Specificity of training in the lingual musculature.
Clark Heather M
Journal of speech, language, and hearing research : JSLHR
PURPOSE:Training specificity for a number of exercise parameters has been demonstrated for the limb musculature. The current study is a Phase I exploration of training specificity in the lingual musculature. METHOD:Twenty-five healthy participants were assigned to 1 of 5 training conditions. Four groups completed 4 weeks of lingual exercise targeting strength, endurance, power, or speed; a control group did not exercise. Performance measures of strength, endurance, power, and speed were obtained before and after training. RESULTS:Although statistically significant group effects were not detected, specificity was observed with respect to effect size for the performance variables of strength, endurance, and power. Further evidence of specificity was provided by the finding that training isotonic endurance did not increase performance on an isometric endurance task. Speed training did not improve performance on any of the outcome measures, nor did speed increase following training with any of the exercises. CONCLUSIONS:The findings provide initial evidence that training specificity may be observed in the lingual musculature. The reported effect sizes can inform future studies examining the benefit of training muscle functions underlying speech and swallowing.
Exercise-based approaches to dysphagia rehabilitation.
Steele Catriona M
Nestle Nutrition Institute workshop series
Rehabilitative techniques for dysphagia (swallowing impairment) increasingly employ exercise modeled on methods used to train muscles in sports medicine. Three techniques in particular show promise for improving muscle strength and function related to swallowing: the Shaker exercise, expiratory muscle strength training, and tongue pressure resistance training. All three techniques invoke principles of task specificity, muscular load, resistance, and intensity, and aim to achieve functional changes in swallowing through changes in muscle physiology derived from strength or endurance training. To date, studies of treatment benefit arising from these techniques involve small sample sizes; this is particularly true of randomized studies with controls receiving standard treatment or experiencing spontaneous recovery. Nevertheless, a review of the available literature shows that improvement of penetration-aspiration is a common finding for individuals with dysphagia receiving one of these three treatment approaches. Although hypothesized as an expected outcome of swallow muscle strength training, improvements in post-swallow residues are noted to be uncommon as an outcome of these exercise-based approaches. The available evidence suggests that exercise-based approaches to swallowing rehabilitation do succeed in changing muscle strength and function, but generalization to true swallowing tasks may be somewhat limited.
Effects of lingual strength training on oropharyngeal muscles in South Korean adults.
Park Ji-Su,Hwang Na-Kyung,Kim Hwan-Hee,Choi Jong-Bae,Chang Moon-Young,Jung Young-Jin
Journal of oral rehabilitation
BACKGROUND:Lingual strength training (LST) has been reported to positively affect the activation of submental muscles, as well as to increase lingual muscle strength. However, there is little evidence to support its effectiveness. OBJECTIVES:This study aimed to investigate the effect of LST on the strength and thickness of oropharyngeal muscles in healthy adults. METHODS:The study included 30 subjects who were assigned to the experimental (n = 15) and the control groups (n = 15). The experimental group performed LST based on tongue-to-palate resistance exercise method. LST was categorised as isometric and isotonic exercise. The intervention was performed five times a week for 6 weeks. The control group did not receive any intervention. The lingual strength was measured using the Iowa Oral Performance Instrument. Changes in the thickness of the mylohyoid and the digastric muscles and the lingual were assessed ultrasonographically. RESULTS:After the intervention, the thickness of the mylohyoid and the digastric muscles in the experimental group was significantly greater than that in the control group (P = 0.037 and 0.042). CONCLUSION:This study demonstrated that LST increases the thickness and the strength of oropharyngeal muscles. Therefore, LST is a useful option in patients with dysphagia or in elderly patients prone to swallowing dysfunction.
Effect of partial head extension swallowing exercise on the strength of the suprahyoid and tongue muscles in healthy subjects: A feasibility study.
Journal of oral rehabilitation
BACKGROUND:Head extension swallowing exercise (HESE) is one of the exercise methods to strengthen the suprahyoid muscle and tongue. In this study, we modified the exercise protocol of the original HESE for application in patients who have difficulty in performing full HESE owing to decreased muscular strength related to swallowing. OBJECTIVE:The purpose of this study was to investigate the feasibility and the effect of partial HESE on suprahyoid muscle activation and the tongue pressure during 30° extension of the head, rather than full extension, for 8 weeks. METHODS:Thirteen healthy young volunteers (mean age, 21.5 ± 1.13 years) participated in this study. The participants extended their head backward by 30° and swallowed their saliva every 10 seconds. The exercise was performed three times a week for 8 weeks. The effect of the exercise was confirmed by surface electromyography and tongue pressure measurement. The measurements were performed three times (baseline, at 4 weeks and at 8 weeks). RESULTS:No significant improvement in the tongue pressure-related parameters and suprahyoid muscle activation compared to those at baseline was observed as a result of the exercise. CONCLUSION:Although partial HESE in healthy adults did not lead to significant improvement in swallowing-related muscle strength, this study confirmed the feasibility of partial HESE. On the basis of these results, future studies should assess the applicability and effectiveness of partial HESE in elderly individuals and patients with dysphagia with swallowing-related muscular weakness.
Tongue motor training support system.
Sasaki Makoto,Onishi Kohei,Nakayama Atsushi,Kamata Katsuhiro,Stefanov Dimitar,Yamaguchi Masaki
Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
In this paper, we introduce a new tongue-training system that can be used for improvement of the tongue's range of motion and muscle strength after dysphagia. The training process is organized in game-like manner. Initially, we analyzed surface electromyography (EMG) signals of the suprahyoid muscles of five subjects during tongue-training motions. This test revealed that four types tongue training motions and a swallowing motion could be classified with 93.5% accuracy. Recognized EMG signals during tongue motions were designed to allow control of a mouse cursor via intentional tongue motions. Results demonstrated that simple PC games could be played by tongue motions, achieving in this way efficient, enjoyable and pleasant tongue training. Using the proposed method, dysphagia patients can choose games that suit their preferences and/or state of mind. It is expected that the proposed system will be an efficient tool for long-term tongue motor training and maintaining patients' motivation.
Ultrasonography Shows Age-related Changes and Related Factors in the Tongue and Suprahyoid Muscles.
Yamaguchi Kohei,Hara Koji,Nakagawa Kazuharu,Yoshimi Kanako,Ariya Chantaramanee,Nakane Ayako,Furuya Junichi,Tohara Haruka
Journal of the American Medical Directors Association
OBJECTIVES:To investigate age and other factors related to the deterioration of the muscles used for swallowing, including the tongue and suprahyoid muscles. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:This study included 146 participants: 47 younger adults (23 men and 24 women; age range 23-44 years) recruited from a dental hospital and 99 community-dwelling older adults (37 men and 62 women, age range 65-86 years). METHODS:Age (<65 years or ≥65 years), body mass index (BMI), skeletal muscle mass index (SMI), and tooth loss (Eichner classification) were measured. The cross-sectional areas (CSAs) of the tongue, geniohyoid muscle, and anterior belly of the digastric muscle were measured using an ultrasonic diagnostic apparatus. The correlation between each muscle's CSA and strength was examined. Multiple regression analyses were performed separately for each sex using each muscle CSA as the dependent variable and age, BMI, SMI, and the Eichner classification as explanatory variables. RESULTS:Older men had a significant positive correlation between tongue pressure and CSA (r = 0.35, P = .031). Jaw opening force was positively correlated with geniohyoid muscle CSA (r = 0.41, P = .001) in older women. In the multiple regression analysis, age, BMI, and SMI were significantly associated with tongue CSA in men. Age was significantly and inversely associated with suprahyoid muscle CSA in both men and women. No explanatory variables were significantly associated with geniohyoid muscle CSA except age. CONCLUSIONS AND IMPLICATIONS:The tongue increased in volume, and the suprahyoid muscles underwent atrophy with age. The study results suggest that interventions to prevent dysphagia associated with aging should be tailored toward specific muscles. Direct muscle training is required for the suprahyoid muscles, whereas the maintenance of tongue muscle mass and function, as well as training for the tongue, requires attention to ensure optimal nutritional status and whole-body skeletal muscle mass.
Tongue-pressure resistance training improves tongue and suprahyoid muscle functions simultaneously.
Namiki Chizuru,Hara Koji,Tohara Haruka,Kobayashi Kenichiro,Chantaramanee Ariya,Nakagawa Kazuharu,Saitou Takayuki,Yamaguchi Kohei,Yoshimi Kanako,Nakane Ayako,Minakuchi Shunsuke
Clinical interventions in aging
PURPOSE:Producing tongue pressure (TP) by pushing the tongue against the palate consists of lifting the tongue muscles and elevating the floor of the mouth via suprahyoid muscle contraction. Though studies have shown that tongue-pressure resistance training (TPRT) increases tongue function, none have focused on suprahyoid muscle function enhancements. Our study aimed to verify whether TPRT improves both tongue function and hyoid movement during swallowing. MATERIALS AND METHODS:Eighteen patients (mean age: 76.8±6.2 years) with presbyphagia presenting with symptoms such as coughing and choking were enrolled. All patients performed daily living activities independently. None of the participants had diseases causing dysphagia or previous oral or pharyngeal surgery. Participants were instructed to push their tongues against the palate as hard as possible with their mouths closed for 10 seconds, and then resting for 10 seconds. A set consisted of five consecutive exercise and resting periods; two sets per day were performed for a month. TP and the oral diadochokinetic rate (ODKR), measured by repetitions of the syllables /ta/ and /ka/, assessed tongue function. The extent of anterior and superior hyoid movement and parameters related to swallowing, including the penetration aspiration scale (PAS) and the normalized residue ratio scale (NRRS) in the valleculae (NRRSv) and piriform sinus (NRRSp), were evaluated based on videofluoroscopic data. RESULTS:The anterior (=0.031) and superior hyoid movement (=0.012), TP (=0.002), ODKR/ta/ (=0.034), ODKR/ka/ (=0.009), and the width of the upper esophageal sphincter (=0.001) were larger at follow-up than at baseline. NRRSp (=0.022), PAS (=0.016), and pharyngeal transit times (=0.004) were smaller at follow-up than at baseline. CONCLUSION:TPRT improved tongue strength, dexterity, both anterior and superior hyoid elevation, and swallowing functions. Therefore, TPRT could improve tongue function and suprahyoid muscle function simultaneously and contribute to prevention of sarcopenic dysphagia.