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Drulia T, Szynkiewicz S, Griffin L, Mulheren R, Murray K, Kamarunas E. A Comparison of Lingual Pressure Generation Measures Using Two Devices in Community-Dwelling, Typically Aging Adults: An Important Clinical Implication. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:429-439. [PMID: 38262037 DOI: 10.1044/2023_jslhr-23-00488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
DESIGN A multisite, prospective, and randomized within-subject design study. SETTING Five university settings in varied geographical areas in the United States. PURPOSE The purpose of this study was to compare lingual pressure generation using the Tongueometer (TO) and the Iowa Oral Performance Instrument (IOPI) in typically aging, community-dwelling adults during three measurement tasks: maximum isometric pressure (MIP), regular effort saliva swallow (RESS) pressure, and effortful saliva swallow pressure (ESP). PARTICIPANTS Eighty-seven typically aging, community-dwelling adults (aged 55 years and over) with no self-reported history of swallowing or neurological disorders were recruited to complete this study. RESULTS Strong positive associations were found between the lingual pressure generation measures from the TO and IOPI in all tasks in typically aging adults, with Pearson correlations ranging from r = .780 to .874, p < .001. Agreement between the devices (Lin's concordance correlation coefficient) ranged from moderate for the MIP (ρc = .78) and ESP (ρc = .61) tasks to weak agreement for the RESS task (ρc = .47). MIP, RESS pressure, and ESP were lower when measured by the TO compared with the IOPI, p < .001. CONCLUSIONS The TO measures lingual pressure generation similarly to the IOPI but pressures register lower when using the TO than the IOPI in typically aging persons. This supports the need for developing normative values specific to the TO device or development of a valid and reliable conversion formula from TO to IOPI normative values. At this time, the clinical use of reference values from the TO should not be generalized to IOPI normative values.
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Affiliation(s)
- Teresa Drulia
- Davies School of Communication Sciences & Disorders, Texas Christian University, Fort Worth
| | - Sarah Szynkiewicz
- Department of Communication Sciences & Disorders, Samford University, Birmingham, AL
| | - Lindsay Griffin
- Department of Communication Sciences and Disorders, Emerson College, Boston, MA
| | - Rachel Mulheren
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Kelsey Murray
- Department of Communication Sciences & Disorders, James Madison University, Harrisonburg, VA
| | - Erin Kamarunas
- Department of Communication Sciences & Disorders, James Madison University, Harrisonburg, VA
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2
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Trucco F, Salmin F, Lizio A, Coratti G, Albamonte E, Frisoni MC, Mauro L, Carraro E, Palazzo G, Lops J, Cattaneo C, Pozzi S, Casiraghi J, Di Bari A, Berti B, Stanca G, Ricci M, Pane M, Heatwole C, Dilek N, Mercuri E, Sansone VA. Assessing Prevalence and Characteristics of Oro-bulbar Involvement in Children and Adults with SMA Type 2 and 3 Using a Multimodal Approach. Dysphagia 2023; 38:1568-1580. [PMID: 37289231 PMCID: PMC10611831 DOI: 10.1007/s00455-023-10584-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/21/2023] [Indexed: 06/09/2023]
Abstract
Bulbar and jaw muscles are impaired in patients with Spinal Muscular Atrophy (SMA) but the assessment of their severity and progression are limited by the lack of age-appropriate and disease-specific measures. We investigated mastication and swallowing in children and adults with SMA, sitters and walkers. In a 2-year multicentre cross-sectional prospective study, lip and tongue strength (Iowa Oral Performance Instrument), chewing and swallowing (Test of Masticating and Swallowing Solids), active mouth opening (aMMO) were compared to age-appropriate normative data. The perceived burden of oro-bulbar involvement (SMA-Health Index) was recorded. 78 patients were included, 45 children (median age 7.4 years),22 adults (median age 26.8 years) on nusinersen and 11 untreated (median age 32.7 years). Forty-three percent children had reduced mouth opening, 50% had prolonged total time to eat. These issues were more prominent in sitters than in walkers (p = 0.019, p = 0.014). Sixty-six percent needed increased swallows for bolus clearance. Nusinersen treated adults had median aMMO, tongue strength and total time at TOMASS values within normal range (z score: -1.40, -1.22, -1.32, respectively) whereas untreated adults had reduced aMMO (z score: -2.68) and tongue strength (z score: -2.20). Only a minority of children (2/17) and treated adults (5/21) reported burden in swallowing or mastication compared to all untreated adults (5/5). After 16 months, mastication and swallowing were stable in treated children and adults, whether sitters or walkers. The reported multimodal approach to assess oro-bulbar functions demonstrate that swallowing and mastication are impaired in SMA despite patients' perception. These results suggest a trend towards stabilization of oro-bulbar function in patients on long-term treatment with nusinersen.
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Affiliation(s)
- Federica Trucco
- Neurorehabilitation Unit, The NeMo Clinical Center in Milan, University of Milan, ASST Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London, UK
- Dept Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
| | | | - Andrea Lizio
- Centro Clinico Nemo, Fondazione Serena Onlus, Milan, Italy
| | - Giorgia Coratti
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | | | - Luca Mauro
- Centro Clinico Nemo, Fondazione Serena Onlus, Milan, Italy
| | - Elena Carraro
- Centro Clinico Nemo, Fondazione Serena Onlus, Milan, Italy
| | | | - Jessica Lops
- Centro Clinico Nemo, Fondazione Serena Onlus, Milan, Italy
| | | | - Susanna Pozzi
- Centro Clinico Nemo, Fondazione Serena Onlus, Milan, Italy
| | | | | | - Beatrice Berti
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giulia Stanca
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Martina Ricci
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Marika Pane
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Chad Heatwole
- Center for Health and Technology (CHeT), The University of Rochester Medical Center, Rochester, NY, USA
| | - Nuran Dilek
- Center for Health and Technology (CHeT), The University of Rochester Medical Center, Rochester, NY, USA
| | - Eugenio Mercuri
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Valeria Ada Sansone
- Neurorehabilitation Unit, The NeMo Clinical Center in Milan, University of Milan, ASST Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy.
- Centro Clinico Nemo, Fondazione Serena Onlus, Milan, Italy.
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Szynkiewicz SH, Drulia T, Griffin L, Mulheren R, Murray KL, Lee T, Kamarunas E. Flexibility for Intensity Dosing in Lingual Resistance Exercises: A Large Randomized Clinical Trial in Typically Aging Adults as Proof of Principle. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:3021-3035. [PMID: 37850842 DOI: 10.1044/2023_ajslp-23-00113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
OBJECTIVE The objective of this study was to determine the effect of intensity dosing during tongue exercise on tongue pressure generation, adherence, and perceived effort. DESIGN This was a five-site, prospective, randomized clinical trial. Outcome measures were obtained across multiple baselines, biweekly during exercise, and 4-weeks post-intervention. SETTING The general community at each study site. PARTICIPANTS Typically aging adults between 55-82 years of age with no history of neurological or swallowing disorders. Eighty-four volunteers completed the study. INTERVENTIONS Participants were randomly assigned to one of four exercise groups: (a) maximum intensity/no biofeedback, (b) progressive intensity/no biofeedback, (c) maximum intensity/biofeedback, and (d) progressive intensity/biofeedback. Half of the participants completed a maintenance exercise program. OUTCOME MEASURES Maximum isometric pressure (MIP), regular effort saliva swallow pressure, adherence, and the Borg Rating of Perceived Exertion Scale. RESULTS All exercise protocols were efficacious for gains in MIP (large effect sizes; Cohen's d). Group 3 made gains in regular effort saliva swallow pressure (medium effect size). There was a significant change in perceived exertion for regular effort saliva swallow pressure at 8 weeks. Tongue pressure gains were maintained at 1 month, regardless of maintenance group status. Mean adherence across groups was high. CONCLUSIONS All groups improved pressure generation. Intensity dosing differences did not affect strength gains, adherence, or detraining. Regular effort saliva swallow pressure may be most responsive to maximum intensity with biofeedback. The findings suggest flexibility in approach to tongue exercise protocols. Tongue muscles may differ from limb muscles in terms of dose response and neuroplasticity principles.
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Affiliation(s)
- Sarah H Szynkiewicz
- Department of Communication Sciences and Disorders, Samford University, Birmingham, AL
| | - Teresa Drulia
- Davies School of Communication Sciences and Disorders, Texas Christian University, Fort Worth
| | - Lindsay Griffin
- Department of Communication Sciences and Disorders, Emerson College, Boston, MA
| | - Rachel Mulheren
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Kelsey L Murray
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | - Theresa Lee
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Erin Kamarunas
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
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Mathis S, Solé G, Damon-Perrière N, Rouanet-Larrivière M, Duval F, Prigent J, Nadal L, Péréon Y, Le Masson G. Clinical Neurology in Practice: The Tongue (Part 1). Neurologist 2023; 28:338-348. [PMID: 37639535 DOI: 10.1097/nrl.0000000000000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND The tongue is an essential organ for the development of certain crucial functions, such as swallowing and language. The examination of the tongue can be very useful in neurology, as the various types of lingual alterations can lead to certain specific diagnoses, the tongue being a kind of "mirror" of some neurological function. REVIEW SUMMARY In this study, we reviewed the literature on anatomy, physiology, and the various aspects of the examination of the tongue. CONCLUSIONS Examination of the tongue should be an integral part of the clinical examination of the cranial nerves. This study aimed to demonstrate the importance of tongue motor and non-motor functions in neurological practice.
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Affiliation(s)
- Stéphane Mathis
- Department of Neurology, Muscle-Nerve
- Referral Center for Neuromuscular Diseases 'AOC'
- ALS Center
| | - Guilhem Solé
- Department of Neurology, Muscle-Nerve
- Referral Center for Neuromuscular Diseases 'AOC'
| | - Nathalie Damon-Perrière
- Department of Clinical Neurophysiology
- Department of Movement Disorders, University Hospitals of Bordeaux (CHU Bordeaux, Amélie Raba-Léon, Bordeaux
| | | | - Fanny Duval
- Department of Neurology, Muscle-Nerve
- Referral Center for Neuromuscular Diseases 'AOC'
| | | | | | - Yann Péréon
- Reference Centre for Neuromuscular Diseases 'AOC'. Filenemus, Euro-NMD, University Hospitals of Nantes (CHU Nantes), Nantes, France
| | - Gwendal Le Masson
- Department of Neurology, Muscle-Nerve
- Referral Center for Neuromuscular Diseases 'AOC'
- ALS Center
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Safi M, Alzyod DM, Opoku MP, Agamy YE. Tongue strength and endurance among typically developing children and children with idiopathic speech sound disorders in the United Arab Emirates. PLoS One 2023; 18:e0289400. [PMID: 37523398 PMCID: PMC10389734 DOI: 10.1371/journal.pone.0289400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/18/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Tongue strength and endurance in adults have been extensively studied, but data on these parameters in young children remain largely unavailable. AIMS This study aimed to collect normative objective tongue strength and endurance data from a pediatric population in the United Arab Emirates (UAE) and to examine the effects of age and sex on these parameters. METHODS This normative study included a total of 65 typically developing (TD; n = 36) children and children with idiopathic speech sound disorders (ISSDs; n = 29). The participants were assigned to four age groups (range: 3-8 years) and stratified by sex. Data on their tongue strength and endurance were collected using the Iowa Oral Performance Instrument. RESULTS Tongue strength scores and endurance time increased with age in both the TD and ISSD groups. Sex had no statistically significant effects on tongue strength or endurance in either group. Furthermore, tongue strength and endurance time scores were higher in the TD group than in the ISSD group. CONCLUSIONS The data obtained in this study would add important normative data to the database of standardized measurements for maximal strength and endurance scores in the pediatric population of the UAE. Future research is encouraged to collect additional data that can help healthcare professionals objectively evaluate children with feeding, swallowing, and speech sound production difficulties.
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Affiliation(s)
- Mohammed Safi
- Department of Speech Language Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | | | - Maxwell Peprah Opoku
- Special Education Department, College of Education, United Arab Emirates University, Al Ain, UAE
| | - Yasser E Agamy
- General Physician and Clinical Tutor, Thumbay University Hospital Complex, Ajman, United Arab Emirates
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Kruse T, Shamai S, Leflerovà D, Wirth B, Heller R, Schloss N, Lehmann HC, Brakemeier S, Hagenacker T, Braumann B, Wunderlich G. Objective measurement of oral function in adults with spinal muscular atrophy. Orphanet J Rare Dis 2023; 18:103. [PMID: 37138365 PMCID: PMC10155305 DOI: 10.1186/s13023-023-02688-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/02/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Impairment of bulbar function in adult individuals with spinal muscular atrophy (SMA) usually is not assessed by established motor scores. Measurements of oral function including quantitative muscle and endurance tests are able to detect subtle changes. The aim of this study was to systematically evaluate the measurement of maximum bite force and endurance, maximum tongue pressure and endurance, as well as maximum mouth opening in adult individuals with SMA types 2 and 3. METHODS Data from oral function tests in 43 individuals were analyzed. Differences in oral function between individuals with different SMA types and numbers of SMN2 copies were tested. Spearman´s rho correlations among oral function measures themselves as well as with established clinical outcome scales were analyzed. RESULTS The absolute maximum measures of oral function (maximum bite force, maximum tongue pressure, maximum mouth opening) were able to discriminate between individuals with different SMA types, individuals with a different number of SMN2 copies and with different walking abilities. The pairwise correlations of the absolute maximum measures of oral function were fair to moderate in size; the same was true for their correlations with the established motor scores. All correlations assessing endurance measures of oral function were weaker and statistically insignificant. CONCLUSIONS Among the oral function tests maximum tongue pressure and maximum mouth opening are particulary promising as clinical and sensitive outcome measures for clinical trials. Oral function tests may supplement existing motor scores, in particular concerning specific questions about bulbar function or in severely affected non-ambulatory individuals where mild (treatment-related) changes would otherwise remain undetected. Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/search/de/trial/DRKS00015842.
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Affiliation(s)
- T Kruse
- Department of Orthodontics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany.
- Center for Rare Diseases Cologne, University of Cologne, Cologne, Germany.
| | - S Shamai
- Department of Orthodontics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
| | - D Leflerovà
- Department of Orthodontics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
- Department of Prosthetic Dentistry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
| | - B Wirth
- Center for Rare Diseases Cologne, University of Cologne, Cologne, Germany
- Institute of Human Genetics, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - R Heller
- Center for Rare Diseases Cologne, University of Cologne, Cologne, Germany
- Institute of Human Genetics, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Genetic Health Service NZ-Northern Hub, Auckland District Health Board, Auckland City Hospital, 90-102 Grafton Rd, Grafton, NZ-Auckland, 1010, New Zealand
| | - N Schloss
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - H C Lehmann
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - S Brakemeier
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Essen, Germany
| | - T Hagenacker
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Essen, Germany
| | - B Braumann
- Department of Orthodontics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
- Center for Rare Diseases Cologne, University of Cologne, Cologne, Germany
| | - G Wunderlich
- Center for Rare Diseases Cologne, University of Cologne, Cologne, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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Differences between Maximum Tongue Force in Women Suffering from Chronic and Asymptomatic Temporomandibular Disorders-An Observational Study. Life (Basel) 2023; 13:life13010229. [PMID: 36676178 PMCID: PMC9866298 DOI: 10.3390/life13010229] [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] [Received: 12/05/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Temporomandibular disorders are craniofacial disorders characterized by the presence of chronic pain in masticatory muscles, with higher incidence in the women population. There is little research that has studied tongue force related to temporomandibular disorders, but there are a lot of studies that have demonstrated the impact of tongue force in vital functions, such as chewing, swallowing, phonation, or breathing. According to this, the aim of this study was to compare the maximum force of the tongue between females with chronic temporomandibular disorders and asymptomatic females. We also wanted to establish whether any relationship existed between the pain and fatigue versus the maximum force developed in females with chronic temporomandibular disorders. Material and methods: A cross-sectional study of 67 women between the ages of 18 and 65 years old was performed. The included women were assigned to one of two groups, according to whether they had chronic temporomandibular disorders or not. The procedure was the same for both groups. Outcome measures included the maximum tongue force, intensity of perceived orofacial pain, and intensity of perceived orofacial fatigue. Results: The results showed significant statistical differences for the maximum tongue force measurement between the chronic temporomandibular disorders group and the control group (p < 0.05) for all the movements, except the lip pressure measurement. Furthermore, the analysis revealed significant statistical differences between the intensity of perceived orofacial fatigue between the groups (p < 0.05). Moreover, the data showed no significant correlations between variables. Conclusion: The study found significant differences in maximum tongue force when comparing women with chronic temporomandibular disorders and asymptomatic women (being superior in these). Likewise, we found that the intensity of perceived orofacial fatigue after tongue exercises showed significant differences between groups. However, this study reveals no correlations between the intensity of perceived orofacial pain and fatigue and the maximum tongue force.
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Effect of Tongue-Pressure Resistance Training in Poststroke Dysphagia Patients With Oral Motor Dysfunction: A Randomized Controlled Trial. Am J Phys Med Rehabil 2022; 101:1134-1138. [PMID: 35320813 DOI: 10.1097/phm.0000000000001998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aims of the study were to investigate the effect of tongue-pressure resistance training in poststroke dysphagia patients with oral motor dysfunction and to examine the therapeutic value of tongue-pressure resistance training in the oral and pharyngeal phases. DESIGN Patients were divided into an experimental and a control group. Both groups received 30 mins of traditional swallowing rehabilitation treatment every day for 4 wks. In addition, the experimental group received tongue-pressure resistance training for an extra 20 mins/d. Maximum tongue pressure and fiberoptic endoscopic examination of swallowing were assessed before and after treatments. RESULTS Compared with the control group, the experimental group showed significant improvement in Functional Communication Measure for swallowing, Oral Motor Function Scale, maximum tongue pressure, Murray Secretion Scale, Rosenbek Penetration-Aspiration Scale, and food residue in pyriform sinuses ( P < 0.05). There was no significant difference in food residue in epiglottic vallecula between both groups ( P > 0.05). CONCLUSIONS This study demonstrated that tongue-pressure resistance training is an effective approach to improve the overall swallowing function in patients with oral motor dysfunction. The improvement of oral motor function could facilitate the recovery of pharyngeal motor function. Tongue-pressure resistance training seems to have more clearance of residue in piriform sinus than epiglottic vallecula.
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Deng W, Zhao G, Li Z, Yang L, Xiao Y, Zhang S, Guo K, Xie C, Liang Y, Liao G. Recovery pattern analysis of swallowing function in patients undergoing total glossectomy and hemiglossectomy. Oral Oncol 2022; 132:105981. [PMID: 35752136 DOI: 10.1016/j.oraloncology.2022.105981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/27/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the recovery process of swallowing function and ascertain swallowing pattern in patients undergoing total glossectomy (TG). MATERIALS AND METHODS A cohort study was conducted in consecutive patients with tongue squamous cell carcinoma who received TG/hemiglossectomy (HG) from May 2017 to December 2019. Exposure factors included tongue resection range (HG and TG) and postoperative radiotherapy (PRT and non-PRT). The swallowing functions were evaluated by M.D. Anderson dysphagia inventory (MDADI), water swallow test (WST), and tongue pressure (TP) at pretreatment, 1, 4, 7, 12, 18 and 24 months postoperatively. Videofluoroscopy swallowing study (VFSS) was applied to analyze swallowing pattern of TG patients. RESULTS A total of 67 patients were enrolled, of which 17 underwent TG and 50 underwent HG. Both MDADI and TP of the TG and PRT group were lower than those of the HG and non-PRT group. TG patients had no evident improvement in MDADI and TP after surgery. There was a higher risk of swallowing unsafety with abnormal WST outcome in TG (P < 0.001, OR = 106.52) than that in HG. VFSS analysis identified prolonged oral and pharyngeal transit time, disorganized swallowing sequence, abnormal hyoid bone movement, and frequent invalid swallows in patients with TG. A shortened OTT (<5066.50 ms) and a larger pharyngeal constriction ratio (PCR > 0.31) were associated with increased risks of penetration and aspiration. CONCLUSION Postoperative swallowing pattern is a characteristic of severely impaired safety and efficacy in patients with TG. Impaired OTT and PCR are variables that should be examined when determining the need for rehabilitation treatment.
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Affiliation(s)
- Wei Deng
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
| | - Guiyi Zhao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
| | - Zhengshi Li
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
| | - Le Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
| | - Yudong Xiao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
| | - Sien Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
| | - Kaixin Guo
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
| | - Chunqing Xie
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
| | - Yujie Liang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
| | - Guiqing Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou 510055, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou 510080, Guangdong, China.
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Alvarado C, Arminjon A, Damieux-Verdeaux C, Lhotte C, Condemine C, Cousin AS, Sigaux N, Bouletreau P, Mateo S. Impaired tongue motor control after temporomandibular disorder: A proof-of-concept case-control study of tongue print. Clin Exp Dent Res 2022; 8:529-536. [PMID: 35220688 PMCID: PMC9033548 DOI: 10.1002/cre2.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/11/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) perturbs the tongue motor control and consequently impairs oral function, but strength training reduces this impairment. However, tongue motor control is widely reduced to a matter of strength. OBJECTIVES To investigate the accuracy of the tongue placement as a measure of tongue motor control in patients with TMD compared with age- and sex-matched healthy participants. MATERIAL AND METHODS This proof-of-concept case-control study was prospective, observational, and part of the TMIQ study (NCT04102306). After pointing against a wood stick while maintaining the tongue as sharp as possible, the examinator drew the contour of the tongue print on the wood stick, which was then scanned for image analyses to compute the area for each participant using ImageJ. RESULTS A total of 94 participants were included, all patients with TMD (n = 47) diagnosed with myalgia, 61% with intra-articular joint disorder accordingly to the DC/TMD. The median (IQR) tongue print area was 117 (111) mm2 for the TMD group and 93.5 (76.2) mm2 for the control group (V = 352, p = .04) and the median [95% confidence interval] difference was 25.4 [1.3; 51.0] mm². Overlapping of the 95% confidence intervals of the area evidenced no significant difference between the categories of the DC/TMD. The corrected each area-total correlation (r = .24) suggests a reasonably homogenous thus valid measure. CONCLUSION The results suggest that TMD impairs the motor control of the tongue. Therefore, the sharpest tongue pointing test may constitute a simple and accessible clinical tool to assess the accuracy of tongue placement in TMD patients. The study was registered on ClinicalTrial.gov with identification number NCT04102306.
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Affiliation(s)
| | | | | | - Claire Lhotte
- Cabinet de kinésithérapie Saint-Alexandre, Lyon, France
| | - Chloé Condemine
- Cabinet de kinésithérapie Saint-Alexandre, Lyon, France.,Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Anne-Sabine Cousin
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Nicolas Sigaux
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Pierre Bouletreau
- Hospices Civils de Lyon, Groupement Hospitalier sud, Chirurgie maxillo-faciale, Pierre-Bénite, Cedex, France
| | - Sébastien Mateo
- Lyon Neuroscience Research Center, Trajectoires Team, CNRS UMR5292, INSERM U1028, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Hôpital Henry Gabrielle, Plate-forme Mouvement et Handicap, Lyon, France
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11
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Augusto MM, da Silva RG, Teixeira Dourado Júnior ME, Godoy JF, Lopes LW, Pernambuco L. Tongue measurements and pharyngeal residue in amyotrophic lateral sclerosis. Neurodegener Dis Manag 2021; 11:459-468. [PMID: 34747630 DOI: 10.2217/nmt-2021-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We aimed to analyze the relationship between tongue measurements and vallecular residue in patients with amyotrophic lateral sclerosis (ALS). Materials & methods: Twenty-one patients with ALS were assessed for posterior maximum tongue isometric pressure (PMTIP) and posterior tongue isometric endurance (PTIE) by the Iowa Oral Performance Instrument; vallecular residue after 10 ml of moderately thickened consistency by Fiberoptic Endoscopic Evaluation of Swallowing; and tongue thickness (TT) by ultrasonography. Results: PMTIP, PTIE and TT were decreased compared with the reference values for healthy individuals and were not different between patients with and without vallecular residue. Conclusion: In ALS, PMTIP, PTIE and TT are not good predictors of vallecular residue in the tested volume and food consistency.
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Affiliation(s)
- Milena Magalhães Augusto
- Graduate Program in Speech, Language & Hearing Sciences (PPgFon-UFPB), Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil
| | - Roberta Gonçalves da Silva
- Graduate Program in Speech, Language & Hearing, Department of Speech, Language & Hearing Sciences, São Paulo State University, Marília Campus - UNESP/Marília - Marília, São Paulo, Brazil
| | - Mario Emílio Teixeira Dourado Júnior
- Onofre Lopes University Hospital (HUOL), Brazilian Hospital Services Company, Federal University of Rio Grande do Norte - UFRN - Natal, Rio Grande do Norte, Brazil
| | - Juliana Fernandes Godoy
- Department of Speech, Language & Hearing Sciences, Federal University of Rio Grande do Norte - UFRN - Natal, Rio Grande do Norte, Brazil
| | - Leonardo Wanderley Lopes
- Graduate Program in Speech, Language & Hearing Sciences (PPgFon-UFPB), Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil.,Department of Speech, Language & Hearing Sciences, Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil
| | - Leandro Pernambuco
- Graduate Program in Speech, Language & Hearing Sciences (PPgFon-UFPB), Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil.,Department of Speech, Language & Hearing Sciences, Federal University of Paraíba - UFPB - João Pessoa, Paraíba, Brazil
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12
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Nakamori M, Imamura E, Fukuta M, Tachiyama K, Kamimura T, Hayashi Y, Matsushima H, Ogawa K, Nishino M, Hirata A, Mizoue T, Wakabayashi S. Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly. PLoS One 2020; 15:e0230224. [PMID: 32764766 PMCID: PMC7413413 DOI: 10.1371/journal.pone.0230224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 07/11/2020] [Indexed: 11/18/2022] Open
Abstract
The term "oral frailty" reflects the fact that oral health is associated with physical frailty and mortality. The gold standard methods for evaluating the swallowing function have several problems, including the need for specialized equipment, the risk of radiation exposure and aspiration, and general physicians not possessing the requisite training to perform the examination. Hence, several simple and non-invasive techniques have been developed for evaluating swallowing function, such as those for measuring tongue pressure and tongue thickness. The aim of this study was to investigate the relationship between tongue thickness ultrasonography and tongue pressure in the Japanese elderly. We evaluated 254 elderly patients, who underwent tongue ultrasonography and tongue pressure measurement. To determine tongue thickness, we measured the vertical distance from the surface of the mylohyoid muscle to the tongue dorsum using ultrasonography. The results of the analyses revealed that tongue thickness was linearly associated with tongue pressure in both sexes. In male participants, dyslipidemia, lower leg circumference, and tongue pressure were independently and significantly associated with tongue thickness. In female participants, body mass index and tongue pressure were independently and significantly associated with tongue thickness. The optimal cutoff for tongue thickness to predict the tongue pressure of < 20 kPa was 41.3 mm in males, and 39.3 mm in females. In the Japanese elderly, tongue thickness using ultrasonography is associated with tongue pressure. Tongue thickness and tongue pressure, which are sensitive markers for oral frailty, decrease with age. We conclude that tongue ultrasonography provides a less invasive technique for determining tongue thickness and predicts oral frailty for elderly patients.
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Affiliation(s)
- Masahiro Nakamori
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- * E-mail:
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Masako Fukuta
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Keisuke Tachiyama
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Teppei Kamimura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hayato Matsushima
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Kanami Ogawa
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Masami Nishino
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Akiko Hirata
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tatsuya Mizoue
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
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13
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Szynkiewicz SH, Kamarunas E, Drulia T, Nobriga CV, Griffin L, O'Donoghue CR. A Randomized Controlled Trial Comparing Physical and Mental Lingual Exercise for Healthy Older Adults. Dysphagia 2020; 36:474-482. [PMID: 32770381 DOI: 10.1007/s00455-020-10164-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/25/2020] [Indexed: 11/25/2022]
Abstract
Mental practice using motor imagery (MP-MI) has been shown to improve motor outcomes of upper and lower extremities especially when combined with physical exercise. Here, we studied community-dwelling, healthy older adults to determine the effects of including an MP-MI component with lingual strengthening exercise. In this pilot study, twenty-nine typically aging participants were assigned to an intervention group: physical lingual exercise (n = 7), physical and MP-MI lingual exercise (n = 8), MPMI lingual exercise (n = 7), or a control group (placebo exercise) (n = 7). All participants completed the assigned exercise regimen with three sessions per day, three days a week, for 6 consecutive weeks. Maximum isometric pressure (MIP) and regular effort saliva swallowing (RESS) pressure were collected at baseline and weeks 2, 4, and 6. A post hoc Bonferroni corrected treatment effect from baseline to week 6 was shown for only participants in the MP-MI/Physical exercise group for MIP (p = 0.003 MPMI/ Physical group; p = 0.11 Control group; p = 0.32 Physical only group; p = 0.14 MP-MI only group) and RESS (p = 0.009 MP-MI/Physical group; p = 0.14 Control group; p = 0.10 Physical only group; p = 0.04 MP-MI only group). Findings also indicate spontaneous carryover of significantly increased swallowing pressure when mental and physical exercise are combined. In conclusion, the potential effect of including an MPMI lingual exercise component in preventative and rehabilitative frameworks with older persons to possibly enhance functional swallowing improvement is promising and should be investigated.
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Affiliation(s)
- Sarah H Szynkiewicz
- College of Science and Mathematics, Communication Sciences and Disorders, University of South Florida, Sarasota-Manate, 8350 N. Tamiami Trail, Sarasota, FL, 34243, USA. .,School of Health Professions, Communication Sciences and Disorders, Samford University, 800 Lakeshore Drive, Birmingham, AL, 35229, USA.
| | - Erin Kamarunas
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
| | - Teresa Drulia
- Harris College of Nursing and Health Sciences, Davies School of Communication Sciences and Disorders, Texas Christian University, TCU Box 297450, Fort Worth, TX, 76109, USA
| | - Christina V Nobriga
- School of Allied Health Professions, Communication Sciences and Disorders, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Lindsay Griffin
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA.,School of Communications, Communication Sciences and Disorders, Emerson College, 120 Boylston Street, Boston, MA, 02116, USA
| | - Cynthia R O'Donoghue
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
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14
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Yoshikawa M, Fukuoka T, Mori T, Hiraoka A, Higa C, Kuroki A, Takeda C, Maruyama M, Yoshida M, Tsuga K. Comparison of the Iowa Oral Performance Instrument and JMS tongue pressure measurement device. J Dent Sci 2020; 16:214-219. [PMID: 33384800 PMCID: PMC7770307 DOI: 10.1016/j.jds.2020.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 06/04/2020] [Indexed: 11/17/2022] Open
Abstract
Background/purpose Tongue pressure measurement conveys important information about eating and swallowing function. The Iowa Oral Performance Instrument® (IOPI) and KAY Swallowing Workstation® are internationally used for tongue pressure measurement, but for legal reasons cannot be used in Japan; rather the JMS tongue pressure measurement device® has been approved for use in Japan. However, it is not clear whether measurement obtained with these devices are directly comparable. Materials and methods This study investigated the correlation between the maximum tongue pressure data measured by the IOPI and the JMS tongue pressure measurement device in young healthy participants (34 males; 23.2 ± 2.0 years old, and 40 females; 21.4 ± 1.3 years old). Results Measurements obtained with these two devices showed significant correlations in the total cohort, and in male and female participants, separately (P < 0.05). Conclusion These findings demonstrate that the measurements obtained with the JMS device is comparable to those obtained with the IOPI. In Japan, JMS tongue pressure measurement device is used not only in dysphagia research field, but also geriatrics field, and extensive and detailed investigations has been carried out.
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Affiliation(s)
- Mineka Yoshikawa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
- Corresponding author. 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8553, Japan. Fax: +81 92 257 5679.
| | - Tatsuyuki Fukuoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Takahiro Mori
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Chiaki Higa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Azusa Kuroki
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Chiho Takeda
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Mariko Maruyama
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
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15
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Suso-Martí L, Paris-Alemany A, La Touche R, Cuenca-Martínez F. Effects of mental and physical orofacial training on pressure pain sensitivity and tongue strength: A single-blind randomized controlled trial. Physiol Behav 2020; 215:112774. [PMID: 31838148 DOI: 10.1016/j.physbeh.2019.112774] [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: 10/30/2019] [Revised: 12/07/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The main objective of this study was to analyze differences on pain pressure thresholds, tongue strength and perceived effort between various orofacial motor exercise training dosages of mental representation training through motor imagery (MI) and action observation (AO), first in isolation and then in combination with real exercise performance. METHODS A single-blind randomized controlled trial was designed. 48 asymptomatic individuals were randomized into two groups: Intensive training group (IG) and Moderate training group (MG). Both groups performed a first session of MI and AO of orofacial exercises training and a second session of actual orofacial exercises combined with mental representation training, but with different dosage in terms of series and repetitions. Pain pressure thresholds (PPTs) in the masseter and temporal muscles and tongue muscle strength were the main variables. RESULTS Regarding the PPT, ANOVA revealed significant between-group differences, where MG showed a significantly higher PPT than IG at post-day2, with a medium effect size. Both groups showed with-in group differences between pre and post intervention measures in the first session, but only the IG showed differences in the second. Regarding tongue muscle strength, ANOVA revealed significant within-group differences only in MG between the pre-day and post-day first intervention. CONCLUSION The results of the present study suggest that movement representation training performed in isolation may have a positive effect on PPTs and tongue muscle strength. In addition, the combination with the actual execution of the exercises could be considered effective, but it is necessary to take into account the training dosage to avoid fatigue responses.
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Affiliation(s)
- Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Departament of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Alba Paris-Alemany
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, España; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - Roy La Touche
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, España; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España.
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
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16
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La Touche R, Herranz-Gómez A, Destenay L, Gey-Seedorf I, Cuenca-Martínez F, Paris-Alemany A, Suso-Martí L. Effect of brain training through visual mirror feedback, action observation and motor imagery on orofacial sensorimotor variables: A single-blind randomized controlled trial. J Oral Rehabil 2020; 47:620-635. [PMID: 32012319 DOI: 10.1111/joor.12942] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 12/31/2019] [Accepted: 01/26/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The main objective was to evaluate the effects of action observation (AO), visual mirror feedback (VMF) and motor imagery (MI), combined with an oro-facial exercise programme, on sensorimotor variables in asymptomatic participants. METHODS We designed a randomised, single-blind, controlled trial that included 52 asymptomatic participants who were randomly assigned to 4 groups, 13 to each of the VMF, MI and AO groups and 13 to the control group (CG), which only performed the exercise programme. The primary outcomes were pain pressure sensitivity and tongue muscle strength. The secondary outcomes were maximum mouth opening, tongue length and the ability to generate mental motor images. Each group underwent a 3-session intervention using their respective exercise. Measurements were performed before starting the intervention and after each of the 3 sessions (pre, mid1, mid2 and post). RESULTS ANOVA revealed significant changes in PPTs in the masseter muscle region in the MI and AO groups in the pre-post and mid1-post changes. ANOVA revealed significant differences in tongue muscle strength in the anterior direction only in the AO group in the pre-mid2 and pre-post changes. CONCLUSIONS AO and MI, in conjunction with exercise, could induce changes in PPTs for the masseter muscle. In addition, only AO produced changes in tongue muscle strength. More research is needed to determine the role of brain representation techniques in the oro-facial region and transferring this exercise to the rehabilitation setting.
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Affiliation(s)
- Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain
| | - Aida Herranz-Gómez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura Destenay
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ingrid Gey-Seedorf
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Alba Paris-Alemany
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Departamento de Fisioterapia, Universidad Cardenal Herrera-CEU, CEU Universidades, Valencia, Spain
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17
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McKay R, Smart S, Cocks N. Investigating Tongue Strength and Endurance in Children Aged 6 to 11 Years. Dysphagia 2019; 35:762-772. [PMID: 31792616 DOI: 10.1007/s00455-019-10081-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/16/2019] [Indexed: 10/25/2022]
Abstract
Objective measures of tongue strength and endurance are used to assess lingual weakness and fatigue, and may have significant clinical value for dysphagia management. Recent studies investigating age and gender effects on tongue strength in children are limited by small sample sizes. The current study investigated age and gender effects on tongue strength with a larger sample size, and collected preliminary normative data for a paediatric population. This study also investigated the reliability of tongue endurance measures in children using a modified method, which has not previously been investigated. Using a cross-sectional design, this study examined tongue strength and endurance in 119 children aged 6 to 11 years, with no history of speech sound disorders, oro-motor deficits, dysphagia or cognitive impairment. Measures were collected using the Iowa Oral Performance Instrument. Children participated in two sessions, 45 min and 10 min in duration. Tongue strength was found to significantly increase with age (p < 0.001), while no gender effects were found. Modified tongue endurance measures involved using only one measure of maximal tongue strength to set parameters for tongue endurance scores. Despite this modification, data did not reach acceptable test-retest reliability, ICC = 0.68, p < 0.001; however, reliability improved from previous studies. These findings provide normative data for tongue strength, as a basis to compare individuals, and highlights the need for more reliable protocols for measuring tongue endurance. Normative data was collected from city-dwelling Australian children.
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Affiliation(s)
- R McKay
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - S Smart
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - N Cocks
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
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18
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La Touche R, Losana-Ferrer A, Pascual-Vaquerizo E, Suso-Martí L, Paris-Alemany A, Chamorro-Sánchez J, Cuenca-Martínez F. Orofacial sensorimotor behaviour in unilateral chewing: A comparative analysis in asymptomatic population. Physiol Behav 2019; 212:112718. [PMID: 31634522 DOI: 10.1016/j.physbeh.2019.112718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/06/2019] [Accepted: 10/17/2019] [Indexed: 01/25/2023]
Abstract
The main aim of the present study was to evaluate the presence of differences in motor, somatosensory and laterality recognise variables between individuals with unilateral chewing (UC) versus bilateral chewing (BC). A cross-sectional study with a nonprobabilistic sample was conducted. Seventy asymptomatic individuals were grouped as UC or BC to assess differences in motor, somatosensory, and laterality recognise variables. The recorded variables were range of motion (ROM), electromyographic (EMG) activity, lip grip force, 2-point discrimination (2-PD), pain pressure threshold (PPT), and laterality recognition. Significant differences in EMG activity of the masseter and temporal muscles were found in group*side (p<.005). Significant changes in group*side (p<.005) were found in lip strength and 2-PD in the maxillary and mandibular branch. For laterality, significant between-group differences in accuracy were found (p=.037). Individuals with UC showed unilateral sensorimotor modifications compared with those with BC. Although the relationship between type of mastication and temporomandibular disorder (TMD) cannot be established, neurophysiological changes in UC could affect biomechanics and temporomandibular joint function and could predispose individuals to the onset, development, and maintenance of TMD because patients with TMD usually present an impairment in orofacial motor and sensory functions, with recruitment abnormalities of the masseter and temporal muscles during chewing.
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Affiliation(s)
- Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
| | - Alejandro Losana-Ferrer
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
| | - Eva Pascual-Vaquerizo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Alba Paris-Alemany
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | | | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
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LoRusso S, Johnson NE, McDermott MP, Eichinger K, Butterfield RJ, Carraro E, Higgs K, Lewis L, Mul K, Sacconi S, Sansone VA, Shieh P, van Engelen B, Wagner K, Wang L, Statland JM, Tawil R. Clinical trial readiness to solve barriers to drug development in FSHD (ReSolve): protocol of a large, international, multi-center prospective study. BMC Neurol 2019; 19:224. [PMID: 31506080 PMCID: PMC6734593 DOI: 10.1186/s12883-019-1452-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/27/2019] [Indexed: 12/14/2022] Open
Abstract
Background Facioscapulohumeral muscular dystrophy (FSHD) is a dominantly-inherited progressive muscular dystrophy caused by de-repression of the DUX4 gene, which causes disease by a toxic-gain-of-function. As molecularly targeted drugs move from preclinical testing into human trials, it is essential that we validate clinical trial tools and methodology to facilitate the drug development process. Methods/design The primary goal of this study is to hasten drug development for FSHD by validating two novel clinical outcome assessments (COAs) and refining clinical trial strategies. We will perform an 18-month longitudinal study in 220 genetically confirmed and clinically affected participants using our FSHD Clinical Trial Research Network, comprised of 8 sites in the United States, and 3 collaborating sites in Europe. Visits occur at baseline and months 3, 12, and 18. At each visit we will collect: 1) a novel FSHD functional composite COA made up of 18 evaluator-administered motor tasks in the domains of shoulder/arm, hand, core/abdominal, leg, and balance function; and 2) electrical impedance myography as a novel muscle quality biomarker (US sites). Other COAs include 1) Domain 1 of the Motor Function Measure; 2) Reachable workspace; 3) orofacial strength using the Iowa Oral Performance Instrument; 4) lean muscle mass using dual-energy X-ray absorptiometry (DEXA); 5) strength as measured by quantitative myometry and manual muscle testing; and 6) the FSHD Health Index and other patient-reported outcomes. Plasma, DNA, RNA, and serum will be collected for future biomarker studies. We will use an industry standard multi-site training plan. We will evaluate the test-retest reliability, validity, and sensitivity to disease progression, and minimal clinically important changes of our new COAs. We will assess associations between demographic and genetic factors and the rate of disease progression to inform refinement of eligibility criteria for future clinical trials. Discussion To the best of our knowledge, this is the largest collaborative study of patients with FSHD performed in the US and Europe. The results of this study will enable more efficient clinical trial design. During the conduct of the study, relevant data will be made available for investigators or companies pursuing novel FSHD therapeutics. Trial registration clinicaltrials.gov NCT03458832; Date of registration: 1/11/2018 Electronic supplementary material The online version of this article (10.1186/s12883-019-1452-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Samantha LoRusso
- Department of Neurology, Ohio State University Wexner Medical Center, 395 W. 12th Ave., 7th Floor, Columbus, OH, 43210, USA
| | - Nicholas E Johnson
- Department of Neurology, Virginia Commonwealth University, 1101 East Marshall St, PO Box 980599, Richmond, VA, 23298, USA
| | - Michael P McDermott
- Department of Biostatistics and Computational Biology and Department of Neurology, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420630, Rochester, NY, 14642, USA
| | - Katy Eichinger
- Department of Neurology, University of Rochester Medical Center, Box 673, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Russell J Butterfield
- Department of Pediatrics and Neurology, University of Utah, Eccles Institute of Human Genetics, Room 2260A, 15 N 2030 E, Salt Lake City, UT, 84112, USA
| | - Elena Carraro
- The NEMO Clinical Center, Neurorehabilitation Unit, University of Milan, Piazza dell'Ospedale Maggiore, 3, Milan, 20162, Italy
| | - Kiley Higgs
- Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 2012, Kansas City, KS, 66160, USA
| | - Leann Lewis
- Department of Neurology, University of Rochester Medical Center, Box 673, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Karlien Mul
- Department of Neurology, Radboud University Medical Center, Reinier Postlaan 4 (935), 6525, GC, Nijmegen, The Netherlands
| | - Sabrina Sacconi
- Université Côte d'Azur, Peripheral Nervous System, Centre Hospitalier Universitaire de Nice, Muscle & ALS Department, Pasteur 2 Hospital, 30 Voie Romaine, 06001, Nice Cedex 1, France
| | - Valeria A Sansone
- The NEMO Clinical Center, Neurorehabilitation Unit, University of Milan, Piazza dell'Ospedale Maggiore, 3, Milan, 20162, Italy
| | - Perry Shieh
- Department of Neurology, University of California, Los Angeles, 300 Medical Plaza, Suite B-200, Los Angeles, CA, 90095, USA
| | - Baziel van Engelen
- Department of Neurology, Radboud University Medical Center, Reinier Postlaan 4 (935), 6525, GC, Nijmegen, The Netherlands
| | - Kathryn Wagner
- Center for Genetic Muscle Disorders, Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD, USA
| | - Leo Wang
- Department of Neurology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Jeffrey M Statland
- Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 2012, Kansas City, KS, 66160, USA.
| | - Rabi Tawil
- Department of Neurology, University of Rochester Medical Center, Box 673, 601 Elmwood Ave, Rochester, NY, 14642, USA
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Yunusova Y, Plowman EK, Green JR, Barnett C, Bede P. Clinical Measures of Bulbar Dysfunction in ALS. Front Neurol 2019; 10:106. [PMID: 30837936 PMCID: PMC6389633 DOI: 10.3389/fneur.2019.00106] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/28/2019] [Indexed: 12/31/2022] Open
Abstract
Bulbar impairment represents a hallmark feature of Amyotrophic Lateral Sclerosis (ALS) that significantly impacts survival and quality of life. Speech and swallowing dysfunction are key contributors to the clinical heterogeneity of ALS and require well-timed and carefully coordinated interventions. The accurate clinical, radiological and electrophysiological assessment of bulbar dysfunction in ALS is one of the most multidisciplinary aspects of ALS care, requiring expert input from speech-language pathologists (SLPs), neurologists, otolaryngologists, augmentative alternative communication (AAC) specialists, dieticians, and electrophysiologists—each with their own evaluation strategies and assessment tools. The need to systematically evaluate the comparative advantages and drawbacks of various bulbar assessment instruments and to develop integrated assessment protocols is increasingly recognized. In this review, we provide a comprehensive appraisal of the most commonly utilized clinical tools for assessing and monitoring bulbar dysfunction in ALS based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) evaluation framework. Despite a plethora of assessment tools, considerable geographical differences exist in bulbar assessment practices and individual instruments exhibit considerable limitations. The gaps identified in the literature offer unique opportunities for the optimization of existing and development of new tools both for clinical and research applications. The multicenter validation and standardization of these instruments will be essential for guideline development and best practice recommendations.
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Affiliation(s)
- Yana Yunusova
- Department of Speech Language Pathology, University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Volcal Tract Visualization Lab, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Emily K Plowman
- Swallowing Systems Core, Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, United States
| | - Jordan R Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA, United States.,Speech and Hearing Biosciences and Technology Program, Harvard University, Cambridge, MA, United States
| | - Carolina Barnett
- Division of Neurology, Department of Medicine, University of Toronto and University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Peter Bede
- Computational Neuroimaging Group, Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
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21
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Oh JC. Effect of partial head extension swallowing exercise on the strength of the suprahyoid and tongue muscles in healthy subjects: A feasibility study. J Oral Rehabil 2018; 46:242-248. [DOI: 10.1111/joor.12740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/04/2018] [Accepted: 10/24/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Jong-Chi Oh
- Department of Occupational Therapy; Cheongju University; Cheongju Chungcheongbuk-do Korea
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22
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Park HS, Park JY, Kwon YH, Choi HS, Kim HJ. Effect of orbicularis oris muscle training on muscle strength and lip closure function in patients with stroke and swallowing disorder. J Phys Ther Sci 2018; 30:1355-1356. [PMID: 30464363 PMCID: PMC6220101 DOI: 10.1589/jpts.30.1355] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/08/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We aimed to investigate the effect of resistance training of the orbicularis
oris muscles on lip muscle strength and closure function in patients with swallowing
disorder with facial palsy after stroke. [Participants and Methods] This study recruited 10 patients with swallowing
disorder and facial palsy after stroke. All the participants received orbicularis oris
muscle training at an intensity of 70% of 1 repetition maximum by using an Iowa oral
performance instrument. Muscle strength and lip closure function were evaluated after
orbicularis oris muscle training. [Results] After the intervention, the orbicularis oris
muscle strength showed a statistically significant increase from 20.5 ± 5.15 to 25.3 ± 4.2
kilopascal. Lip closure function showed a statistically significant improvement from 2.6 ±
1.5 to 1.2 ± 1.0. [Conclusion] This study recommends to train at an intensity of 70% of 1
repetition maximum for 4 weeks to increase theorbicularis oris muscle strength and improve
lip closure function.
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Affiliation(s)
- Hee-Su Park
- Department of Occupational Therapy, Kyungdong University: 815 Gyeonhwon-ro, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea
| | - Jae-Young Park
- Department of Physical Therapy, Kyungwoon University, Republic of Korea
| | - Young-Hwa Kwon
- Department of Occupational Therapy, Kyungdong University: 815 Gyeonhwon-ro, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea
| | - Hee Su Choi
- Department of Occupational Therapy, Kyungdong University: 815 Gyeonhwon-ro, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea
| | - Hee Jeong Kim
- Department of Occupational Therapy, Kyungdong University: 815 Gyeonhwon-ro, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea
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Effects of Tongue-Hold Swallows on Suprahyoid Muscle Activation According to the Relative Tongue Protrusion Length in the Elderly Individuals. Dysphagia 2018; 34:382-390. [DOI: 10.1007/s00455-018-9948-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/18/2018] [Indexed: 01/18/2023]
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24
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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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25
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Oh JC. Effect of the head extension swallowing exercise on suprahyoid muscle activity in elderly individuals. Exp Gerontol 2018; 110:133-138. [PMID: 29894751 DOI: 10.1016/j.exger.2018.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 05/28/2018] [Accepted: 06/04/2018] [Indexed: 11/19/2022]
Abstract
Aging causes motor function deterioration in the elderly population, which in turn can cause weakness in the muscles associated with swallowing. Swallowing-related problems in elderly individuals can be prevented or their symptoms can be improved with strengthening exercises for the muscles involved in swallowing. The existing strengthening exercises for the suprahyoid muscle have their limitations. Therefore, it is necessary to find another exercise that can be performed by individuals whose personal characteristics make it difficult for them to perform the existing exercises. In this study, we investigated the changes in suprahyoid muscle activation, tongue strength, and thickness of the suprahyoid muscle after 8 weeks of the head extension swallowing exercise (HESE). A total of 23 healthy elderly individuals participated in an 8-week exercise program (20 min/session, 2 times/week for 8 weeks). Suprahyoid muscle activation during effortful swallowing and the effortful-normal ratio were significantly increased at 8 weeks compared to the baseline values (p = 0.002, and 0.033, respectively). Tongue tip pressure, tongue base pressure, normal swallowing pressure, effortful swallowing pressure, and tongue tip endurance were significantly increased at 8 weeks compared with baseline (p = 0.014, 0.004, 0.046, 0.009, and 0.004, respectively). The thickness of the digastric muscle and that of the mylohyoid muscle were significantly increased at 8 weeks compared with baseline (p = 0.000 and 0.004, respectively). This study showed that HESE can be a good option for improving the suprahyoid muscle and tongue strength in the elderly population. Additionally, this exercise does not require any additional equipment and has the advantage of being able to be performed anytime and anywhere. A variety of exercise options tailored according to individual characteristics may be helpful in choosing the most appropriate exercise.
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Affiliation(s)
- Jong-Chi Oh
- Department of Occupational Therapy, Cheongju University, Cheongju, Chungcheongbuk-do, Republic of Korea.
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26
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Reis VSD, Araújo TGD, Furlan RMMM, Motta AR. Correlation between tongue pressure and electrical activity of the suprahyoid muscles. REVISTA CEFAC 2017. [DOI: 10.1590/1982-021620171968617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to investigate the correlation between the tongue pressure and the electrical activity of the suprahyoid muscles. Methods: a across-sectional, observational and analytical study conducted with 15 men and 22 women. Each participant underwent simultaneous assessment of maximal tongue pressure through the Iowa Oral Performance Instrument (IOPI) and the surface electromyography of the suprahyoid muscles. They were asked to press the tongue against the hard palate in the anterior and posterior region, with and without IOPI. The adopted significance level of the performed analyses was 5%. Results: there was a moderate and significant correlation only between suprahyoid electrical activity and tongue pressure in the posterior region. It was verified that the measured electrical potentials, when using the IOPI, were greater in the tasks of anterior pressure than in the tasks of the posterior one, bilaterally. Without using the IOPI, the electrical potentials were greater in the posterior pressure than in the anterior one, bilaterally. Finally, the values of lingual pressure were compared with the bulb positioned in the anterior and posterior parts, and the anterior tongue pressure was higher. Conclusion: there was a moderate correlation between tongue pressure and electrical potential of the suprahyoid muscles, researched by the surface electromyography, only when performing activities with the posterior portion of the tongue.
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27
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Partal I, Aksu M. Changes in lips, cheeks and tongue pressures after upper incisor protrusion in Class II division 2 malocclusion: a prospective study. Prog Orthod 2017; 18:29. [PMID: 28944417 PMCID: PMC5610954 DOI: 10.1186/s40510-017-0182-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/27/2017] [Indexed: 11/10/2022] Open
Abstract
Background The etiology of Class II division 2 (CII/2) malocclusion focuses on heredity; however lip, cheek, and tongue pressures that are associated with the environmental effect are considered to have an effect. The aim of this study was to evaluate the relation between perioral pressures and the upper incisor inclination in CII/2 malocclusion. Methods Twenty patients (8 females, 12 males; mean age 10.29 ± 0.90 years) with CII/2 malocclusion were included in the study group, and 15 patients (5 females, 10 males; mean age 10.56 ± 1.06 years) with Class I malocclusion were included. The upper incisors were protruded with a utility arch (0.016 × 0.022 in. blue elgiloy wire). Perioral pressure assessment was made with the Iowa Oral Pressure Instrument. Upper lip pressure, lower lip pressure, vertical lip pressure, left-right buccal pressures, swallowing, and maximum tongue pressures were measured. Repeated measure ANOVA was used to test the intragroup differences. Intergroup comparisons were made using two-way repeated measure ANOVA with Bonferroni correction. Relationships between the variables were analyzed using rank correlation (Spearman’s rho). The significance for all statistical tests was predetermined at p < 0.05. Results A significant change occurred in the upper lip pressure, lower lip pressure, and vertical lip pressure; however, significant difference was not found between the groups. Upper lip pressure increased significantly in both groups. In the CII/2 group, lower lip pressure increased after protrusion and decreased after retention, while vertical lip pressure decreased and then increased significantly. Left buccal pressure changes between the groups were not parallel. Right buccal pressure, swallowing, and maximum tongue pressure changes were not statistically significant. Statistically significant correlation was found between U1-NA (mm) and vertical lip pressure (r −0.467). Conclusions In the CII/2 group, upper lip pressure increased only in retention. Lower lip pressure increased and vertical lip pressure decreased after protrusion. Nevertheless, these changes did not remain stable after the retention period. The difference between groups was not statistically significant at the end of retention.
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Affiliation(s)
- Irmak Partal
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Muge Aksu
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
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Mcilduff CE, Yim SJ, Pacheck AK, Rutkove SB. Optimizing electrical impedance myography of the tongue in amyotrophic lateral sclerosis. Muscle Nerve 2016; 55:539-543. [DOI: 10.1002/mus.25375] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 07/17/2016] [Accepted: 08/08/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Courtney E. Mcilduff
- Department of Neurology; Beth Israel Deaconess Medical Center; 330 Brookline Avenue, CC-810 Boston Massachusetts 02215 USA
| | - Sung J. Yim
- Department of Neurology; Beth Israel Deaconess Medical Center; 330 Brookline Avenue, CC-810 Boston Massachusetts 02215 USA
| | - Adam K. Pacheck
- Department of Neurology; Beth Israel Deaconess Medical Center; 330 Brookline Avenue, CC-810 Boston Massachusetts 02215 USA
| | - Seward B. Rutkove
- Department of Neurology; Beth Israel Deaconess Medical Center; 330 Brookline Avenue, CC-810 Boston Massachusetts 02215 USA
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Rogus-Pulia N, Connor NP. Muscle Strengthening Approaches to Dysphagia Rehabilitation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016. [DOI: 10.1007/s40141-016-0136-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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30
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Park JS, Kim HJ, Oh DH. Effect of tongue strength training using the Iowa Oral Performance Instrument in stroke patients with dysphagia. J Phys Ther Sci 2015; 27:3631-4. [PMID: 26834320 PMCID: PMC4713759 DOI: 10.1589/jpts.27.3631] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 08/30/2015] [Indexed: 01/19/2023] Open
Abstract
[Purpose] The aim of this study was to evaluate the effectiveness of a structured program
of resistance training for the tongue in order to improve swallowing function in stroke
patients with dysphagia. [Subjects and Methods] Twenty-seven stroke patients with
dysphagia were randomly divided into two groups. The experimental group participated in a
resistance-training program involving a 1-repetition maximum, with an intensity of 80%,
along with 50 repetitions per day each for the anterior and posterior regions of the
tongue. Both groups received conventional therapy for dysphagia for 30 min per day, 5
times per week, for 6 weeks. [Results] The experimental group showed statistically
significant improvements in both, the anterior and posterior regions of the tongue. In
contrast, the control group showed significant improvements only in the anterior region of
the tongue. In the videofluoroscopic dysphagia scale evaluation, improvement was noted at
both, the oral and pharyngeal stages in the experimental group, whereas significant
improvements were only noted in the oral stage and total score in the control group.
[Conclusion] Our study confirmed that tongue resistance training is an effective
intervention for stroke patients with dysphagia, offering improved tongue muscle strength
and overall improvement in swallowing.
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Affiliation(s)
- Ji-Su Park
- Department of Occupational Therapy, Graduate School, Inje University, Republic of Korea
| | - Hee-Jeong Kim
- Department of Occupational Therapy, Kyungdong University, Republic of Korea
| | - Dong-Hwan Oh
- Department of Occupational Therapy, Kyung hee Medical Center, Republic of Korea
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Kim YK, Choi JH, Yoon JG, Lee JW, Cho SS. Improved Dysphagia After Decannulation of Tracheostomy in Patients With Brain Injuries. Ann Rehabil Med 2015; 39:778-85. [PMID: 26605176 PMCID: PMC4654085 DOI: 10.5535/arm.2015.39.5.778] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 05/15/2015] [Indexed: 01/25/2023] Open
Abstract
Objective To investigate improved dysphagia after the decannulation of a tracheostomy in patients with brain injuries. Methods The subjects of this study are patients with brain injuries who were admitted to the Department of Rehabilitation Medicine in Myongji Hospital and who underwent a decannulation between 2012 and 2014. A video fluoroscopic swallowing study (VFSS) was performed in order to investigate whether the patients' dysphagia had improved. We measured the following 5 parameters: laryngeal elevation, pharyngeal transit time, post-swallow pharyngeal remnant, upper esophageal width, and semisolid aspiration. We analyzed the patients' results from VFSS performed one month before and one month after decannulation. All VFSS images were recorded using a camcorder running at 30 frames per second. An AutoCAD 2D screen was used to measure laryngeal elevation, post-swallow pharyngeal remnant, and upper esophageal width. Results In this study, a number of dysphagia symptoms improved after decannulation. Laryngeal elevation, pharyngeal transit time, and semisolid aspiration showed no statistically significant differences (p>0.05), however after decannulation, the post-swallow pharyngeal remnant (pre 37.41%±24.80%, post 21.02%±11.75%; p<0.001) and upper esophageal width (pre 3.57±1.93 mm, post 4.53±2.05 mm; p<0.001) showed statistically significant differences. Conclusion When decannulation is performed on patients with brain injuries who do not require a ventilator and who are able to independently excrete sputum, improved esophageal dysphagia can be expected.
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Affiliation(s)
- Yong Kyun Kim
- Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea
| | - Jung-Hwa Choi
- Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea
| | - Jeong-Gyu Yoon
- Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea
| | - Jang-Won Lee
- Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea
| | - Sung Sik Cho
- Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea
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McIlduff C, Yim S, Pacheck A, Geisbush T, Mijailovic A, Rutkove SB. An improved electrical impedance myography (EIM) tongue array for use in clinical trials. Clin Neurophysiol 2015; 127:932-935. [PMID: 26242815 DOI: 10.1016/j.clinph.2015.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/17/2015] [Accepted: 06/15/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Electrical impedance myography (EIM) measurements of the tongue could provide valuable information about bulbar dysfunction in amyotrophic lateral sclerosis (ALS). A prototype tongue depressor EIM array produced gag reflexes. The objectives of this study were to determine the reliability, mean phase values, and tolerability of tongue EIM measurements using a smaller electrode array. METHODS Tongue EIM measurements were performed in a total of 31 healthy individuals and four neuromuscular patients with lingual abnormalities. Reliability was assessed by calculating the intraclass correlation coefficient (ICC) and percent difference in addition to performing Bland-Altman analyses. Standard descriptive statistics, including results of a Mann-Whitney test, were also determined. RESULTS At the 50 kHz frequency, the ICCs for intra- and inter-rater reliability were 0.76 with 5.17% difference and 0.78 with 5.34% difference respectively. The mean EIM phase values of healthy participants (11.61° ± 1.00°) and patients (9.87° ± 1.28°) were significantly different (p=0.0051). None of the participants experienced gag reflexes or discomfort. CONCLUSIONS The small tongue array provided good inter- and intra-rater reliability, could preliminarily distinguish between healthy and diseased muscle, and was well-tolerated. SIGNIFICANCE Biomarker information about tongue health could be more comfortably obtained with a smaller EIM array.
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Affiliation(s)
- Courtney McIlduff
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Sung Yim
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Adam Pacheck
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Tom Geisbush
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Aleksandar Mijailovic
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Shumway KR, Porfirio DJ, Bailey EF. Phonation-related rate coding and recruitment in the genioglossus muscle. Exp Brain Res 2015; 233:2133-40. [PMID: 25899868 DOI: 10.1007/s00221-015-4284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 04/10/2015] [Indexed: 11/26/2022]
Abstract
Motor unit recruitment was assessed in two muscles with similar muscle fiber-type compositions and that participate in skilled movements: the tongue muscle, genioglossus (GG), and the hand muscle, first dorsal interosseous (FDI). Our primary objectives were to determine in the framework of a voluntary movement whether muscle force is regulated in tongue as it is in limb, i.e., via processes of rate coding and recruitment. Recruitment in the two muscles was assessed within each subject in the context of ramp force (FDI) and in the tongue (GG) during vowel production and specifically, in the context of ramp increases in loudness, and subsequently expressed relative to the maximal. The principle findings of the study are that the general rules of recruitment and rate coding hold true for both GG and FDI, and second, that average firing rates, firing rates at recruitment and peak firing rates in GG are significantly higher than for FDI (P < 0.001) despite tasks performed across comparable force ranges (~2-40 % of max). The higher firing rates observed in the tongue within the context of phonation may be a function of that muscle's dual role as (prime) mover and hydrostatic support element.
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Affiliation(s)
- K R Shumway
- Department of Physiology, College of Medicine, The University of Arizona, Tucson, AZ, 85721-0093, USA
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