The Relationship Between Tongue Pressure and Oral Dysphagia in Stroke Patients.
OBJECTIVE
To evaluate the relationships between tongue pressure and different aspects of the oral-phase swallowing function.


METHODS
We included 96 stroke patients with dysphagia, ranging in age from 40 to 88 years (mean, 63.7 years). Measurements of tongue pressure were obtained with the Iowa Oral Performance Instrument, a device with established normative data. Three trials of maximum performance were performed for lip closure pressure (LP), anterior hard palate-to-tongue pressure (AP), and posterior hard palate-to-tongue pressure (PP); buccal-to-tongue pressures on both sides were also recorded (buccal-to-tongue pressure, on the weak side [BW]; buccal-to-tongue pressure, on the healthy side [BH]). The average pressure in each result was compared between the groups. Clinical evaluation of the swallowing function was performed with a videofluoroscopic swallowing study.


RESULTS
The average maximum AP and PP values in the intact LC group were significantly higher than those in the inadequate lip closure group (AP, p=0.003; PP, p<0.001). AP and PP showed significant relationships with bolus formation (BF), mastication, premature bolus loss (PBL), tongue to palate contact (TP), and oral transit time (OTT). Furthermore, LP, BW, and BH values were significantly higher in the groups with intact mastication, without PBL and intact TP.


CONCLUSIONS
These findings indicate that the tongue pressure appears to be closely related to the oral-phase swallowing function in post-stroke patients, especially BF, mastication, PBL, TP and OTT.
Department of Rehabilitation & Physical Medicine, Kyung-Hee Medical Center, Seoul, Korea.
Jong Ha
0000-0002-7627-6543
JH
Lee
Department of Rehabilitation & Physical Medicine, Kyung-Hee Medical Center, Seoul, Korea.
Hee-Sang
0000-0003-4985-0594
HS
Kim
Department of Rehabilitation & Physical Medicine, Kyung-Hee Medical Center, Seoul, Korea.
Dong Hwan
0000-0003-1800-319X
DH
Yun
Department of Rehabilitation & Physical Medicine, Kyung-Hee Medical Center, Seoul, Korea.
Jinmann
0000-0002-4186-6623
J
Chon
Department of Rehabilitation & Physical Medicine, Kyung-Hee Medical Center, Seoul, Korea.
Yoo Jin
0000-0003-3256-9931
YJ
Han
Department of Rehabilitation & Physical Medicine, Kyung-Hee University Hospital at Gangdong, Seoul, Korea.
Seung Don
0000-0003-4513-2560
SD
Yoo
Department of Rehabilitation & Physical Medicine, Kyung-Hee University Hospital at Gangdong, Seoul, Korea.
Dong Hwan
0000-0002-3812-5509
DH
Kim
Department of Rehabilitation & Physical Medicine, Kyung-Hee University Hospital at Gangdong, Seoul, Korea.
Seung Ah
0000-0002-3426-6259
SA
Lee
Department of Rehabilitation & Physical Medicine, Kyung-Hee University Hospital at Gangdong, Seoul, Korea.
Hye In
0000-0002-0943-4628
HI
Joo
Department of Occupational Therapy, Inje University Busan Paik Hospital, Busan, Korea.
Ji-Su
0000-0001-7113-4792
JS
Park
Department of Rehabilitation & Physical Medicine, Kyung-Hee Medical Center, Seoul, Korea.
Jin Chul
0000-0002-4405-5463
JC
Kim
Department of Rehabilitation & Physical Medicine, Kyung-Hee University Hospital at Gangdong, Seoul, Korea.
Yunsoo
0000-0001-8368-4900
Y
Soh
Dysphagia; Iowa Oral Performance Instrument; Stroke; Tongue pressure; VFSS