Tongue-pressure resistance training improves tongue and suprahyoid muscle functions simultaneously
Received 15 November 2018
Accepted for publication 11 February 2019
Published 22 March 2019 Volume 2019:14 Pages 601—608
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Chizuru Namiki,1 Koji Hara,1 Haruka Tohara,1 Kenichiro Kobayashi,2 Ariya Chantaramanee,1 Kazuharu Nakagawa,1 Takayuki Saitou,2 Kohei Yamaguchi,1 Kanako Yoshimi,1 Ayako Nakane,1 Shunsuke Minakuchi1
1Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan; 2Kobayashi Dental Clinic, Tokyo, Japan
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 (P=0.031) and superior hyoid movement (P=0.012), TP (P=0.002), ODKR/ta/ (P=0.034), ODKR/ka/ (P=0.009), and the width of the upper esophageal sphincter (P=0.001) were larger at follow-up than at baseline. NRRSp (P=0.022), PAS (P=0.016), and pharyngeal transit times (P=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.
Keywords: sarcopenic dysphagia, swallowing muscle, tongue function, suprahyoid muscle
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