancer, stroke, neuromuscular disease, or whole-body sarcopenia to evaluate intramuscular fatty infiltration (IMF) and lean muscle mass (LMM) in the tongue, geniohyoid, and pharyngeal muscles. The pharyngeal lumen size was also assessed. Tongue pressure, jaw-opening strength, occlusal force, and head-lifting strength were evaluated within a week before and after MRI. RESULTS Aging significantly affected the IMF of the swallowing-related muscles, and the tongue muscle was most affected, followed by the pharyngeal muscle and then the geniohyoid muscle. Only the LMM of the geniohyoid muscle significantly decreased with aging. The pharyngeal lumen size did not significantly differ between the elderly and young participants, and only tongue pressure was significantly correlated with tongue, geniohyoid, and pharyngeal muscle mass. CONCLUSIONS IMF is primarily associated with age-related composition changes in swallowing-related muscles, and it is commonly observed in the tongue and pharyngeal muscles. The geniohyoid muscle is more at risk of muscle atrophy rather than fatty infiltration. In addition, tongue pressure can be a parameter for the evaluation of swallowing-related muscle mass.
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Affiliation(s)
- Yuta Nakao
- Department of Rehabilitation, Hyogo College of Medicine College Hospital, Nishinomiya, Hyogo, Japan
- Department of Rehabilitation, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Kosuke Honda
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Taiji Yamashita
- Department of Rehabilitation Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
- Department of Rehabilitation, Matsuyama Rehabilitation Hospital, Matsuyama, Ehime, Japan
| | - Shota Saito
- Department of Rehabilitation, Hyogo College of Medicine College Hospital, Nishinomiya, Hyogo, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
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Chen KC, Jeng Y, Wu WT, Wang TG, Han DS, Özçakar L, Chang KV. Sarcopenic Dysphagia: A Narrative Review from Diagnosis to Intervention. Nutrients 2021; 13:nu13114043. [PMID: 34836299 PMCID: PMC8621579 DOI: 10.3390/nu13114043] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
Sarcopenia, defined as a decline in muscle mass and function related to aging, affects both limb and swallowing-related muscles. Sarcopenic dysphagia is characterized by decreased swallowing function; therefore, early detection of subclinical dysphagia and subsequent intervention appear to be crucial in the elderly. Numerous tools have been employed to measure the function, strength, and mass of swallowing-related muscles in sarcopenic elderly. The swallowing function can be evaluated by questionnaires like Eating Assessment Tool, Functional Oral Intake Scale, and Food Intake Level Scale, and tests such as the modified water swallowing test and videofluoroscopic swallowing study. Surface electromyography and high-resolution manometry can be applied for quantifying swallowing-related muscle strength. Modalities such as ultrasonography and magnetic resonance imaging are capable of estimating the swallowing muscle mass. In patients with sarcopenic dysphagia, a thorough assessment should be given followed by an integrated intervention combining swallowing muscle strengthening, nutrition support, food texture modification, physical, and occupational therapies. This article aimed to comprehensively summarize the diagnostic criteria/tools as well as their associations/performance in sarcopenic dysphagia. The intervention strategy will also be narrated in this review.
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Affiliation(s)
- Kuan-Cheng Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan; (K.-C.C.); (T.-G.W.); (D.-S.H.)
- Department of Physical Medicine and Rehabilitation, Far Eastern Memorial Hospital, New Taipei 22000, Taiwan
| | - Ying Jeng
- Department of Medical Image, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan;
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan;
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan; (K.-C.C.); (T.-G.W.); (D.-S.H.)
| | - Der-Sheng Han
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan; (K.-C.C.); (T.-G.W.); (D.-S.H.)
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan;
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey;
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan; (K.-C.C.); (T.-G.W.); (D.-S.H.)
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan;
- Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei 11600, Taiwan
- Correspondence: ; Tel.: +886-223717101 (ext. 5309)
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Shirobe M, Watanabe Y, Tanaka T, Hirano H, Kikutani T, Nakajo K, Sato T, Furuya J, Minakuchi S, Iijima K. Effect of an Oral Frailty Measures Program on Community-Dwelling Elderly People: A Cluster-Randomized Controlled Trial. Gerontology 2021; 68:377-386. [PMID: 34247160 DOI: 10.1159/000516968] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 05/01/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Oral frailty describes a trivial decline in the oral function and is considered to be related to frailty. Thus, effective management of oral frailty could prevent or ameliorate physical frailty and the need for care. However, there is a lack of consensus regarding specific interventions for oral frailty. In this cluster-randomized controlled trial, we investigated the effects of a newly developed oral frailty measures program mentored by dentists and dental hygienists for elderly people in a clinical setting. METHODS Of 3,296 participants included in a field survey, 219 who regularly visited dental clinics and met at least 3 of the following 6 criteria for oral frailty were considered eligible: <20 natural teeth, decreased chewing ability, decreased articulatory oral-motor skills, decreased tongue pressure, and substantial subjective difficulties in eating and swallowing. After applying the inclusion and exclusion criteria, we studied 51 patients in the intervention group (14 men and 37 women; mean age, 78.6 years) and 32 patients in the control group (7 men and 25 women; mean age, 78.0 years). We implemented a 12-week oral frailty measures program only for the intervention group. The program included preparatory oral exercises, mouth-opening training, tongue pressure training, prosodic training, and masticatory training. Primary outcome measures were the chewing ability score, articulatory oral motor skill for /ta/, tongue pressure, subjective difficulty in eating tough foods, and subjective difficulty in swallowing. We compared baseline characteristics using the Mann-Whitney U and χ2 tests for continuous and categorical variables, respectively. A repeated-measures two-way ANOVA was used to determine the efficacy of independent intervention variables, following the Wilcoxon signed-rank test. The groups (intervention/control) and time (baseline/week 12) were the independent variables. Oral frailty measures were the dependent variables. RESULTS Baseline characteristics and assessment results were similar between groups. We observed significant improvements in the intervention group in terms of articulatory oral motor skill for /ta/ and tongue pressure (p < 0.001). No improvements were observed in the control group. DISCUSSION/CONCLUSION Our results suggest that our oral frailty measures program effectively alleviates oral frailty. Future studies are needed to clarify the impact on preventing physical frailty and improving the nutritional status.
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Affiliation(s)
- Maki Shirobe
- The Tokyo Metropolitan Support Center for Preventative Long-Term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan, .,Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan,
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan.,Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takeshi Kikutani
- Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry, Tokyo, Japan
| | - Kazuko Nakajo
- Odawara Public Health and Welfare Center, Kanagawa Prefectural Government, Odawara, Japan
| | | | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan.,Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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Iwasaki M, Motokawa K, Watanabe Y, Shirobe M, Ohara Y, Edahiro A, Kawai H, Fujiwara Y, Kim H, Ihara K, Obuchi S, Hirano H. Oral hypofunction and malnutrition among community-dwelling older adults: Evidence from the Otassha study. Gerodontology 2021; 39:17-25. [PMID: 34212426 DOI: 10.1111/ger.12580] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/19/2021] [Accepted: 06/08/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE This study investigated the association between oral hypofunction and malnutrition among community-dwelling older adults. BACKGROUND Oral hypofunction, a 7-component phenotype of the clinical features of oral health, has been described in Japan. Data about its association with nutritional status are limited. MATERIALS AND METHODS This cross-sectional study enrolled 715 adults (mean age, 73.5 years; range, 65-91 years) from the Otassha Study. Oral hypofunction was defined as the presence of ≥3 of the following 7 components: poor oral hygiene; oral dryness; low occlusal force; low articulatory oral motor skill; low tongue pressure; low masticatory performance; and compromised swallowing function. The Mini Nutritional Assessment® -Short Form (MNA® -SF) was used to assess the nutritional status. Malnutrition was defined as having an MNA® -SF score of seven or less. The association between oral hypofunction and nutritional status was evaluated using ordinal logistic regression analyses. RESULTS The prevalence rates of oral hypofunction and malnutrition were 42.7% and 4.1%, respectively. Multivariable Poisson regression analyses revealed that oral hypofunction was associated with malnutrition. The adjusted relative risk of malnutrition in the study participants with oral hypofunction was 3.00 with a 95% confidence interval of 1.29-6.98. CONCLUSION Community-dwelling older adults whose oral functions were compromised in multiple aspects had poor nutritional status.
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Affiliation(s)
| | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Faculty of Dental Medicine Gerodontology, Department of Oral Health Science, Hokkaido University, Sapporo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Kim S, Doh RM, Yoo L, Jeong SA, Jung BY. Assessment of Age-Related Changes on Masticatory Function in a Population with Normal Dentition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136899. [PMID: 34199065 PMCID: PMC8296882 DOI: 10.3390/ijerph18136899] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the influence of changes in age-related physiological muscular and dental factors on masticatory function. This study was conducted in 211 healthy participants divided into four different age groups: 20–45 years (Gr1); 45–60 years (Gr2); 61–70 years (Gr3); and ≥71 years (Gr4). For objective evaluation of masticatory function, the masticatory performance, bite force, posterior bite area (PBA), functional tooth units (FTUs), the number of remaining teeth, tongue pressure, masseter muscle thickness (MMT), and handgrip strength were examined. Food intake ability (FIA) and the Oral Health Impact Profile-14 score were assessed subjectively using questionnaires. A significant decrease in the number of remaining teeth, FTUs, handgrip strength, and FIA was found in Gr4, and a significant decrease in the tongue pressure, PBA, and bite force was found in those aged ≥61 years. In groups 1 and 3, an association of the PBA with masticatory performance was observed. However, there was no significant decreasing trend in the MMT with respect to masticatory performance with aging. With sufficient FTUs and posterior tooth support, although age-dependent decreases in the bite force, tongue pressure and handgrip strength were observed, masticatory performance was maintained. Establishing the PBA by improving occlusion through dental treatment is thought to be important for masticatory function.
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Affiliation(s)
- Seonhui Kim
- Department of Dentistry, The Graduate School, Yonsei University, Seoul 03722, Korea;
| | - Re-Mee Doh
- Department of Advanced General Dentistry, College of Dentistry, Dankook University, Cheonan 31116, Korea;
| | - Leegang Yoo
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (L.Y.); (S.-A.J.)
| | - Sol-Ah Jeong
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (L.Y.); (S.-A.J.)
| | - Bock-Young Jung
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (L.Y.); (S.-A.J.)
- Correspondence: ; Tel.: +82-2-2228-8980
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Chen KC, Lee TM, Wu WT, Wang TG, Han DS, Chang KV. Assessment of Tongue Strength in Sarcopenia and Sarcopenic Dysphagia: A Systematic Review and Meta-Analysis. Front Nutr 2021; 8:684840. [PMID: 34249993 PMCID: PMC8264147 DOI: 10.3389/fnut.2021.684840] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/28/2021] [Indexed: 12/21/2022] Open
Abstract
Sarcopenic dysphagia is defined as difficulty in swallowing due to sarcopenia, which may be related to weakness of the tongue muscles. This meta-analysis aimed to explore the association between tongue strength and sarcopenia and to determine whether tongue strength measurement could be a specific indicator of sarcopenic dysphagia. We conducted a systematic search of electronic databases from their inception to February 2021 for clinical studies that investigated tongue strength in participants with and without sarcopenia. The primary outcome was the weighted mean difference (WMD) and standardized mean difference (SMD) of tongue pressure between the different groups. The secondary outcome was the correlation of tongue pressure with the subcomponents that defined sarcopenia. Ten studies that involved 1,513 participants were included in the meta-analysis. Compared with those without sarcopenia, patients with sarcopenia had significantly less tongue pressure, with a WMD of -4.353 kPa (95% CI, -7.257 to -1.450) and an SMD of -0.581 (95% CI, -0.715 to -0.446). There was no significant difference in tongue pressure between patients with sarcopenic dysphagia and those with non-sarcopenic dysphagia, with a WMD of -1.262 kPa (95% CI, -8.442 to 5.918) and an SMD of -0.187 (95% CI, -1.059 to 0.686). Significant positive associations were identified between tongue pressure and grip strength and between tongue pressure and gait speed, with correlation coefficients of 0.396 (95% CI, 0.191 to 0.567) and 0.269 (95% CI, 0.015 to 0.490), respectively. Reduced tongue strength is associated with sarcopenia but is not an exclusive marker for sarcopenic dysphagia. Tongue strength correlates with the values of subcomponents that define sarcopenia. In patients with low performance of sarcopenia subcomponent, tongue pressure must be examined to diagnose subclinical dysphagia. Protocol registration: This meta-analysis was registered on INPLASY (registration number INPLASY202120060).
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Affiliation(s)
- Kuan-Cheng Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tsung-Min Lee
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Der-Sheng Han
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.,Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Nakamura M, Hamada T, Tanaka A, Nishi K, Kume K, Goto Y, Beppu M, Hijioka H, Higashi Y, Tabata H, Mori K, Mishima Y, Uchino Y, Yamashiro K, Matsumura Y, Makizako H, Kubozono T, Tabira T, Takenaka T, Ohishi M, Sugiura T. Association of Oral Hypofunction with Frailty, Sarcopenia, and Mild Cognitive Impairment: A Cross-Sectional Study of Community-Dwelling Japanese Older Adults. J Clin Med 2021; 10:1626. [PMID: 33921265 PMCID: PMC8068799 DOI: 10.3390/jcm10081626] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 01/01/2023] Open
Abstract
Oral hypofunction is a new concept that addresses the oral function of older adults. Few studies have investigated the relationship between oral hypofunction and general health conditions such as frailty, sarcopenia, and mild cognitive impairment. This paper explores these relationships in a large-scale, cross-sectional cohort study. The relationships of oral hypofunction with frailty, sarcopenia, and mild cognitive impairment were examined using data from 832 individuals who participated in the 2018 health survey of the residents of Tarumizu City, Kagoshima Prefecture, Japan. Individuals with frailty, sarcopenia, and mild cognitive impairment had significantly higher rates of oral hypofunction. Frailty was independently associated with deterioration of the swallowing function (odds ratio 2.56; 95% confidence interval, 1.26-5.20), and mild cognitive impairment was independently associated with reduced occlusal force (odds ratio 1.48; 95% confidence interval, 1.05-2.08) and decreased tongue pressure (odds ratio 1.77; 95% confidence interval, 1.28-2.43). There was no independent association found between sarcopenia and oral function. In conclusion, early intervention for related factors such as deterioration of the swallowing function in frailty, reduced occlusal force, and decreased tongue pressure in mild cognitive impairment could lead to the prevention of general hypofunction in older adults.
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Affiliation(s)
- Maya Nakamura
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Tomofumi Hamada
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
- Department of Oral & Maxillofacial Surgery, Hakuaikai Medical Cooperation, Sagara Hospital, Kagoshima 892-0833, Japan
| | - Akihiko Tanaka
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Keitaro Nishi
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Kenichi Kume
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yuichi Goto
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Mahiro Beppu
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Hiroshi Hijioka
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yutaro Higashi
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Hiroaki Tabata
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Kazuki Mori
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yumiko Mishima
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yoshinori Uchino
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Kouta Yamashiro
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yoshiaki Matsumura
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-0075, Japan;
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (T.K.); (M.O.)
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-0085, Japan;
| | - Toshihiro Takenaka
- Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital, Kagoshima 891-2124, Japan;
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (T.K.); (M.O.)
| | - Tsuyoshi Sugiura
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
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Izumi M, Sonoki K, Ohta Y, Fukuhara M, Nagata M, Akifusa S. Tongue cleaning maintains respiratory function in older individuals: A 1-year randomised controlled trial. J Oral Rehabil 2021; 48:730-737. [PMID: 33687734 DOI: 10.1111/joor.13165] [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: 11/15/2020] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this 1-year longitudinal randomised controlled trial was to evaluate the effectiveness of tongue cleaning on the maintenance of respiratory function in older adults requiring care. METHODS The participants included 24 residents of two nursing homes in Kitakyushu, Japan. The participants were randomised to receive tongue cleaning with routine oral care (intervention group, n = 12), or routine oral care alone (control group, n = 12). Among the participants, three in the intervention group and four in the control group had cerebrovascular disease history, four in the intervention group and four in the control group had a history of cardiac disease, and five in the intervention group and four in the control group were without medical history. Respiratory function was assessed on the basis of the peak expiratory flow rate (PEFR). Tongue pressure, swallowing function, oral health status, activities of daily living and nutritional status were also measured at baseline and at the end of the 1-year follow-up period. RESULTS The number of analysed participants in each group was 12. In the control group, the PEFR (1.6 [0.4-4.2] L s-1 vs 1.4 [0.4-3.2] L s-1 , P = .034) and tongue pressure (16.4 [1.7-35.2] kPa vs 8.0 [1.4-38.6] kPa, P = .032) significantly declined after 1-year. However, the PEFR (1.5 [0.8-2.9] L s-1 vs 1.6 [0.7-4.2] L s-1 , P = .366) and tongue pressure (18.1 [4.2-37.1] kPa vs 16.1 [5.2-41] kPa, P = .307) were maintained in the intervention group. The change in the PEFR was significantly greater in the intervention group compared with the control group (0.130 [-0.45-1.70] L s-1 vs -1.70 [-10.00-10.00] L s-1 , P = .028). CONCLUSION Our findings suggest that tongue cleaning may help maintain tongue and respiratory function in older adults requiring care.
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Affiliation(s)
- Maya Izumi
- Faculty of Dentistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Kazuo Sonoki
- Faculty of Dentistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Yuko Ohta
- Division of Comprehensive Internal Medicine, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | - Masayo Fukuhara
- Division of Comprehensive Internal Medicine, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | | | - Sumio Akifusa
- Faculty of Dentistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
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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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Oommen ER, Cuellar ME, Scholten A, Rylander B, David M. Objective measures of lingual and jaw function in healthy adults and persons with Parkinson's disease: Implications for swallowing. Physiol Behav 2021; 232:113349. [PMID: 33545210 DOI: 10.1016/j.physbeh.2021.113349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022]
Abstract
The study examines the effects of age and Parkinson's disease on lingual and jaw function in neurotypical adults, as well as persons with Parkinson's Disease. Preliminary results provide reference measures in these populations and support the systematic collection of objective data regarding lingual strength, lingual range of motion, and jaw range of motion in clinical populations. The application of this clinically meaningful protocol also provides a means to track physiological changes over time in order to maximize the results of rehabilitative efforts to restore swallow function.
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Affiliation(s)
- Elizabeth R Oommen
- Calvin University, Speech Pathology and Audiology Department, 1810 E. Beltline Ave SE, Grand Rapids, MI 49546, United States
| | - Megan E Cuellar
- San José State University, Communicative Disorders & Sciences, One Washington Square, San Jose, CA 95192-0046, United States.
| | - Alyssa Scholten
- Helen DeVos Children's Hospital, 100 Michigan St NE, Grand Rapids, MI 49503, United States
| | - Bethany Rylander
- Colt Early Childhood Center, 4344 W. Michigan Ave, Lansing, MI 48917, United States
| | - Mallika David
- Metro Health, Univ of Michigan, 5900 Byron Center Ave, Wyoming, MI 49519, United States
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Hansen T, Thomassen JD, Jensen LE, Irgens MR, Kjaersgaard A. Development of an Intervention for Improving Ingestion in Elders with Oropharyngeal Dysphagia. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2020.1800159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Tina Hansen
- Division of Occupational Therapy, Faculty of Health and Technology, University College Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, University Hospital Hvidovre-Amager, Hvidovre, Denmark
| | - Julie Damm Thomassen
- Division of Occupational Therapy, Faculty of Health and Technology, University College Copenhagen, Copenhagen, Denmark
| | - Lea Elm Jensen
- Division of Occupational Therapy, Faculty of Health and Technology, University College Copenhagen, Copenhagen, Denmark
| | - Maja Rosenkrands Irgens
- Division of Occupational Therapy, Faculty of Health and Technology, University College Copenhagen, Copenhagen, Denmark
| | - Annette Kjaersgaard
- Department for Education, Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
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Mori T, Wakabayashi H, Ogawa N, Fujishima I, Oshima F, Itoda M, Kunieda K, Shigematsu T, Nishioka S, Tohara H, Yamada M, Ogawa S. The Mass of Geniohyoid Muscle Is Associated with Maximum Tongue Pressure and Tongue Area in Patients with Sarcopenic Dysphagia. J Nutr Health Aging 2021; 25:356-360. [PMID: 33575728 DOI: 10.1007/s12603-020-1528-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We investigated the associations about the mass of geniohyoid and tongue muscle and the maximum tongue pressure in patients with sarcopenic dysphagia using ultrasonography. DESIGN Cross sectional study. SETTING 5 hospitals including 3 acute and 2 rehabilitation hospitals and 1 older facility. PARTICIPANTS 36 inpatients with sarcopenic dysphagia. MEASUREMENTS Ultrasonography was performed for geniohyoid muscle and tongue. The area for geniohyoid and tongue muscles in sagittal plane and the mean brightness level (0-255) in the muscle area were calculated. Maximum tongue pressure as strength of swallowing muscle were investigated. Partial correlation coefficient and multiple regression analysis adjusting for age and sex were performed. RESULTS The mean age was 81.1 ± 7.9. Men were 23. The mean BMI was 19.0 ± 4.1. The mean maximum tongue pressure was 21.3 ± 9.3 kPa. The mean cross sectional area for geniohyoid muscles was 140 ± 47 mm2. The mean brightness for geniohyoid muscle was 18.6 ± 9.0. The mean cross sectional area for tongue muscles was 1664.1 ± 386.0 mm2. The mean brightness for tongue muscles was 34.1 ± 10.6. There was a significant positive correlation between area of geniohyoid muscle and maximum tongue pressure (r = 0.38, p = 0.04). Geniohyoid muscle area was an explanatory factor for maximum tongue pressure (p = 0.012) and tongue muscle area (p = 0.031) in multivariate analysis. CONCLUSIONS Geniohyoid muscle mass was an independent explanatory factor for maximum tongue pressure and tongue muscle mass.
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Affiliation(s)
- T Mori
- Hidetaka Wakabayashi, MD, PhD, Dpt. of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Japan, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan. Code; 162-0054, , Tel: +81-3-3353-8111, FAX: +81-3-5269-7639
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Nagashima K, Kikutani T, Miyashita T, Yajima Y, Tamura F. Tongue muscle strength affects posterior pharyngeal wall advancement during swallowing: A cross-sectional study of outpatients with dysphagia. J Oral Rehabil 2020; 48:169-175. [PMID: 33112420 PMCID: PMC7983890 DOI: 10.1111/joor.13120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/17/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022]
Abstract
Background Tongue muscle strength is important for swallowing but decreases with age, in association with reduced skeletal muscle mass. However, the relationships between pharyngeal dynamics and both skeletal muscle mass and tongue muscle strength are unknown. Objective To investigate the effect of reductions in tongue muscle strength on pharyngeal movement during swallowing in patients with dysphagia. Methods Subjects were selected from male outpatients ≥65 years old who were examined for the main complaint of dysphagia. Patients with history of neurodegenerative disease affecting tongue movement, cerebrovascular disease or oral cancer were excluded. As a result, 82 men (mean age, 80.6 ± 6.8 years) participated. Skeletal muscle mass index (SMI) as physical parameters and maximum tongue pressure (MTP) as tongue muscles strength were measured. Status and dynamics of the pharyngeal organs, including change in posterior pharyngeal wall advancement (PPWA) when swallowing 3.0 mL of moderately thick liquid, were measured by analysing videofluoroscopic images. Simple bivariate correlation and multiple regression analysis were used to statistically analyse correlations between parameters. Results MTP showed a significant positive correlation with SMI (r = .43, P < .01). PPWA showed a significant negative correlation with MTP (r = −0.30, P < .01), but no association with SMI. Conclusions While tongue muscle strength is affected by skeletal muscle mass, posterior pharyngeal wall advancement is not readily affected by decreases in skeletal muscle mass. Posterior pharyngeal wall advancement may increase to compensate for swallowing function among individuals with reduced tongue muscle strength.
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Affiliation(s)
- Keigo Nagashima
- Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry, Tokyo, Japan
| | - Takeshi Kikutani
- Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry, Tokyo, Japan.,Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Tama Oral Rehabilitation Clinic, Tokyo, Japan.,Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tokyo, Japan
| | - Taishi Miyashita
- Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry, Tokyo, Japan
| | - Yuri Yajima
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Fumiyo Tamura
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Tama Oral Rehabilitation Clinic, Tokyo, Japan.,Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tokyo, Japan
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Kim KL, Park GY, Kwon DR, Kwon DY, Kwak SG, Cho HK. Airway invasion in non-neurologically ill patients with dysphagia: Contributing factors and associated problems during swallowing process. A retrospective observational study. Medicine (Baltimore) 2020; 99:e22977. [PMID: 33157940 PMCID: PMC7647595 DOI: 10.1097/md.0000000000022977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Dysphagia can occur among patients receiving medical care despite having no history of neurologic disease. The current study aimed to investigate factors contributing to airway invasion among non-neurologically ill patients with dysphagia.This retrospective study included 52 non-neurologically ill patients who complained of swallowing difficulty and consulted the Department of Rehabilitation Medicine for videofluoroscopic swallowing studies between January 2018 and June 2019. Patients were then divided into 2 groups according to the presence of airway invasion (penetration or aspiration) based on videofluoroscopic swallowing study findings, with group 1 (n = 26) consisting of patients with airway invasion and group 2 (n = 26) consisting of those without airway invasion. Demographic information, functional ambulation ability within the past 3 months, presence of community acquired pneumonia (CAP), nutritional status, degree of dehydration, history of intensive care unit stay, history of endotracheal intubation, and videofluoroscopic dysphagia scale were reviewed.Patients with airway invasion exhibited decreased functional ambulation ability, greater incidence of CAP, and lower serum albumin concentration than patients without airway invasion (P < .05). Airway invasion among non-neurologically ill patients was significantly associated with functional ambulation ability [odds ratio (OR), 3.57; 95% confidence interval (CI), 1.14-11.19; P = .03], serum albumin concentration under 3.5 g/dL (OR, 4.90; 95% CI, 1.39-17.32; P = .01), and presence of CAP (OR, 5.06; 95% CI, 1.56-16.44; P = .01). Groups 1 and 2 had a videofluoroscopic dysphagia scale score of 37.18 and 16.17, respectively (P < .05). Moreover, bolus formation, tongue-to-palate contact, premature bolus loss, vallecular residue, coating of pharyngeal wall, and aspiration score differed significantly between both groups (P < .05).Airway invasion among non-neurologically ill patients was related to decreased functional ambulation ability, lower serum albumin concentration, and presence of CAP. The results presented herein can help guide clinical management aimed at preventing airway invasion among non-neurologically ill patients.
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Affiliation(s)
- Kang Lip Kim
- Department of Physical Medicine and Rehabilitation
| | | | | | - Do Yun Kwon
- Department of Physical Medicine and Rehabilitation
| | - Sang Gyu Kwak
- Department of Medical Statistics, Catholic University of Daegu School of Medicine, Republic of Korea
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Suzuki M, Okamoto T, Akagi Y, Matsui K, Sekiguchi H, Satoya N, Inoue Y, Tatsuta A, Hagiwara N. Efficacy of oral myofunctional therapy in middle-aged to elderly patients with obstructive sleep apnoea treated with continuous positive airway pressure. J Oral Rehabil 2020; 48:176-182. [PMID: 33080062 DOI: 10.1111/joor.13119] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Oral myofunctional therapy (MFT) is an effective treatment for mild-to-moderate obstructive sleep apnoea (OSA) in middle-aged patients. However, few reports have described its use in elderly patients with moderate and severe OSA. Moreover, no studies have examined the relationship between changes in tongue pressure with MFT and the severity of OSA. OBJECTIVE We conducted an interventional study using MFT to evaluate the effect of MFT on middle-to-senior-aged patients with moderate or severe OSA and compared changes in apnoea-hypopnea index (AHI) and tongue pressure. METHODS Thirty-two OSA patients (≥45 years) treated with continuous positive airway pressure (CPAP) were included. MFT was performed in parallel with CPAP. Three days after CPAP discontinuation, polysomnographies were performed and tongue pressures were measured before and after MFT. RESULTS Patients were 69.3 ± 1.5 years old. After 6 months of MFT, AHI decreased significantly from 34.7 to 29.0/h (P = .03), while tongue pressure significantly increased from 35.9 to 45.6 kPa (P < .01). Seven patients (22%), including 6 of the 12 patients with moderate OSA (50%), experienced successful CPAP discontinuation. CONCLUSIONS MFT can be a useful intervention even among middle-aged to elderly patients with OSA. Increased tongue pressure may have contributed to the AHI improvement. Clinical trials: Trial registration at www.umin.ac.jp UMIN000027547.
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Affiliation(s)
- Mayumi Suzuki
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University, Tokyo, Japan.,Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Toshihiro Okamoto
- Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuichi Akagi
- Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Kentaro Matsui
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University, Tokyo, Japan.,Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.,Department of Clinical Laboratory, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan.,Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan
| | - Haruki Sekiguchi
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University, Tokyo, Japan.,Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.,Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Fukakusa, Japan.,Clinical Research Institute, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Natsumi Satoya
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuji Inoue
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Akihisa Tatsuta
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
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Chen YC, Chen PY, Wang YC, Wang TG, Han DS. Decreased swallowing function in the sarcopenic elderly without clinical dysphagia: a cross-sectional study. BMC Geriatr 2020; 20:419. [PMID: 33087067 PMCID: PMC7579958 DOI: 10.1186/s12877-020-01832-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 10/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background Sarcopenia and dysphagia are prevalent health issues as the elderly population continues to grow. However, whether sarcopenia, defined by either reduced handgrip strength or gait speed, would lead to pathological effects on swallowing function is still a matter of debate. Studies focusing on subclinical changes in the swallowing function in the sarcopenic elderly are lacking. This study evaluates the swallowing function in the sarcopenic elderly without dysphagia. Methods: A cross-sectional study was conducted including subjects recruited from the community. Ninety-four individuals aged 65 and older without dysphagia were divided into two groups: sarcopenia and nonsarcopenia. The swallowing assessment included tongue pressure measurement, hyoid displacement (HD), hyoid velocity (HV) measurement with submental ultrasonography, 100-ml water-swallowing test, and the 10-item Eating Assessment Tool (EAT-10). Results The average tongue pressure was 47.0 ± 13.7 and 48.6 ± 11.5 kPa in the sarcopenia and nonsarcopenia groups, respectively (p = 0.55), whereas the average HD during swallowing was 15.3 ± 4.4 and 13.0 ± 4.2 mm in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). The median of HV during swallowing was 19.5 (6.41–45.86) and 15.9 (3.7–39.7) mm/s in the sarcopenia and nonsarcopenia group (p < 0.05). The median of time needed for consuming 100 ml water was 12.43 (3.56–49.34) and 5.66 (2.07–19.13) seconds in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). The median of the EAT-10 score was 0 (0–2) and 0 (0–1) in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). Conclusions In elderly individuals, swallowing function was significantly impaired with sarcopenia before clinical symptoms become clear. However, tongue muscles exhibited resistance to sarcopenia. We observed compensative strategies in patients with sarcopenia, such as reduced swallowing speed and increased hyoid bone movement.
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Affiliation(s)
- Yen-Chih Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No.1, Changde Street, Zhongzheng District, Taipei City, 10048, Taiwan, Republic of China
| | - Pei-Yun Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No.1, Changde Street, Zhongzheng District, Taipei City, 10048, Taiwan, Republic of China
| | - Yu-Chen Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No.1, Changde Street, Zhongzheng District, Taipei City, 10048, Taiwan, Republic of China
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No.1, Changde Street, Zhongzheng District, Taipei City, 10048, Taiwan, Republic of China.
| | - Der-Sheng Han
- Physical Medicine & Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, No.87, Neijiang Street, Wanhua District, Taipei City, Taiwan
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Kim H, Cho NB, Kim J, Kim KM, Kang M, Choi Y, Kim M, You H, Nam SI, Shin S. Implementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study. JMIR Mhealth Uhealth 2020; 8:e22080. [PMID: 33012704 PMCID: PMC7600016 DOI: 10.2196/22080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/07/2020] [Accepted: 10/03/2020] [Indexed: 02/06/2023] Open
Abstract
Background Tongue pressure is an effective index of swallowing function, and it decreases with aging and disease progression. Previous research has shown beneficial effects of swallowing exercises combined with myofunctional tongue-strengthening therapy on tongue function. Tongue exercises delivered through mobile health (mHealth) technologies have the potential to advance health care in the digital age to be more efficient for people with limited resources, especially older adults. Objective The purpose of this study is to explore the immediate and long-term maintenance effects of an 8-week home-based mHealth app intervention with biweekly (ie, every 2 weeks) human mediation aimed at improving the swallowing tongue pressure in older adults. Methods We developed an mHealth app intervention that was used for 8 weeks (3 times/day, 5 days/week, for a total of 120 sessions) by 11 community-dwelling older adults (10 women; mean age 75.7 years) who complained of swallowing difficulties. The app included a swallowing monitoring and intervention protocol with 3 therapy maneuvers: effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation. The 8-week intervention was mediated by biweekly face-to-face meetings to monitor each participant’s progress and ability to implement the training sessions according to the given protocol. Preintervention and postintervention isometric and swallowing tongue pressures were measured using the Iowa Oral Performance Instrument. We also investigated the maintenance effects of the intervention on swallowing tongue pressure at 12 weeks postintervention. Results Of the 11 participants, 8 adhered to the home-based 8-week app therapy program with the optimal intervention dosage. At the main trial end point (ie, 8 weeks) of the intervention program, the participants demonstrated a significant increase in swallowing tongue pressure (median 17.5 kPa before the intervention and 26.5 kPa after the intervention; P=.046). However, long-term maintenance effects of the training program on swallowing tongue pressure at 12 weeks postintervention were not observed. Conclusions Swallowing tongue pressure is known to be closely related to dysphagia symptoms. This is the first study to demonstrate the effectiveness of the combined methods of effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation using mobile app training accompanied by biweekly human mediation in improving swallowing tongue pressure in older adults. The mHealth app is a promising platform that can be used to deliver effective and convenient therapeutic service to vulnerable older adults. To investigate the therapeutic efficacy with a larger sample size and observe the long-term effects of the intervention program, further studies are warranted. International Registered Report Identifier (IRRID) RR2-10.2196/19585
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Affiliation(s)
- HyangHee Kim
- Graduate Program in Speech-Language Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Nam-Bin Cho
- Graduate Program in Speech-Language Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinwon Kim
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Kyung Min Kim
- Graduate Program in Speech-Language Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minji Kang
- Graduate Program in Speech-Language Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Younggeun Choi
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Minjae Kim
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Heecheon You
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Seok In Nam
- Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Soyeon Shin
- Graduate Program in Speech-Language Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Nagano A, Maeda K, Koike M, Murotani K, Ueshima J, Shimizu A, Inoue T, Sato K, Suenaga M, Ishida Y, Mori N. Effects of Physical Rehabilitation and Nutritional Intake Management on Improvement in Tongue Strength in Sarcopenic Patients. Nutrients 2020; 12:nu12103104. [PMID: 33053651 PMCID: PMC7601202 DOI: 10.3390/nu12103104] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 12/14/2022] Open
Abstract
The study aimed to investigate the impact of physical intervention and the amount of nutritional intake on the increase in tongue strength and swallowing function in older adults with sarcopenia. From November 2018 and May 2019, older patients with sarcopenia who were admitted for rehabilitation were analyzed. The intervention employed in the study was the usual physical and occupational therapy for two months. Tongue strength was measured before and after two months of treatment. Data on tongue strength, the amount of energy and protein intake, intervention time, and swallowing function were examined. A total of 95 sarcopenic older patients were included (mean age 83.4 ± 6.5 years). The mean tongue strength after the intervention was significantly increased from 25.4 ± 8.9 kPa to 30.5 ± 7.6 kPa as a result of the treatment (p < 0.001). After adjusting the confounding factors in the multivariable models, an energy intake of ≥30 kcal/kg/day and a protein intake of ≥1.2 g/kg/day based on the ideal body weight had a significant impact on the increase in tongue strength after the treatment (p = 0.011 and p = 0.020, respectively). Swallowing function assessed using the Mann Assessment of Swallowing Ability was significantly increased after the treatment (mean difference between pairs: 1.12 [0.53-1.70]; p < 0.001). Physical intervention and strict nutritional management for older inpatients with sarcopenia could be effective to improve tongue strength and swallowing function.
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Affiliation(s)
- Ayano Nagano
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan;
| | - Keisuke Maeda
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan;
- Correspondence: ; Tel.: +81-561-62-3311; Fax: +81-561-78-6364
| | - Masaki Koike
- Division of Rehabilitation, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Japan;
| | - Kenta Murotani
- Biostatistics Center, Kurume University, 67 Asahimachi, Kurume 830-0011, Japan;
| | - Junko Ueshima
- Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8625, Japan;
| | - Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wago-kita, Naka-ku, Hamamatsu, Shizuoka 433-8127, Japan;
| | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan;
| | - Keisuke Sato
- Okinawa Chuzan Hospital Clinical Research Center, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Japan;
| | - Masaki Suenaga
- Department of Rehabilitation Medicine, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Japan;
| | - Yuria Ishida
- Department of Nutrition, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan;
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan;
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