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      Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan

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          Abstract

          This study collected 11 parameters regarding the labial and lingual strength for maximum isometric and swallowing tasks among 150 healthy Chinese adults in Taiwan. Measurements were performed using the Iowa Oral Performance Instrument (IOPI). All of the labial and lingual strength parameters were measured three times. The maximal value of three trials represents the pressure of every parameter. The overall mean (±standard deviation) and maximum isometric pressures of the lips, anterior tongue, and posterior tongue were 24.81 ± 5.64, 55.95 ± 14.13, and 53.23 ± 12.24 kPa, respectively. The mean value of posterior tongue strength was less than that of the anterior tongue by approximately 5%. The percentages of maximum isometric tongue pressure during the swallowing of saliva and water were 85% and 80% for the anterior tongue and 90% and 81% for the posterior tongue, respectively. The average endurances for the anterior tongue and posterior tongue were 13.86 ± 7.08 and 10.06 ± 5.40 s, respectively. The maximum isometric pressures were greater than both the saliva and water swallowing pressures, and the saliva swallowing pressures were greater than the water swallowing pressures. A value of 33 kPa in maximum isometric pressure could serve as a demarcation of weak tongue strength for healthy Chinese adults. As for the repeated trials of labial and lingual strength, there were no statistically significant differences for any of the pressures obtained from the 11 labial and lingual strength parameters. The normative data can be used for the objective assessment of labial and lingual strength in healthy Chinese adults.

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          Most cited references34

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          European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome

          This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization’s classification of diseases. It can cause severe complications such as malnutrition, dehydration, respiratory infections, aspiration pneumonia, and increased readmissions, institutionalization, and morbimortality. OD is a prevalent and serious problem among all phenotypes of older patients as oropharyngeal swallow response is impaired in older people and can cause aspiration. Despite its prevalence and severity, OD is still underdiagnosed and untreated in many medical centers. There are several validated clinical and instrumental methods (videofluoroscopy and fiberoptic endoscopic evaluation of swallowing) to diagnose OD, and treatment is mainly based on compensatory measures, although new treatments to stimulate the oropharyngeal swallow response are under research. OD matches the definition of a geriatric syndrome as it is highly prevalent among older people, is caused by multiple factors, is associated with several comorbidities and poor prognosis, and needs a multidimensional approach to be treated. OD should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications. More research is needed to develop and standardize new treatments and management protocols for older patients with OD, which is a challenging mission for our societies.
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            A systematic review and meta-analysis of measurements of tongue and hand strength and endurance using the Iowa Oral Performance Instrument (IOPI).

            The purpose of this systematic review was to examine the evidence for the use of the Iowa Oral Performance Instrument (IOPI) to measure strength and endurance of the tongue and hand in healthy populations and those with medical conditions. A systematic search of the scientific literature published since 1991 yielded 38 studies that addressed this purpose. The IOPI was used primarily for tongue strength (38 studies) and endurance (15 studies) measurement; relatively few studies measured hand strength (9 studies) or endurance (6 studies). The majority of the studies identified used the IOPI as an evaluation tool, although four used it as an intervention tool. Half the studies were conducted in healthy people, primarily adults. Most of the other participants had disorders with dysphagia, primarily Parkinson's disease or head or neck cancer. Age and gender, as well as a number of medical conditions, influence the values of tongue and hand strength. There is sufficient evidence to support the use of the IOPI as a suitable tool for measuring tongue strength and endurance and as an assessment tool for intervention studies, and there is growing support for its use to assess hand strength and endurance in healthy and clinical populations.
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              Differences in tongue strength across age and gender: is there a diminished strength reserve?

              Maximum tongue strength was investigated and compared to mean swallowing pressure elicited by the anterior tongue to calculate the percentage of maximum tongue strength used during swallowing in 96 participants with normal swallowing, divided into three 20-year age groups. The purposes of this investigation were to investigate normal swallowing physiology and to determine whether tongue strength reserves diminished according to age or gender. The results of the study yielded significant maximum tongue strength differences between the youngest and oldest and middle and oldest age groups; the oldest group had the weakest tongues. Mean swallowing pressure did not differ based on age, but women were found to have significantly higher pressures than men. The percentage of maximum tongue strength used during swallowing did not vary as a function of age, but women used a significantly higher percentage of tongue strength to swallow than men. Based on the results, it appears that a diminishing strength reserve does not exist based on age, but it does exist based on gender. Specifically, it appears that women have a reduced tongue strength reserve compared to men. Clinical implications are discussed.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                28 October 2020
                November 2020
                : 17
                : 21
                : 7904
                Affiliations
                [1 ]Department of Nursing, Taichung Veterans General Hospital Puli Branch, Nantou 54552, Taiwan; ernr1191@ 123456gmail.com
                [2 ]Department of Public Health, China Medical University, Taichung 40447, Taiwan
                [3 ]Department of Nursing, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan; 107179@ 123456ctust.edu.tw
                [4 ]Department of Internal Medicine, Taichung Veterans General Hospital Puli Branch, Nantou 54552, Taiwan; proteinmad@ 123456yahoo.com.tw
                [5 ]Department of Eldercare, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan
                [6 ]General Education Center in the Overseas Chinese University, Taichung 40721, Taiwan; fyl@ 123456seed.net.tw
                [7 ]College of Nursing, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan
                Author notes
                [* ]Correspondence: yjhwu@ 123456ctust.edu.tw ; Tel.: +886-4-22397176
                Author information
                https://orcid.org/0000-0001-8298-2850
                https://orcid.org/0000-0002-8572-0175
                Article
                ijerph-17-07904
                10.3390/ijerph17217904
                7663130
                33126580
                f1042d52-36a0-4dbd-adc5-10a2b21baeba
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 21 September 2020
                : 26 October 2020
                Categories
                Article

                Public health
                tongue strength,labial strength,endurance,presbyphagia
                Public health
                tongue strength, labial strength, endurance, presbyphagia

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