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Clinical Trial
. 2013 Oct;15(5):492-502.
doi: 10.3109/17549507.2012.752864. Epub 2013 Jan 22.

Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury

Catriona M Steele  1 , Gemma L Bailey, Rebecca E Cliffe Polacco, Sarah F Hori, Sonja M Molfenter, Mohamed Oshalla, Erin M Yeates
Affiliations
Free PMC article
Clinical Trial

Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury

Catriona M Steele et al. Int J Speech Lang Pathol. 2013 Oct.
Free PMC article

Abstract

The purpose of this study was to measure treatment outcomes in a group of six adults with chronic dysphagia following acquired brain injury, who each completed 24 sessions of tongue-pressure resistance training, over a total of 11-12 weeks. The treatment protocol emphasized both strength and accuracy. Biofeedback was provided using the Iowa Oral Performance Instrument. Amplitude accuracy targets were set between 20-90% of the patient's maximum isometric pressure capacity. Single subject methods were used to track changes in tongue strength (maximum isometric pressures), with functional swallowing outcomes measured using blinded ratings of a standard pre- and post-treatment videofluoroscopy protocol. Improvements were seen in post-treatment measures of tongue pressure and penetration-aspiration. No improvements were seen in pharyngeal residues, indeed worsening residue was seen in some patients.

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Figures

Figure 1.
Figure 1.
Flow-chart of a tongue-pressure strength and accuracy training session.
Figure 2.
Figure 2.
Control charts showing progress in anterior maximum isometric tongue–palate pressures over the course of therapy. Dashed horizontal lines indicate a moderate effect size band around baseline performance, used as a threshold to determine whether there was evidence of change in the form of at least three consecutive data points exceeding the effect size band.
Figure 3.
Figure 3.
Control charts showing progress in posterior maximum isometric tongue–palate pressures over the course of therapy. Dashed horizontal lines indicate a moderate effect size band around baseline performance, used as a threshold to determine whether there was evidence of change in the form of at least three consecutive data points exceeding the effect size band.
Figure 4.
Figure 4.
Control charts showing progress in saliva swallowing pressures over the course of therapy. Dashed horizontal lines indicate a moderate effect size band around baseline performance, used as a threshold to determine whether there was evidence of change in the form of at least three consecutive data points exceeding the effect size band.
See this image and copyright information in PMC

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