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Hooijmans MT, Veeger TTJ, Mazzoli V, van Assen HC, de Groot JH, Gottwald LM, Nederveen AJ, Strijkers GJ, Kan HE. Muscle fiber strain rates in the lower leg during ankle dorsi-/plantarflexion exercise. NMR IN BIOMEDICINE 2024; 37:e5064. [PMID: 38062865 DOI: 10.1002/nbm.5064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 02/17/2024]
Abstract
Static quantitative magnetic resonance imaging (MRI) provides readouts of structural changes in diseased muscle, but current approaches lack the ability to fully explain the loss of contractile function. Muscle contractile function can be assessed using various techniques including phase-contrast MRI (PC-MRI), where strain rates are quantified. However, current two-dimensional implementations are limited in capturing the complex motion of contracting muscle in the context of its three-dimensional (3D) fiber architecture. The MR acquisitions (chemical shift-encoded water-fat separation scan, spin echo-echoplanar imaging with diffusion weighting, and two time-resolved 3D PC-MRI) wereperformed at 3 T. PC-MRI acquisitions and performed with and without load at 7.5% of the maximum voluntary dorsiflexion contraction force. Acquisitions (3 T, chemical shift-encoded water-fat separation scan, spin echo-echo planar imaging with diffusion weighting, and two time-resolved 3D PC-MRI) were performed with and without load at 7.5% of the maximum voluntary dorsiflexion contraction force. Strain rates and diffusion tensors were calculated and combined to obtain strain rates along and perpendicular to the muscle fibers in seven lower leg muscles during the dynamic dorsi-/plantarflexion movement cycle. To evaluate strain rates along the proximodistal muscle axis, muscles were divided into five equal segments. t-tests were used to test if cyclic strain rate patterns (amplitude > 0) were present along and perpendicular to the muscle fibers. The effects of proximal-distal location and load were evaluated using repeated measures ANOVAs. Cyclic temporal strain rate patterns along and perpendicular to the fiber were found in all muscles involved in dorsi-/plantarflexion movement (p < 0.0017). Strain rates along and perpendicular to the fiber were heterogeneously distributed over the length of most muscles (p < 0.003). Additional loading reduced strain rates of the extensor digitorum longus and gastrocnemius lateralis muscle (p < 0.001). In conclusion, the lower leg muscles involved in cyclic dorsi-/plantarflexion exercise showed cyclic fiber strain rate patterns with amplitudes that varied between muscles and between the proximodistal segments within the majority of muscles.
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Affiliation(s)
- Melissa T Hooijmans
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Thom T J Veeger
- C. J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Valentina Mazzoli
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Hans C van Assen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jurriaan H de Groot
- Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Lukas M Gottwald
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Hermien E Kan
- C. J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Duchenne Center Netherlands, Leiden, The Netherlands
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Lee DS, Kim HE, Choi JS. Oral Health-Related Factors Associated with Dysphagia Risk among Older, Healthy, Community-Dwelling Korean Adults: A Pilot Study. Healthcare (Basel) 2024; 12:267. [PMID: 38275546 PMCID: PMC10815140 DOI: 10.3390/healthcare12020267] [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: 12/24/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Most previous studies addressing dysphagia examined individuals who already had diseases causing dysphagia and did not pay much attention to oral health conditions as a risk factor. This pilot study investigated 62 healthy adults aged 65 years or older who were living independently in the community, performed basic activities of daily living independently, and had no history of a causative disease of dysphagia to identify the factors associated with dysphagia risk, especially oral health. The Dysphagia Risk Assessment Scale was used to screen the patients for dysphagia. Hyposalivation was diagnosed by evaluating the unstimulated salivary flow rate, and orofacial muscle strength (anterior tongue elevation, buccinator muscle, and lip strength) was quantitatively measured using the Iowa Oral Performance Instrument. To analyze the factors associated with dysphagia risk, the Mann-Whitney test, Kruskal-Wallis test, and multiple logistic regression analyses were conducted. In the final regression model adjusted for sociodemographic characteristics, the oral health-related factors independently associated with dysphagia risk were buccinator muscle strength, hyposalivation, and subjective masticatory discomfort (p < 0.05). Therefore, our findings suggest that weak buccinator muscle strength, hyposalivation, and subjective masticatory discomfort are valuable indicators for the early detection of dysphagia in older, healthy, independent, community-dwelling adults.
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Affiliation(s)
- Da-Som Lee
- Department of Dental Hygiene, Graduate School, Gachon University, Incheon 21936, Republic of Korea;
| | - Hee-Eun Kim
- Department of Dental Hygiene, College of Medical Science, Gachon University, Incheon 21936, Republic of Korea;
| | - Jun-Seon Choi
- Department of Dental Hygiene, College of Medical Science, Gachon University, Incheon 21936, Republic of Korea;
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Yamano T, Nishi K, Omori F, Nakamura A, Fukuyo K. Outpatient Treatment of Mild Dysphagia in Ear-Nose-and-Throat Clinics. Cureus 2024; 16:e52395. [PMID: 38361677 PMCID: PMC10867718 DOI: 10.7759/cureus.52395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE Many reports on inpatient dysphagia rehabilitation in acute and convalescent rehabilitation hospitals exist, but there are a few reports on outpatient treatments. Otolaryngologists still take a trial-and-error approach when treating dysphagia. Here, we explore the effectiveness and limitations of outpatient treatment in ear-nose-and-throat (ENT) clinics. METHODS Sixty-four patients (41 males and 23 females) aged 27-101 years (mean 78 years) visited an outpatient clinic specialising in feeding and swallowing conditions (the Fukuyo ENT Clinic). All were able to perform the activities of daily living (ADL) to the extent that outpatient visits were possible; no home visits were made. The weekly outpatient day was staffed by an otolaryngologist and a speech-language-hearing therapist (SLHT). All patients were subjected to fibreoptic endoscopic evaluation of swallowing (FEES), followed by appropriate training as revealed by the examinations. RESULTS Salivary retention in the glottis valley and piriform sinuses improved (both p < 0.05) in 30 patients who underwent repeat FEES; we compared the initial and final figures. In 14 cases in whom maximal tongue pressure (TP) was measured, this was higher at the final than at the first examination (p < 0.01). CONCLUSION Outpatient treatment at ENT clinics for patients who are able to maintain their ADLs to the extent that they are able to walk to a hospital is an option for the treatment of age-related dysphagia. For severe cases, however, house calls and collaboration with the home and nursing care sector will be necessary and should be considered in the future.
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Affiliation(s)
- Takafumi Yamano
- Department of Otorhinolaryngology, Department of Medicine, Fukuoka Dental College, Fukuoka, JPN
| | - Kensuke Nishi
- Department of Otorhinolaryngology, Department of Medicine, Fukuoka Dental College, Fukuoka, JPN
| | - Fumitaka Omori
- Department of Otorhinolaryngology, Fukuoka Dental College Hospital, Fukuoka, JPN
| | - Ayumi Nakamura
- Department of Physical Medicine and Rehabilitation, Fukuyo ENT Clinic, Itoshima, JPN
| | - Kazumasa Fukuyo
- Department of Otorhinolaryngology, Fukuyo ENT Clinic, Itoshima, JPN
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Mialland A, Atallah I, Bonvilain A. Toward a robust swallowing detection for an implantable active artificial larynx: a survey. Med Biol Eng Comput 2023; 61:1299-1327. [PMID: 36792845 DOI: 10.1007/s11517-023-02772-8] [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: 02/17/2022] [Accepted: 01/04/2023] [Indexed: 02/17/2023]
Abstract
Total laryngectomy consists in the removal of the larynx and is intended as a curative treatment for laryngeal cancer, but it leaves the patient with no possibility to breathe, talk, and swallow normally anymore. A tracheostomy is created to restore breathing through the throat, but the aero-digestive tracts are permanently separated and the air no longer passes through the nasal tracts, which allowed filtration, warming, humidification, olfaction, and acceleration of the air for better tissue oxygenation. As for phonation restoration, various techniques allow the patient to talk again. The main one consists of a tracheo-esophageal valve prosthesis that makes the air passes from the esophagus to the pharynx, and makes the air vibrate to allow speech through articulation. Finally, swallowing is possible through the original tract as it is now isolated from the trachea. Yet, many methods exist to detect and assess a swallowing, but none is intended as a definitive restoration technique of the natural airway, which would permanently close the tracheostomy and avoid its adverse effects. In addition, these methods are non-invasive and lack detection accuracy. The feasibility of an effective early detection of swallowing would allow to further develop an implantable active artificial larynx and therefore restore the aero-digestive tracts. A previous attempt has been made on an artificial larynx implanted in 2012, but no active detection was included and the system was completely mechanic. This led to residues in the airway because of the imperfect sealing of the mechanism. An active swallowing detection coupled with indwelling measurements would thus likely add a significant reliability on such a system as it would allow to actively close an artificial larynx. So, after a brief explanation of the swallowing mechanism, this survey intends to first provide a detailed consideration of the anatomical region involved in swallowing, with a detection perspective. Second, the swallowing mechanism following total laryngectomy surgery is detailed. Third, the current non-invasive swallowing detection technique and their limitations are discussed. Finally, the previous points are explored with regard to the inherent requirements for the feasibility of an effective swallowing detection for an artificial larynx. Graphical Abstract.
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Affiliation(s)
- Adrien Mialland
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France.
| | - Ihab Atallah
- Institute of Engineering and Management Univ. Grenoble Alpes, Otorhinolaryngology, CHU Grenoble Alpes, 38700, La Tronche, France
| | - Agnès Bonvilain
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France
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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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Orsbon CP, Gidmark NJ, Gao T, Ross CF. XROMM and diceCT reveal a hydraulic mechanism of tongue base retraction in swallowing. Sci Rep 2020; 10:8215. [PMID: 32427836 PMCID: PMC7237434 DOI: 10.1038/s41598-020-64935-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/06/2020] [Indexed: 11/09/2022] Open
Abstract
During primate swallowing, tongue base retraction (TBR) drives the food bolus across the oropharynx towards the esophagus and flips the epiglottis over the laryngeal inlet, protecting against penetration and aspiration of food into the airway. Despite the importance of TBR for swallowing performance, the mechanics of TBR are poorly understood. Using biplanar videoradiography (XROMM) of four macaque monkeys, we tested the extrinsic muscle shortening hypothesis, which posits that shortening of the hyoglossus and styloglossus muscles pulls the tongue base posteriorly, and the muscular hydrostat or intrinsic tongue muscle hypothesis, which suggests that, because the tongue is composed of incompressible fluid, intrinsic muscle shortening increases tongue length and displaces the tongue base posteriorly. Our data falsify these hypotheses. Instead we suggest a novel hydraulic mechanism of TBR: shortening and rotation of suprahyoid muscles compresses the tongue between the hard palate, hyoid and mouth floor, squeezing the midline tongue base and food bolus back into the oropharynx. Our hydraulic mechanism is consistent with available data on human tongue swallowing kinematics. Rehabilitation for poor tongue base retraction might benefit from including suprahyoid muscle exercises during treatment.
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Affiliation(s)
- Courtney P Orsbon
- Department of Organismal Biology & Anatomy, The University of Chicago, Chicago, IL, 60637, USA
| | - Nicholas J Gidmark
- Department of Organismal Biology & Anatomy, The University of Chicago, Chicago, IL, 60637, USA
- Biology Department, Knox College, Galesburg, IL, 61401, USA
| | - Tingran Gao
- Committee on Computational and Applied Mathematics, Department of Statistics, The University of Chicago, Chicago, IL, 60637, USA
| | - Callum F Ross
- Department of Organismal Biology & Anatomy, The University of Chicago, Chicago, IL, 60637, USA.
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7
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Setzke C, Broytman O, Russell JA, Morel N, Sonsalla M, Lamming DW, Connor NP, Teodorescu M. Effects of inhaled fluticasone propionate on extrinsic tongue muscles in rats. J Appl Physiol (1985) 2020; 128:576-585. [PMID: 31944881 PMCID: PMC7099439 DOI: 10.1152/japplphysiol.00359.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 12/12/2019] [Accepted: 12/31/2019] [Indexed: 12/16/2022] Open
Abstract
Obstructive sleep apnea (OSA) is more common in patients with asthma, and inhaled corticosteroids may contribute to OSA pathogenesis in these patients. This study tested the effects of orally inhaled fluticasone propionate (FP) on extrinsic tongue muscles. Unanesthetized rats were treated with FP or placebo for 28 days. On day 29, tongue retrusive and protrusive functions were tested via hypoglossal nerve stimulation under a state of anesthesia, followed by genioglossus (GG), styloglossus (SG) and hyoglossus (HG) muscle extraction, after euthanasia, for histology [myosin heavy chain (MHC) fibers and laminin content reflecting extracellular matrix (ECM)]. On protrusive testing, FP increased percent maximum tetanic force at 40 Hz (P = 0.03 vs. placebo) and endurance index (P = 0.029 vs. placebo). On retrusive testing, FP increased maximum twitch (P = 0.026 vs. placebo) and tetanic forces (P = 0.02 vs. placebo) with no effect on endurance index. On histology, FP increased GG cross-sectional area of MHC type IIa (P = 0.036 vs. placebo) and tended to increase type IIb (P = 0.057 vs. placebo) fibers and HG MHC IIx fibers (P = 0.065). The FP group had significantly increased laminin-stained areas, of greatest magnitude in the HG muscle. FP affects tongue protrusive and retrusive functions differently, concurrent with a shift in MHC fibers and increased ECM accumulation. These differential alterations may destabilize the tongue's "muscle hydrostat" during sleep and promote collapse.NEW & NOTEWORTHY The effects of inhaled corticosteroid on upper airway may contribute to OSA pathogenesis in asthma. In this study, we tested the effects of orally inhaled fluticasone propionate on tongue protrusive and retrusive functions and on tongue extrinsic muscle fiber composition and molecular properties. We found that fluticasone treatment: 1) increased protrusive endurance and retrusive maximum twitch and tetanic force; and 2) on histology, increased cross-sectional area of myosin heavy chain (MHC) type IIa fibers and tended to increase cross-sectional area of MHC type IIb fibers in the protrusive muscle and of MHC IIx fibers in the retrusors. It also increased laminin-stained areas, across extrinsic tongue muscles, of greatest magnitude in the retrusors; and 3) reduced protein degradation and activated pathways associated with increased protein synthesis in the protrusor. These differential effects on the protrusors and retrusors may destabilize the tongue's "muscle hydrostat" properties during sleep and promote collapse.
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Affiliation(s)
- Christopher Setzke
- Department of Medicine and University of Wisconsin, Madison, Wisconsin
- William S. Middleton Memorial Veterans Affairs Medical Center, Madison, Wisconsin
| | - Oleg Broytman
- Department of Medicine and University of Wisconsin, Madison, Wisconsin
- William S. Middleton Memorial Veterans Affairs Medical Center, Madison, Wisconsin
| | - John A Russell
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Natalie Morel
- Department of Medicine and University of Wisconsin, Madison, Wisconsin
| | - Michelle Sonsalla
- Department of Medicine and University of Wisconsin, Madison, Wisconsin
- William S. Middleton Memorial Veterans Affairs Medical Center, Madison, Wisconsin
| | - Dudley W Lamming
- Department of Medicine and University of Wisconsin, Madison, Wisconsin
- William S. Middleton Memorial Veterans Affairs Medical Center, Madison, Wisconsin
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Mihaela Teodorescu
- Department of Medicine and University of Wisconsin, Madison, Wisconsin
- William S. Middleton Memorial Veterans Affairs Medical Center, Madison, Wisconsin
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Van den Steen L, De Bodt M, Guns C, Elen R, Vanderwegen J, Van Nuffelen G. Tongue-Strengthening Exercises in Healthy Older Adults: Effect of Exercise Frequency – A Randomized Trial. Folia Phoniatr Logop 2020; 73:109-116. [DOI: 10.1159/000505153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/01/2019] [Indexed: 11/19/2022] Open
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Pearson WG, Griffeth JV, Ennis AM. Functional Anatomy Underlying Pharyngeal Swallowing Mechanics and Swallowing Performance Goals. ACTA ACUST UNITED AC 2019. [DOI: 10.1044/2019_pers-sig13-2018-0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
Rehabilitation of pharyngeal swallowing dysfunction requires a thorough understanding of the functional anatomy underlying the performance goals of pharyngeal swallowing. These goals include the safe and efficient transfer of a bolus through the hypopharynx into the esophagus. Penetration or aspiration of a bolus threatens swallowing safety. Bolus residue indicates swallowing inefficiency. Several primary mechanics, or elements of the swallowing mechanism, underlie these performance goals, with some elements contributing to both goals. These primary mechanics include velopharyngeal port closure, hyoid movement, laryngeal elevation, pharyngeal shortening, tongue base retraction, and pharyngeal constriction. Each element of the swallowing mechanism is under neuromuscular control and is therefore, in principle, a potential target for rehabilitation. Secondary mechanics of pharyngeal swallowing, those movements dependent on primary mechanics, include opening the upper esophageal sphincter and epiglottic inversion.
Conclusion
Understanding the functional anatomy of pharyngeal swallowing underlying swallowing performance goals will facilitate anatomically informed critical thinking in the rehabilitation of pharyngeal swallowing dysfunction.
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Affiliation(s)
- William G. Pearson
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University
- Department of Otolaryngology, Medical College of Georgia,Augusta University
| | | | - Alexis M. Ennis
- Department of Academic Affairs, Medical College of Georgia, Augusta University
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Bilston LE, Bolsterlee B, Nordez A, Sinha S. Contemporary image-based methods for measuring passive mechanical properties of skeletal muscles in vivo. J Appl Physiol (1985) 2019; 126:1454-1464. [PMID: 30236053 DOI: 10.1152/japplphysiol.00672.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Skeletal muscles' primary function in the body is mechanical: to move and stabilize the skeleton. As such, their mechanical behavior is a key aspect of their physiology. Recent developments in medical imaging technology have enabled quantitative studies of passive muscle mechanics, ranging from measurements of intrinsic muscle mechanical properties, such as elasticity and viscosity, to three-dimensional muscle architecture and dynamic muscle deformation and kinematics. In this review we summarize the principles and applications of contemporary imaging methods that have been used to study the passive mechanical behavior of skeletal muscles. Elastography measurements can provide in vivo maps of passive muscle mechanical parameters, and both MRI and ultrasound methods are available (magnetic resonance elastography and ultrasound shear wave elastography, respectively). Both have been shown to differentiate between healthy muscle and muscles affected by a broad range of clinical conditions. Detailed muscle architecture can now be depicted using diffusion tensor imaging, which not only is particularly useful for computational modeling of muscle but also has potential in assessing architectural changes in muscle disorders. More dynamic information about muscle mechanics can be obtained using a range of dynamic MRI methods, which characterize the detailed internal muscle deformations during motion. There are several MRI techniques available (e.g., phase-contrast MRI, displacement-encoded MRI, and "tagged" MRI), each of which can be collected in synchrony with muscle motion and postprocessed to quantify muscle deformation. Together, these modern imaging techniques can characterize muscle motion, deformation, mechanical properties, and architecture, providing complementary insights into skeletal muscle function.
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Affiliation(s)
- Lynne E Bilston
- Neuroscience Research Australia, Randwick, New South Wales , Australia.,Prince of Wales Clinical School, University of New South Wales, Randwick, New South Wales , Australia
| | - Bart Bolsterlee
- Neuroscience Research Australia, Randwick, New South Wales , Australia.,Graduate School of Biomedical Engineering, University of New South Wales , Kensington, New South Wales , Australia
| | - Antoine Nordez
- Health and Rehabilitation Research Institute, Auckland University of Technology , Auckland , New Zealand.,Movement, Interactions, Performance Laboratory (EA 4334), Faculty of Sport Sciences, University of Nantes , Nantes , France
| | - Shantanu Sinha
- Muscle Imaging and Modeling Laboratory, Department of Radiology, University of California , San Diego, California
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Namiki C, Hara K, Tohara H, Kobayashi K, Chantaramanee A, Nakagawa K, Saitou T, Yamaguchi K, Yoshimi K, Nakane A, Minakuchi S. Tongue-pressure resistance training improves tongue and suprahyoid muscle functions simultaneously. Clin Interv Aging 2019; 14:601-608. [PMID: 30962680 PMCID: PMC6432900 DOI: 10.2147/cia.s194808] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Producing tongue pressure (TP) by pushing the tongue against the palate consists of lifting the tongue muscles and elevating the floor of the mouth via suprahyoid muscle contraction. Though studies have shown that tongue-pressure resistance training (TPRT) increases tongue function, none have focused on suprahyoid muscle function enhancements. Our study aimed to verify whether TPRT improves both tongue function and hyoid movement during swallowing. Materials and methods Eighteen patients (mean age: 76.8±6.2 years) with presbyphagia presenting with symptoms such as coughing and choking were enrolled. All patients performed daily living activities independently. None of the participants had diseases causing dysphagia or previous oral or pharyngeal surgery. Participants were instructed to push their tongues against the palate as hard as possible with their mouths closed for 10 seconds, and then resting for 10 seconds. A set consisted of five consecutive exercise and resting periods; two sets per day were performed for a month. TP and the oral diadochokinetic rate (ODKR), measured by repetitions of the syllables /ta/ and /ka/, assessed tongue function. The extent of anterior and superior hyoid movement and parameters related to swallowing, including the penetration aspiration scale (PAS) and the normalized residue ratio scale (NRRS) in the valleculae (NRRSv) and piriform sinus (NRRSp), were evaluated based on videofluoroscopic data. Results The anterior (P=0.031) and superior hyoid movement (P=0.012), TP (P=0.002), ODKR/ta/ (P=0.034), ODKR/ka/ (P=0.009), and the width of the upper esophageal sphincter (P=0.001) were larger at follow-up than at baseline. NRRSp (P=0.022), PAS (P=0.016), and pharyngeal transit times (P=0.004) were smaller at follow-up than at baseline. Conclusion TPRT improved tongue strength, dexterity, both anterior and superior hyoid elevation, and swallowing functions. Therefore, TPRT could improve tongue function and suprahyoid muscle function simultaneously and contribute to prevention of sarcopenic dysphagia.
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Affiliation(s)
- Chizuru Namiki
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
| | - Koji Hara
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
| | - Haruka Tohara
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
| | | | - Ariya Chantaramanee
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
| | - Kazuharu Nakagawa
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
| | | | - Kohei Yamaguchi
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
| | - Kanako Yoshimi
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
| | - Ayako Nakane
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
| | - Shunsuke Minakuchi
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan,
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12
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Yano J, Yamamoto-Shimizu S, Yokoyama T, Kumakura I, Hanayama K, Tsubahara A. Effects of anterior tongue strengthening exercises on posterior tongue strength in healthy young adults. Arch Oral Biol 2019; 98:238-242. [DOI: 10.1016/j.archoralbio.2018.11.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/21/2018] [Accepted: 11/27/2018] [Indexed: 12/17/2022]
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13
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Tongue-Strengthening Exercises in Healthy Older Adults: Does Exercise Load Matter? A Randomized Controlled Trial. Dysphagia 2018; 34:315-324. [DOI: 10.1007/s00455-018-9940-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 09/05/2018] [Indexed: 11/29/2022]
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14
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Hara K, Tohara H, Kobayashi K, Yamaguchi K, Yoshimi K, Nakane A, Minakuchi S. Age-related declines in the swallowing muscle strength of men and women aged 20-89 years: A cross-sectional study on tongue pressure and jaw-opening force in 980 subjects. Arch Gerontol Geriatr 2018; 78:64-70. [PMID: 29902686 DOI: 10.1016/j.archger.2018.05.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/10/2018] [Accepted: 05/28/2018] [Indexed: 12/14/2022]
Abstract
Swallowing muscle strength weakens with aging. Although numerous studies have investigated tongue pressure (TP) changes with age, studies on jaw-opening force (JOF), an indicator of suprahyoid muscle strength, are lacking. We investigated differences between age-related declines in TP and JOF in a cross-sectional study of 980 healthy and independent participants (379 men, 601 women) without dysphagia. Hand grip strength (HGS), TP, and JOF were compared among decade-based age groups in multiple comparison analyses with post-hoc tests and effect size calculated. Participants were divided into adult (20 s-50 s) and elderly groups (60 s-80 s); within each group, Pearson correlations between age and muscle strength indices were evaluated. TP started to significantly decline in the 60 s and 50 s for men and women (p < .01, medium effect size and p < .05, small effect size, respectively); HGS also declined at these ages (men: p < .01, women: p < .01, medium effect size). JOF started to significantly decline in men in their 80 s (p < .01, large effect size), but remained unchanged in women. In the elderly group, all measurements declined with age more sharply in men (HGS: r = -0.56, TP: r = -0.63, JOF: r = -0.13) than in women (HGS: r = -0.38, TP: r = -0.49, JOF: r = -0.003). TP declined more steeply than did JOF. Thus, the age related-decline in TP was similar to that of the HGS, but not the JOF. The results reveal that different patterns exist in the age-related decline in swallowing muscle strength, and suggest that maintenance of JOF might contribute to safe swallowing in healthy elderly individuals.
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Affiliation(s)
- Koji Hara
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruka Tohara
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan.
| | | | - Kohei Yamaguchi
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kanako Yoshimi
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayako Nakane
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
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15
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Mazzoli V, Gottwald LM, Peper ES, Froeling M, Coolen BF, Verdonschot N, Sprengers AM, Ooij P, Strijkers GJ, Nederveen AJ. Accelerated 4
D
phase contrast
MRI
in skeletal muscle contraction. Magn Reson Med 2018; 80:1799-1811. [DOI: 10.1002/mrm.27158] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/15/2018] [Accepted: 02/06/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Valentina Mazzoli
- Department of RadiologyAcademic Medical CenterAmsterdam The Netherlands
- Biomedical NMR, Department of Biomedical EngineeringEindhoven University of TechnologyEindhoven The Netherlands
- Orthopaedic Research LabRadboud UMCNijmegen The Netherlands
| | - Lukas M. Gottwald
- Department of RadiologyAcademic Medical CenterAmsterdam The Netherlands
| | - Eva S. Peper
- Department of RadiologyAcademic Medical CenterAmsterdam The Netherlands
| | - Martijn Froeling
- Department of RadiologyUniversity Medical Center UtrechtUtrecht The Netherlands
| | - Bram F. Coolen
- Biomedical Engineering and PhysicsAcademic Medical CenterAmsterdam The Netherlands
| | - Nico Verdonschot
- Orthopaedic Research LabRadboud UMCNijmegen The Netherlands
- Laboratory for Biomechanical EngineeringUniversity of TwenteEnschede The Netherlands
| | - Andre M. Sprengers
- Orthopaedic Research LabRadboud UMCNijmegen The Netherlands
- Laboratory for Biomechanical EngineeringUniversity of TwenteEnschede The Netherlands
| | - Pim Ooij
- Department of RadiologyAcademic Medical CenterAmsterdam The Netherlands
| | - Gustav J. Strijkers
- Biomedical NMR, Department of Biomedical EngineeringEindhoven University of TechnologyEindhoven The Netherlands
- Biomedical Engineering and PhysicsAcademic Medical CenterAmsterdam The Netherlands
| | - Aart J. Nederveen
- Department of RadiologyAcademic Medical CenterAmsterdam The Netherlands
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16
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Moritaka H, Mineki M, Kobayashi M, Ono T, Hori K. Effect of carrot puree in vegetable juice on linguapalatal swallowing pressure. J Texture Stud 2017; 49:240-246. [PMID: 29226954 DOI: 10.1111/jtxs.12315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 11/07/2017] [Accepted: 12/05/2017] [Indexed: 11/28/2022]
Abstract
This study aimed to ascertain the influence of various amounts (0-30%) of carrot puree (CP) in vegetable juice on linguapalatal swallowing pressure in healthy volunteers. Twenty healthy women (age range: 20-22 years) swallowed a 17-ml drink in a natural state, and linguapalatal swallowing pressure was measured using a special sensor sheet. Peak magnitude (maximum pressure of the tongue pushing on the hard palate), integrated values of linguapalatal swallowing pressure on the waveform, and duration of linguapalatal swallowing pressure were increased with increases in CP concentrations. The total integrated value for 30% CP vegetable juice was larger than that of vegetable juice with no CP. The apparent viscosity of the vegetable juice with a low CP concentration was smaller than that with a high CP concentration at the same shear rate. These results suggest that vegetable juice containing CP affects mechanoreceptor activity in the mouth and generates a neuromotor response. PRACTICAL APPLICATIONS This study aimed to ascertain the influence of various amounts of carrot puree (CP) in vegetable juice on linguapalatal swallowing pressure measured by using a special sensor sheet in healthy volunteers. Obtained results of this study clearly showed that vegetable juice containing CP affects the movement of the tongue in maneuvering the bolus. Moreover, the results demonstrated that this effect depended on the concentration of CP in the vegetable juice. These findings are expected to provide clinically valuable data on the effect of mechanical stimulation during the oral stage of swallowing.
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Affiliation(s)
- Hatsue Moritaka
- Institute of Women's Health Sciences, Showa Women's University, Meguro-ku, Tokyo, Japan
| | - Machiko Mineki
- Graduate School of Human Life Science, Tokyo Kasei University, Itabashi-ku, Tokyo, Japan
| | - Makoto Kobayashi
- Central Research Institute, ITO EN LTD., Makinohara, Shizuoka, Japan
| | - Takahiro Ono
- Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata, Japan
| | - Kazuhiro Hori
- Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata, Japan
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17
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Van den Steen L, Schellen C, Verstraelen K, Beeckman AS, Vanderwegen J, De Bodt M, Van Nuffelen G. Tongue-Strengthening Exercises in Healthy Older Adults: Specificity of Bulb Position and Detraining Effects. Dysphagia 2017; 33:337-344. [PMID: 29052051 DOI: 10.1007/s00455-017-9858-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
Abstract
Clinical tongue-strengthening therapy programs are generally based on the principles of exercise and motor learning, including the specificity paradigm. The aim of this study was to investigate the specific effect of anterior and posterior tongue-strengthening exercises (TSE) on tongue strength (TS) in healthy older adults and to measure possible detraining effects. Sixteen healthy elderly completed 8 weeks of TSE by means of the Iowa Oral Performance Instrument (IOPI). They were distributed in two different treatment arms and performed either exclusively anterior or posterior TSE (ATSE, n = 9 or PTSE, n = 7) depending on the treatment arm. Anterior and posterior maximal isometric pressures (MIPA, MIPP) were measured at baseline, halfway, and after completion of the training sessions. Detraining was measured by repeating MIPA and MIPP measures 4 weeks after the last session of TSE. MIPA and MIPP increased significantly in both treatment arms. MIPA was significantly higher in the ATSE group compared to the PTSE group across all measures in time. No significant differences were observed in MIPP between the ATSE and PTSE groups. Regardless of treatment arm, there was no significant detraining effect measured 4 weeks after the last TSE session. This study suggests that TSE show partial specificity concerning bulb position. We conclude that especially anterior training results in higher anterior TS in comparison with posterior exercises. Furthermore, we found no detraining effects, independent of bulb location.
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Affiliation(s)
- Leen Van den Steen
- Department of Otolaryngology and Head & Neck Surgery - Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Wilrijkstraat 10 Edegem, 2650, Antwerp, Belgium. .,Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1 Wilrijk, 2610, Antwerp, Belgium.
| | - Charlotte Schellen
- University College Arteveldehogeschool, Voetweg 66, 9000, Ghent, Belgium
| | - Katja Verstraelen
- University College Arteveldehogeschool, Voetweg 66, 9000, Ghent, Belgium
| | | | - Jan Vanderwegen
- University College Thomas More, Molenstraat 8, 2018, Antwerp, Belgium.,CHU Saint-Pierre, Hoogstraat 322, 1000, Brussels, Belgium
| | - Marc De Bodt
- Department of Otolaryngology and Head & Neck Surgery - Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Wilrijkstraat 10 Edegem, 2650, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1 Wilrijk, 2610, Antwerp, Belgium.,Faculty of Speech, Pathology and Audiology, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Gwen Van Nuffelen
- Department of Otolaryngology and Head & Neck Surgery - Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Wilrijkstraat 10 Edegem, 2650, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1 Wilrijk, 2610, Antwerp, Belgium.,Faculty of Speech, Pathology and Audiology, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
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18
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Meirelles L, Cunha Matheus Rodrigues Garcia R. Influence of bruxism and splint therapy on tongue pressure against teeth. Cranio 2017; 34:100-4. [PMID: 25975418 DOI: 10.1179/2151090315y.0000000010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES This study estimated the maximum tongue pressure (MTP) against teeth in bruxers, and verified the effect of a stabilization splint. METHOD Forty subjects (mean age: 26.57 years) were assigned to two groups (n520): bruxers and nonbruxers. Sleep bruxism was diagnosed by self-report, presence of tooth wear and tongue indentation, and by using a BiteStrip2 device. Maximum tongue pressure was measured by intraoral appliances containing pressure sensors. After baseline evaluation, bruxers received a stabilization splint and non-bruxers received a palatal splint, both for nocturnal use. Maximum tongue pressure was reassessed after 30 and 60 days. Data were submitted to repeated-measures ANOVA and Tukey test (Pv0.05). RESULTS Bruxers showed an increased MTP against teeth (Pv0.05). Splint therapy decreased MTP for bruxers and non-bruxers. DISCUSSION Bruxers present tongue indentations or ulcerations; however, there is no evidence on their MTP. Further research should focus on therapies to avoid tongue ulcerations in bruxers.
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Affiliation(s)
- Lis Meirelles
- a Department of Prosthodontics and Periodontology , Piracicaba Dental School, University of Campinas , Av. Limeira, no 901, Bairro Areia˜ o, Sa˜o Paulo, Piracicaba , CEP 13414-903 , Brazil
| | - Renata Cunha Matheus Rodrigues Garcia
- a Department of Prosthodontics and Periodontology , Piracicaba Dental School, University of Campinas , Av. Limeira, no 901, Bairro Areia˜ o, Sa˜o Paulo, Piracicaba , CEP 13414-903 , Brazil
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19
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Sinha U, Malis V, Csapo R, Moghadasi A, Kinugasa R, Sinha S. Age-related differences in strain rate tensor of the medial gastrocnemius muscle during passive plantarflexion and active isometric contraction using velocity encoded MR imaging: potential index of lateral force transmission. Magn Reson Med 2014; 73:1852-63. [PMID: 25046255 DOI: 10.1002/mrm.25312] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 05/16/2014] [Accepted: 05/18/2014] [Indexed: 11/05/2022]
Abstract
PURPOSE The strain rate (SR) tensor measures the principal directions and magnitude of the instantaneous deformation; this study aims to track age-related changes in the 2D SR tensor in the medial gastrocnemius during passive joint rotation and active isometric contraction. METHODS SR tensors were derived from velocity encoded magnetic resonance phase-contrast images in nine young (28 years) and eight senior (78 years) women. Strain rates along and in the cross-section of the fiber were calculated from the SR tensor and used to derive the out-plane SR. Age-related and regional differences in the SR eigenvalues, orientation, and the angle between the SR and muscle fiber (SR-fiber angle) were statistically analyzed. RESULTS SR along the fiber was significantly different between the cohorts during isometric contraction with higher values in the young (P < 0.05). The SR-fiber angle was larger in the young for both motion types but this difference was not statistically significant. Significant regional differences in the SR indices was seen in passive joint rotation (P < 0.05) for both cohorts. CONCLUSION SR mapping reflects age-related and regional differences during active and passive motion respectively; this may arise from differences in contractility (active motion) and elastic properties (active and passive motion).
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Affiliation(s)
- Usha Sinha
- Physics Department, San Diego State University, San Diego, California, USA
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20
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Hara K, Tohara H, Wada S, Iida T, Ueda K, Ansai T. Jaw-Opening Force Test to Screen for Dysphagia: Preliminary Results. Arch Phys Med Rehabil 2014; 95:867-74. [DOI: 10.1016/j.apmr.2013.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 08/30/2013] [Accepted: 09/09/2013] [Indexed: 12/17/2022]
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21
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Lin CW. Ultrasonography in Evaluating Tongue Movement. J Med Ultrasound 2014. [DOI: 10.1016/j.jmu.2014.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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22
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Norton JE, Wallis GA, Spyropoulos F, Lillford PJ, Norton IT. Designing food structures for nutrition and health benefits. Annu Rev Food Sci Technol 2014; 5:177-95. [PMID: 24387609 DOI: 10.1146/annurev-food-030713-092315] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In addition to providing specific sensory properties (e.g., flavor or textures), there is a need to produce foods that also provide functionality within the gastrointestinal (GI) tract, over and above simple nutrition. As such, there is a need to understand the physical and chemical processes occurring in the mouth, stomach, small intestine, and large intestine, in addition to the food structure-physiology interactions. In vivo techniques and in vitro models have allowed us to study and simulate these processes, which aids us in the design of food microstructures that can provide functionality within the human body. Furthermore, it is important to be aware of the health or nutritional needs of different groups of consumers when designing food structures, to provide targeted functionality. Examples of three groups of consumers (elderly, obese, and athletes) are given to demonstrate their differing nutritional requirements and the formulation engineering approaches that can be utilized to improve the health of these individuals. Eating is a pleasurable process, but foods of the future will be required to provide much more in terms of functionality for health and nutrition.
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23
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Moritaka H, Kitade M, Sawamura SI, Takihara T, Awano I, Ono T, Tamine K, Hori K. Effect of Carbon Dioxide in Carbonated Drinks on Linguapalatal Swallowing Pressure. Chem Senses 2013; 39:133-42. [DOI: 10.1093/chemse/bjt062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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24
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Kieser JA, Farland MG, Jack H, Farella M, Wang Y, Rohrle O. The role of oral soft tissues in swallowing function: what can tongue pressure tell us? Aust Dent J 2013; 59 Suppl 1:155-61. [PMID: 24152133 DOI: 10.1111/adj.12103] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Tongue pressure data taken from healthy subjects during normal oral activities such as mastication, speech and swallowing are providing us with new ways of understanding the role of the tongue in craniofacial growth and function. It has long been recognized that the sequential contact between the tongue and the palate plays a crucial role in the oropharyngeal phase of swallowing. However, because the focus of most research on intraoral pressure has been on the generation of positive pressure by the tongue on the hard palate and teeth, generation and coordination of absolute intraoral pressures and regional pressure gradients has remained unexplored. Ongoing research in our laboratory has uncovered highly variable individual pressure patterns during swallowing, which can nonetheless be divided into four stages: preparatory, primary propulsive, intermediate and terminal. These stages may further be sub-classified according to pressure patterns generated at the individual level as tipper or dipper patterns in the preparatory stage, roller or slapper in the primary propulsive and monophasic or biphasic during the intermediate stage. Interestingly, while an increase in bolus viscosity can result in significant changes to pressure patterns in some individuals, it has little effect in others. Highly individual responses to increased viscosity are also observed with swallowing duration. The above, together with other findings, have important implications for our understanding of the aetiology of widely differing conditions such as protrusive and retrusive malocclusions, dysphagia and sleep apnoea, as well as the development of novel food products.
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Affiliation(s)
- J A Kieser
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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25
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Fregosi RF, Ludlow CL. Activation of upper airway muscles during breathing and swallowing. J Appl Physiol (1985) 2013; 116:291-301. [PMID: 24092695 DOI: 10.1152/japplphysiol.00670.2013] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The upper airway is a complex muscular tube that is used by the respiratory and digestive systems. The upper airway is invested with several small and anatomically peculiar muscles. The muscle fiber orientations and their nervous innervation are both extremely complex, and how the activity of the muscles is initiated and adjusted during complex behaviors is poorly understood. The bulk of the evidence suggests that the entire assembly of tongue and laryngeal muscles operate together but differently during breathing and swallowing, like a ballet rather than a solo performance. Here we review the functional anatomy of the tongue and laryngeal muscles, and their neural innervation. We also consider how muscular activity is altered as respiratory drive changes, and briefly address upper airway muscle control during swallowing.
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Affiliation(s)
- Ralph F Fregosi
- Department of Physiology, University of Arizona, Tucson, Arizona
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26
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Krival K, Bates C. Effects of club soda and ginger brew on linguapalatal pressures in healthy swallowing. Dysphagia 2011; 27:228-39. [PMID: 21811834 DOI: 10.1007/s00455-011-9358-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 05/06/2011] [Indexed: 11/27/2022]
Abstract
Oral chemesthesis is the detection of chemicals that activate temperature and pain receptors in the oral mucosa. Presentation of orally chemesthetic input has been theorized to stimulate a faster, stronger swallow. We measured differences in peak linguapalatal swallowing pressures, pressure durations, and pressure adjustments in response to two volumes of water and carbonation (in Schweppes® Club Soda) and carbonation + gingerol (in Reed's Extra Ginger Brew) in 20 young adult women. There was a main effect of stimulus on linguapalatal swallowing pressure, F(6,74) = 6.247, p = 0.000, hp(2) = 0.536 (Reed's Extra Ginger Brew > Schweppes Club Soda > water). Rising and releasing linguapalatal pressure durations were greater for carbonation + gingerol and carbonation than for water. Our results add to the evidence that orally chemesthetic beverages influence greater neuromotor activity compared to water during the oral stage of swallowing. Our findings also suggest that there may be some benefit to the cumulative addition of chemosensory agents in a beverage. Clinically, this provides a theoretical basis for considering the use of these or chemically similar beverages as facilitating stimuli in patients who aspirate thin liquids.
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Affiliation(s)
- Kate Krival
- Kent State University, 1325 Theater Drive, Kent, OH 44242, USA.
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27
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KIESER JULES, BOLTER CHRIS, RANIGA NITIN, WADDELL JNEIL, SWAIN MICHAEL, FARLAND GUY. TONGUE-PALATE INTERACTIONS DURING SWALLOWING. J Texture Stud 2011. [DOI: 10.1111/j.1745-4603.2010.00274.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Mijailovich SM, Stojanovic B, Kojic M, Liang A, Wedeen VJ, Gilbert RJ. Derivation of a finite-element model of lingual deformation during swallowing from the mechanics of mesoscale myofiber tracts obtained by MRI. J Appl Physiol (1985) 2010; 109:1500-14. [PMID: 20689096 PMCID: PMC2980378 DOI: 10.1152/japplphysiol.00493.2010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Accepted: 07/30/2010] [Indexed: 11/22/2022] Open
Abstract
To demonstrate the relationship between lingual myoarchitecture and mechanics during swallowing, we performed a finite-element (FE) simulation of lingual deformation employing mesh aligned with the vector coordinates of myofiber tracts obtained by diffusion tensor imaging with tractography in humans. Material properties of individual elements were depicted in terms of Hill's three-component phenomenological model, assuming that the FE mesh was composed of anisotropic muscle and isotropic connective tissue. Moreover, the mechanical model accounted for elastic constraints by passive and active elements from the superior and inferior directions and the effect of out-of-plane muscles and connective tissue. Passive bolus effects were negligible. Myofiber tract activation was simulated over 500 ms in 1-ms steps following lingual tip association with the hard palate and incorporated specifically the accommodative and propulsive phases of the swallow. Examining the displacement field, active and passive muscle stress, elemental stretch, and strain rate relative to changes of global shape, we demonstrate that lingual reconfiguration during these swallow phases is characterized by (in sequence) the following: 1) lingual tip elevation and shortening in the anterior-posterior direction; 2) inferior displacement related to hyoglossus contraction at its inferior-most position; and 3) dominant clockwise rotation related to regional contraction of the genioglossus and contraction of the hyoglossus following anterior displacement. These simulations demonstrate that lingual deformation during the indicated phases of swallowing requires temporally patterned activation of intrinsic and extrinsic muscles and delineate a method to ascertain the mechanics of normal and pathological swallowing.
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Affiliation(s)
- Srboljub M Mijailovich
- Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
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29
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Kennedy D, Kieser J, Bolter C, Swain M, Singh B, Waddell JN. Tongue pressure patterns during water swallowing. Dysphagia 2009; 25:11-9. [PMID: 19568810 DOI: 10.1007/s00455-009-9223-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 03/24/2009] [Indexed: 11/28/2022]
Abstract
Bolus propulsion during the normal oral phase of swallowing is thought to be characterised by the sequential elevation of the front, middle, and posterior regions of the dorsum of the tongue. However, the coordinated orchestration of lingual movement is still poorly understood. This study examined how pressures generated by the tongue against the hard palate differed between three points along the midline of the tongue. Specifically, we tested three hypotheses: (1) that there are defined individual patterns of pressure change within the mouth during liquid swallowing; (2) that there are significant negative pressures generated at defined moments during normal swallowing; and, (3) that liquid swallowing is governed by the interplay of pressures generated in an anteroposterior direction in the mouth. Using a metal appliance described previously, we measured absolute pressures during water swallows in six healthy volunteers (4 male, 2 female) with an age range of 25-35 years. Participants performed three 10-ml water swallows from a small cup on five separate days, thus providing data for a total of 15 separate water swallows. There was a distinct pattern to the each of the pressure signals, and this pattern was preserved in the mean obtained when the data were pooled. Furthermore, raw signals from the same subjects presented consistent patterns at each of the five testing sessions. In all subjects, pressure at the anterior and hind palate tended to be negative relative to the preswallow value; at mid-palate, however, pressure changes were less consistent between individuals. When the pressure differences between the sites were calculated, we found that during the swallow a net negative pressure difference developed between anterior and mid-palate and a net positive pressure difference developed between mid-palate and hind palate. Large, rapid fluctuations in pressure occurred at all sites and these varied several-fold between subjects. When the brief sharp reduction in pressure that occurred early in each swallow was used to determine the sequence of events, we found that activity occurred first at the anterior of the palate followed by the mid-palate and then the hind palate. There was a considerably longer and more variable delay between the start of activity at the front of the palate than at the rear of the palate. To obtain an index of the "effort" involved in generating the pressures at each site regardless of direction (positive or negative), we obtained the product of the root mean square (RMS) pressure change during each swallow (kPa) and its duration (s). Overall, the most effort appears to have occurred at the front of the palate and the least at mid-palate. Our results also showed that some participants exerted a small amount of midline pressure when swallowing, while others used a relatively large amount of tongue pressure. We conclude that while tongue behaviour during swallowing follows a classical sequence of rapid shape changes intended to contain and then propel the bolus from the oral cavity to the pharynx, there is a large range of individual variability in how this process is accomplished.
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Affiliation(s)
- Daniel Kennedy
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
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Current World Literature. Curr Opin Otolaryngol Head Neck Surg 2008; 16:292-5. [DOI: 10.1097/moo.0b013e3283041256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Felton SM, Gaige TA, Benner T, Wang R, Reese TG, Wedeen VJ, Gilbert RJ. Associating the mesoscale fiber organization of the tongue with local strain rate during swallowing. J Biomech 2008; 41:1782-9. [PMID: 18456271 DOI: 10.1016/j.jbiomech.2008.01.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 01/15/2008] [Accepted: 01/17/2008] [Indexed: 11/30/2022]
Abstract
The tongue is an intricately configured muscular organ that undergoes a stereotypical set of deformations during the course of normal human swallowing. In order to demonstrate quantitatively the relationship between 3D aligned lingual fiber organization and mechanics during swallowing, the tissue's myoarchitecture and strain rate were imaged before and during the propulsive phase of a 3.0ml water bolus swallow. Mesoscale fiber organization was imaged with high-resolution diffusion tensor imaging (DTI) and multi-voxel myofiber tracts generated along maximum diffusion vectors. Tissue compression/expansion was obtained via lingual pressure-gated phase-contrast (PC) MRI, a method which determines local strain rate as a function of the phase shift occurring along an applied gradient vector. The co-alignment of myofiber tract direction and the localized principal strain rate vectors was obtained by translating the strain rate tensor into the reference frame with the primary axis parallel to the maximum diffusion vector using Mohr's circle, resulting in the generation of fiber-aligned strain rate (FASR). DTI tractography displayed the complete fiber anatomy of the tongue, consisting of a core region of orthogonally aligned fibers encased within a longitudinal sheath, which merge with the externally connected styloglossus, hyoglossus, and genioglossus fibers. FASR images obtained in the mid-sagittal plane demonstrated that bolus propulsion was associated with prominent compressive strain aligned with the genioglossus muscle combined with expansive strain aligned with the verticalis and geniohyoid muscles. These data demonstrate that lingual deformation during swallowing involves complex interactions involving intrinsic and extrinsic muscles, whose contractility is directed by the alignment of mesoscale fiber tracts.
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Affiliation(s)
- Samuel M Felton
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
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Seo HS, Hwang IK, Han TR, Kim IS. Sensory and instrumental analysis for slipperiness and compliance of food during swallowing. J Food Sci 2008; 72:S707-13. [PMID: 18034757 DOI: 10.1111/j.1750-3841.2007.00544.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In spite of its importance, there have been few attempts to evaluate the sensory attributes of the food bolus during swallowing. In the current study, the slipperiness, the degree of slide for the food bolus through the mucosal surface of the oro-pharynx, and the compliance, how easily the shape of a food bolus can be transformed for automatic and comfortable swallowing, were derived among several sensory attributes related to the swallowing. Therefore, the study aims were twofold: (1) to develop the methods of sensory and instrumental analyses for determining the slipperiness and compliance of the food bolus during swallowing and (2) to examine the appropriateness of the newly designed devices by correlating the data between the sensory and instrumental analyses. Six commercial food products were evaluated by 10 trained panelists for each attribute. The devices for assessing each attribute were developed in consideration of the oro-pharyngeal movements. The sensory and instrumental analyses showed high correlation and regression coefficients as well as intensity differences of the 6 samples for each attribute. In conclusion, the slipperiness and the compliance were suitable for acquiring a better understanding of the sensory attributes of the food bolus during swallowing, and the newly developed devices showed a high potential for determining those attributes.
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Affiliation(s)
- H-S Seo
- Dept. of Food and Nutrition, College of Human Ecology, Seoul Natl. Univ., Seoul 151-742, Korea
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