Pressure profile similarities between tongue resistance training tasks and liquid swallows

Catriona M. Steele, Gemma L. Bailey, Sonja M. Molfenter, Erin M. Yeates, Karen Grace-Martin
2010 Journal of rehabilitation research and development  
Tongue-pressure resistance training is known to increase tongue strength in seniors and individuals with strokerelated dysphagia. However, evid ence of as sociated functiona l improvements in swallowing is equiv ocal. We investigated similarities in pressure waveform profiles between swallowing and several tongue-palate pressure task s to identify tasks that may be best suited for inclusion in tongue-pressure resistance training protocols for patients who are unable to safely perform real bolus
more » ... perform real bolus swallows in treatment. Tongue-palate pressures were recorded in 20 healthy young adults. Participants performed water and n ectarthick juice swallows, ef fortful and noneffortful saliva swallows, and "half-maximum" tongue-palate partial-pressure tasks emphasizing either anterior or posterior tongue-palate contact at different speeds. Pressure slopes (am plitude change over time) during the pressure application (rise) and w ithdrawal (rele ase) phas es were analyzed. A subset of four tasks with the greatest similarity in slope characteristics to those seen in bolus swal lows was identified: anterior-emphasis half-maximum tongue-palate presses, posterior-emphasis maximum isometric tongue-palate presses, posterior-emphasis half-maximum slow tongue-palate presses, and ef fortful saliva swallows. We propose that future research should explore the degree to which swallowing improvements are obtained from treatment protocols that emphasize these tasks. Abbreviations: AHMAX = ant erior-emphasis hal f-maximum tongue-palate press , AHMAXFAST = AHMAX performed a t fast rat e, AHMAXSLOW = AHMAX performed at slow rate, ANOVA = anal ysis of varian ce, df = degrees of freed om, DSANEC = discr ete nectar-thick apple juice sw allow, DSW = discrete water swallow, ESS = effortful saliva swallo w, IOPI = Iowa Oral Performance Inst rument, NESS = noneffortful saliva swallow, PHMAX = posterior-emphasis half-maximum tonguepalate press, PHMAXFAST = PH MAX performed at fast rate, PHMAXSLOW = PHMAX performed at slow rate, PMAXTP = posterior-emphasis maximum isometric tongue-palate press. * Address all corr espondence to Catriona M. S teele, PhD; Toronto Reha bilitation Institute, 550 University A venue, 12030, Toronto, ON, M5G 2A2, Canada; 416-597-3422, ext 7603.
doi:10.1682/jrrd.2009.05.0068 fatcat:xkayvodfyrhgbpepi7ljpu5ele