title: Oral tactile sensitivity and masticatory performance are impaired in stroke patients.
abstract: Oro-facial impairment following stroke frequently involves reduced chewing performance, that is oral phase dysphagia. The aim was to investigate the sensitivity of oral tissues following stroke and its potential impact on masticatory function. Therefore, hospitalised post-stroke patients were recruited and compared to healthy controls. Outcome measures comprised masticatory performance employing a colour-mixing ability, that is a bolus-kneading test, maximum lip- and bite force and the one-point and two-point tactile thresholds. Food hoarding and prevalence of dry mouth were evaluated with ordinal scales. Twenty-seven stroke patients (age 64·3 ± 14·1 years) and 27 healthy controls (age 60·8 ± 14·3 years, P = 0·254) participated in this study. The groups had similar numbers of occluding units. Stroke patients reported more frequently dry mouth sensations and food hoarding. The intra-oral tactile sensitivity on the contra-lesional side was significantly lower in stroke patients compared to controls (0·0001 < P < 0·0002), and significant intra-group side differences were found only in the stroke group (0·0001 < P < 0·0010). For the lip, both sides were less sensitive in the stroke group compared with controls. The experiments confirmed lower masticatory performance and lip force in the stroke group, but the bite force was similar compared to healthy controls. Oral sensitivity was correlated with masticatory performance when a global correlation model was applied. A stroke may affect the sensitivity of the intra-oral tissues contra-lesionally, thus potentially affecting chewing function. Rehabilitation should therefore not only focus on motor impairment, but equally stimulate the sensitivity of the oral tissues, employing dry ice application or similar specific treatments.
authors.affiliation: Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.|Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: M
authors.identifier: http://orcid.org/0000-0001-9700-5534
authors.initials: M
authors.lastname: Schimmel
authors.affiliation: Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Voegeli
authors.affiliation: Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Duvernay
authors.affiliation: Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals and University of Geneva, Geneva, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Leemann
authors.affiliation: Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.|Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Müller
mesh_terms: D000368:Aged; D001732:Bite Force; D003680:Deglutition Disorders / Q000150:complications / Q000503:physiopathology*; D005158:Facial Paralysis / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008046:Lip / Q000503:physiopathology*; D008409:Mastication; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D020521:Stroke / Q000150:complications* / Q000503:physiopathology*; D014110:Touch; D014987:Xerostomia / Q000150:complications / Q000503:physiopathology*
keywords: chewing gum; dysphagia; mastication; stroke; symptom assessment; tactile perception