Tongue strength as a clinical feature of oral health in neurological patients: A Systematic Review.

Abstract

Objective: Current oral health assessment has a compre-hensive view of the relationship between hard and soft tissues of the mouth as seen by orthodontics and prosthodontics in a healthy population. Despite knowing the influence this relationship has on functional outcomes such as swallowing and mastication, motor evaluation of soft tissue such as the tongue is still scarce. This lack of knowledge is even greater in individuals with a neurological condition. In this sense, the measurement of lingual strength has been addressed by some research as a key element accompanying oral rehabilitation in healthy populations. Acknowledging the importance of tongue strength in oral biomechanics, the Iowa Oral Performance Instrument (IOPI) has become a gold standard instrument. The purpose of this article was to search for scientific studies on tongue strength using the IOPI as a research tool in populations with neurological conditions, to know about its inclusion in the clinical practice and comprehensive oral health rehabilitation in this population. Material and Methods: A systematic search in five major databases was carried out based on the PRISMA Protocol. Searches were conducted in the PubMed, Medline, Lilacs, Web of Science and MedCarib databases including articles from 2007 to 2020. To generate the search in each database, three main constructs were developed: (1) "tongue strength IOPI"; (2) "Swallowing Disorders"; (3) "Neurological Diseases". Results: 152 studies were identified, 14 were included in the final review. The PEDro scale showed great heterogeneity in the level of evidence between the studies with only 5 RCTs and only two of them on lingual strength training. Conclusion: The IOPI was used mainly to measure tongue strength and only 36% as a clinical training device, which could contribute to improving oral health. The stroke was the most represented (79%).IIIISU.

References

1. Kharade P, Dholam K, Bachher G. Appraisal of Function After Rehabilitation With Tongue Prosthesis. J Craniofac Surg. 2018;29(1):41-44.
2. Mendell DA, Logemann JA. Temporal sequences of swallow events during the oropharyngeal swallow. J Speech, Lang Hear Res. 2007;50(5):1256–71.
3. Robbins J, Hamilton JW, Lof GL, Kempster GB. Oro-pharyngeal swallowing in normal adults of different ages. Gastroenterology. 1992;103(3):823–9.
4. Morita K, Tsuka H, Kato K, Mori T, Nishimura R, Yoshida M, Tsuga K. Factors related to masticatory performance in healthy elderly individuals. J Prosthodont Res. 2018;62(4):432-5.
5. Luchesi KF, Kitamura S, Mourão LF. Dysphagia progression and swallowing management in Parkinson’s disease: An obser-vational study. Braz J Otorhinolaryngol. 2015;81(1):24–30.
6. Nakazawa Y, Kikutani T, Igarashi K, Yajima Y, Tamura F. Associations between tongue strength and skeletal muscle mass under dysphagia rehabilitation for geriatric out patients. J Prosthodont Res. 2020;64(2):188–92.
7. Adams V, Mathisen B, Baines S, Lazarus C, Callister R. A systematic review and meta-analysis of measurements of tongue and hand strength and endurance using the Iowa Oral Performance Instrument (IOPI). Dysphagia. 2013;28:350–69.
8. Murakami K, Hori K, Minagi Y, Uehara F, Salazar SE, Ishihara S, et al. Coordination of tongue pressure production, hyoid movement, and suprahyoid muscle activity during squeezing of gels. Arch Oral Biol. 2020;111:104631.
9. Obana M, Furuya J, Matsubara C, Tohara H, Inaji M, Miki K, Numasawa Y, Minakuchi S, Maehara T. Effect of a collaborative transdisciplinary team approach on oral health status in acute stroke patients. J Oral Rehabil. 2019;46(12):1170-6.
10. Yajima Y, Kikutani T, Tamura F, Yoshida M. Relationship between tongue strength and 1-year life expectancy in elderly people needing nursing care. Odontology. 2017;105(4):477–83.
11. Robbins JA, Levine R, Wood J, Roecker EB, Luschei E. Age effects on lingual pressure generation as a risk factor for dysphagia. Journals Gerontol - Ser A Biol Sci Med Sci. 1995;50A(5):257–62.
12. Ma D, Shuler JM, Kumar A, Stanford QR, Tungtur S, Nishimune H, Stanford JA. Effects of Tongue Force Training on Bulbar Motor Function in the Female SOD1-G93A Rat Model of Amyotrophic Lateral Sclerosis. Neurorehabil Neural Repair. 2017;31(2):147-56.
13. Świder K, Matys J. Complete dentures for a patient after a stroke by means of orofacial myofunctional therapy: A clinical report. J Prosthet Dent. 2018;120(2):177–80.
14. Hirota N, Konaka K, Ono T, Tamine K, Kondo J, Hori K, Yoshimuta Y, Maeda Y, Sakoda S, Naritomi H. Reduced tongue pressure against the hard palate on the paralyzed side during swallowing predicts Dysphagia in patients with acute stroke. Stroke. 2010;41(12):2982-4.
15. Park HS, Oh DH, Yoon T, Park JS. Effect of effortful swallowing training on tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia: a double-blind, randomized controlled trial. Int J Lang Commun Disord. 2019;54(3):479–84.
16. Furuya J, Suzuki H, Tamada Y, Onodera S, Nomura T, Hidaka R, Minakuchi S, Kondo H. Food intake and oral health status of inpatients with dysphagia in acute care settings. J Oral Rehabil. 2020;47(6):736-742.
17. Yoon WL, Khoo JKP, Rickard Liow SJ. Chin tuck against resistance (CTAR): New method for enhancing suprahyoid muscle activity using a shaker-type exercise. Dysphagia. 2014;29(2):243–8.
18. Steele CM, Bayley MT, Peladeau-Pigeon M, Nagy A, Namasivayam AM, Stokely SL, Wolkin T. A Randomized Trial Comparing Two Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia. Dysphagia. 2016;31(3):452-61
19. Hewitt A, Hind J, Kays S, Nicosia M, Doyle J, Tompkins W, Gangnon R, Robbins J. Standardized instrument for lingual pressure measurement. Dysphagia. 2008;23(1):16-25.
20. Kim JH, Choi JW, Lee SH, Cho YS. Difference in tongue strength using visual feedback in healthy adults. J Phys Ther Sci. 2017;29(12):2075–6.
21. Chen H, Burton EA, Ross GW, Huang X, Savica R, Abbott RD, Ascherio A, Caviness JN, Gao X, Gray KA, Hong JS, Kamel F, Jennings D, Kirshner A, Lawler C, Liu R, Miller GW, Nussbaum R, Peddada SD, Rick AC, Ritz B, Siderowf AD, Tanner CM, Tröster AI, Zhang J. Research on the premotor symptoms of Parkinson's disease: clinical and etiological implications. Environ Health Perspect. 2013;121(11-12):1245-52.
22. Braak H, Del Tredici K, Rüb U, De Vos RAI, Jansen Steur ENH, Braak E. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging. 2003; 24(2):197–211.
23. Kanna SV, Bhanu K. A simple bedside test to assess the swallowing dysfunction in Parkinson’s disease. Ann Indian Acad Neurol. 2014;17(1):62–5.
24. Clarke CE, Gullaksen E, Macdonald S, Lowe F. Referral criteria for speech and language therapy assessment of dysphagia caused by idiopathic Parkinson’s disease. Acta Neurol Scand. 2009;97(1):27–35.
25. Takizawa C, Gemmell E, Kenworthy J, Speyer R. A Systematic Review of the Prevalence of Oropharyngeal Dysphagia in Stroke, Parkinson’s Disease, Alzheimer’s Disease, Head Injury, and Pneumonia. Dysphagia. 2016;31(3):434–41.
26. Chan V, Zagorski B, Parsons D, Colantonio A. Older adults with acquired brain injury: A population based study. BMC Geriatr. 2013;13(1):1.
27. Feigin VL, Barker-Collo S, Krishnamurthi R, Theadom A, Starkey N. Epidemiology of ischaemic stroke and traumatic brain injury. Best Pract Res Clin Anaesthesiol. 2010;24(4):485–94.
28. De Medeiros Correia S, Morillo LS, Filho WJ, Mansur LL. A deglutição nas fases moderada e grave da doença de Alzheimer. Arq Neuropsiquiatr. 2010;68(6):855–61.
29. Sato E, Hirano H, Watanabe Y, Edahiro A, Sato K, Yamane G, Katakura A. Detecting signs of dysphagia in patients with Alzheimer's disease with oral feeding in daily life. Geriatr Gerontol Int. 2014;14(3):549-55.
30. Zhang TM, Yu SY, Guo P, Du Y, Hu Y, Piao YS, et al. Nonmotor symptoms in patients with Parkinson disease: A cross-sectional observational study. Med (United States). 2016;95(50):e5400.
31. Panebianco M, Marchese-Ragona R, Masiero S, Restivo DA. Dysphagia in neurological diseases: a literature review. Neurol Sci. 2020 Nov;41(11):3067-3073.
32. González-Garza MT, Martínez HR, Caro-Osorio E, Cruz-Vega DE, Hernández-Torre M, Moreno-Cuevas JE. Differentiation of CD133 + Stem Cells From Amyotrophic Lateral Sclerosis Patients Into Preneuron Cells. Stem Cells Transl Med. 2013;2(2):129–35.
33. Sandstedt P, Littorin S, Johansson S, Gottberg K, Ytterberg C, Kierkegaard M. Disability and contextual factors in patients with amyotrophic lateral sclerosis - A three-year observational study. J Neuromuscul Dis. 2018;5(4):439–49.
34. DePaul R, Brooks BR. Multiple orofacial indices in amyotrophic lateral sclerosis. J Speech Hear Res. 1993;36(6):1158–67.
35. Marrie RA, Cohen J, Stuve O, Trojano M, Sørensen PS, Reingold S, Cutter G, Reider N. A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: overview. Mult Scler. 2015;21(3):263-81.
36. Holtbernd F, Deppe M, Bachmann R, Mohammadi S, Ringelstein EB, Reilmann R. Deficits in tongue motor control are linked to microstructural brain damage in multiple sclerosis: A pilot study. BMC Neurol. 2015;15(1):190.
37. Arakawa I, Igarash, K, Imamura Y, Müller F, Abou-Ayash S, Schimmel M. Variability in tongue pressure among elderly and young healthy cohorts: A systematic review and meta-analysis. J Oral Rehabil, 2021;48(4): 430-48
38. Gingrich LL, Stierwalt JAG, Hageman CF, Lapointe LL, Lieshout V, Falls C. Generated by the Anteromedian and Posteromedian Tongue by Healthy Young Adults. 2012;4388:960–73.
39. Yamanashi H, Shimizu Y, Higashi M, Koyamatsu J, Sato S, Nagayoshi M, et al. Validity of maximum isometric tongue pressure as a screening test for physical frailty: Cross-sectional study of Japanese community-dwelling older adults. Geriatr Gerontol Int. 2018;18(2):240–9.
40. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA; PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015 2;350:g7647.
42. Hirota N, Konaka K, Ono T, Tamine K, Kondo J, Hori K, et al. Reduced tongue pressure against the hard palate on the paralyzed side during swallowing predicts dysphagia in patients with acute stroke. Stroke. 2010;41(12):2982–4.
42. Stierwalt JAG, Youmans SR. Tongue measures in individuals with normal and impaired swallowing. Am J Speech-Language Pathol. 2007;16(2):148–56.
43. Robbins J, Kays SA, Gangnon RE, Hind JA, Hewitt AL, Gentry LR, Taylor AJ. The effects of lingual exercise in stroke patients with dysphagia. Arch Phys Med Rehabil. 2007;88(2):150-8.
44. Yeates EM, Molfenter SM, Steele CM. Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: Three case reports. Clin Interv Aging. 2008;3(4):735–47.
45. Easterling C, Antinoja J, Cashin S, Barkhaus PE. Changes in tongue pressure, pulmonary function, and salivary flow in patients with amyotrophic lateral sclerosis. Dysphagia. 2013;28(2):217–25.
46. Steele CM, Bailey GL, Polacco RE, Hori SF, Molfenter SM, Oshalla M, Yeates EM. Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury. Int J Speech Lang Pathol. 2013;15(5):492-502.
47. 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(12):3631–4.
48. Kim HD, Choi JB, Yoo SJ, Chang MY, Lee SW, Park JS. Tongue-to-palate resistance training improves tongue strength and oropharyngeal swallowing function in subacute stroke survivors with dysphagia. J Oral Rehabil. 2017;44(1):59–64.
49. Easterling C. Management and Treatment of Patients with Dysphagia. Curr Phys Med Rehabil Reports. 2018;29(6):213–219.
50. Byeon H. Effect of orofacial myofunctional exercise on the improvement of dysphagia patients’ orofacial muscle strength and diadochokinetic rate. J Phys Ther Sci. 2016;28(9):2611–4.
51. Lee JH, Kim HS, Yun DH, Chon J, Han YJ, Yoo SD, Kim DH, Lee SA, Joo HI, Park JS, Kim JC, Soh Y. The Relationship Between Tongue Pressure and Oral Dysphagia in Stroke Patients. Ann Rehabil Med. 2016;40(4):620-8.
52. Oliveira GD de, Valentim AF, Vicente LCC, Motta AR. Fatores associados à pressão de língua em pacientes pós-acidente vascular cerebral. Audiol - Commun Res. 2017;22(0):1870–1.
53. Oh DH, Park JS, Kim WJ. Effect of neuromuscular electrical stimulation on lip strength and closure function in patients with dysphagia after stroke. J Phys Ther Sci. 2017;29(11):1974–5.
54. Robbins JA, Gangnon RE, Theis SM, Kays SA, Hewitt AL, Hind JA. The effects of lingual exercise on swallowing in older adults. J Am Geriatr Soc. 2005;53(9):1483–9.
55. Pitts LL, Morales S, Stierwalt JAG. Lingual pressure as a clinical indicator of swallowing function in Parkinson’s disease. J Speech, Lang Hear Res. 2018 ;61(2):257–65.
56. Clark HM, Solomon NP. Age and sex differences in orofacial strength. Dysphagia. 2012;27(1):2–9.
57. Moon JH, Hong DG, Kim KH, Park YA, Hahm SC, Kim SJ, Won YS, Cho HY. Effects of lingual strength training on lingual strength and articulator function in stroke patients with dysarthria. J Phys Ther Sci. 2017;29(7):1201-4.
58. Cashin AG, McAuley JH. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale. J Physiother. 2020:66(1): 59.
59. Watanabe D, Yoshida T, Yokoyama K, Yoshinaka Y, Watanabe Y, Kikutani T, Yoshida M, Yamada Y, Kimura M, Kyoto-Kameoka Study Group. Association between Mixing Ability of Masticatory Functions Measured Using Color-Changing Chewing Gum and Frailty among Japanese Older Adults: The Kyoto-Kameoka Study. Int J Environ Res Public Health. 2020;17(12):4555.
60. Smaoui S, Langridge A, Steele CM. The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review. Dysphagia. 2020;35(5):745-61.
61. Dorsey ER, Sherer T, Okun MS, Bloem BR. The Emerging Evidence of the Parkinson Pandemic. J Parkinsons. Dis.2018;8:S3–S8.
62. 2016 Global, regional, and national burden of Parkinson’s disease, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. Neurol. 2018; 17:939–953
Published
2021-08-31
How to Cite
PLAZA-TAUCARE, Exequiel et al. Tongue strength as a clinical feature of oral health in neurological patients: A Systematic Review.. Journal of Oral Research, [S.l.], v. 10, n. 4, p. 1-14, aug. 2021. ISSN 0719-2479. Available at: <https://joralres.com/index.php/JOralRes/article/view/joralres.2021.055>. Date accessed: 20 may 2024. doi: https://doi.org/10.17126/joralres.2021.055.
Section
Reviews