Age- and sex-related variations in jaw-opening and tongue functions in healthy adults.

ObjectiveTongue muscles play critical roles in swallowing function. This study was designed to investigate the tongue function of healthy individuals without food intake and compose a tongue function database in Taiwan across age, gender, and two tongue bulb placement positions.MethodsBoth tongue strength and tongue endurance were measured at the anterior and the posterior tongue position. A total of 214 participants (102 males and 112 females) across six age groups completed the tongue strength study. Only 203 participants (96 males and 107 females) completed the tongue endurance study.ResultsResults of this study found no significant interaction effects between age and gender for all the tongue strength and endurance measures. Both anterior and posterior tongue strength were significantly lower in the older group (60+) compared with the middle‐aged participants (31–40). Although no significant differences were found in younger age groups at either tongue positions on endurance measures, significantly lower tongue endurances were noticed in the 60+ age group. The tongue strength and tongue endurance measurements were greater at the anterior position than the posterior position, decrease in the 60+ age group.ConclusionThe tongue endurance duration was similar between males and females and remained relatively stable throughout life. In contrast, the impact of age and gender on the maximum tongue strength measurement was more obvious. Tongue strength and endurance level were observed to decline with advancing age at both the anterior and the posterior positions. These data could be one feasible reference indicator for oral function and swallowing state in Taiwanese population.

Self-administered tongue exercises (TEs) are proposed as an effective, low-cost and convenient intervention for improving maximum tongue strength and endurance. However, age-related factors make self-administered TEs more challenging for older individuals. This study aimed to evaluate the effects of self-administered TEs on maximum tongue strength and endurance in older individuals. Seventy-two healthy volunteers, both young and older groups, were randomly allocated to three self-administered TE groups: tongue wrap, tongue corner and tongue paint. Maximum tongue strength and tongue endurance were assessed at baseline (T0) and after 4 weeks of training (T1) using the Iowa Oral Performance Instrument (IOPI). The Wilcoxon signed-rank test was used to compare pre- and post-intervention outcomes within groups, and the Kruskal-Wallis test was used to compare gains among groups. After 4 weeks of self-administered TEs, the average gains in maximum tongue strength and endurance did not differ significantly between young and older participants. The gains in maximum tongue strength for young and older participants were as follows: tongue wrap (7.7 vs. 3.3 kPa, p = 0.2), tongue corner (4.0 vs. 1.7 kPa, p = 0.6) and tongue paint (3.5 vs. 3.7 kPa, p = 1.0). For tongue endurance, young and older participants gained 3.9 vs. 13.0 s (p = 0.2), 1.3 vs. 11.0 s (p = 0.1) and 3.8 vs. -0.2 s (p = 0.5), respectively. While the tongue paint exercise resulted in the highest gains in maximum tongue strength, and the tongue wrap exercise showed the greatest improvement in tongue endurance among older adults, these differences were not statistically significant. Four weeks of self-administered TEs had a positive impact on tongue strength and endurance in older individuals. Although our findings are most compatible with no important difference among exercise types in the older, notable patterns suggest potential benefits. Future studies should explore optimal exercise intensity and duration to maximise effectiveness.

Developmental Changes in Tongue Strength, Swallow Pressures, and Tongue Endurance.

It is generally accepted that age-related changes occur in voluntary muscle. Studies of hand grip strength and aging demonstrate a decrease in strength with age; however, there are little data regarding tongue function. The purpose of this study was to determine the relationship of increased age to tongue strength and endurance. A pressure transducer, the Iowa Oral Performance Instrument, was used to measure maximal strength and endurance of both the hand and tongue. Ninety-nine healthy volunteers from the oral physiology component of the Baltimore Longitudinal Study of Aging were divided into four age groups, ranging from 21 to 96 years of age. A multivariate analysis of variance was used to determine differences in strength and endurance between age groups and genders. Regression analysis was done to determine the relationship of strength and endurance with age. Gender analysis indicated that both tongue and hand strength were greater in males; however, tongue and hand endurance demonstrated no gender differences. The strength in both the tongue and hand decreased with age. Individuals over the age of 79 years showed statistically decreased tongue strength, and individuals over the age of 59 years showed statistically decreased hand strength. There was no significant change in the tongue and hand endurance with age. The results of this study suggest that tongue function is gender- and age-dependent and follows the same trends as hand function. Tongue strength is decreased in older individuals and females, while tongue endurance is gender- and age-independent.

ABSTRACTBackgroundThere is a physiological association of the neck movements and jaw and tongue movements. However, there are no previous data regarding the performance of the tongue when the neck is under a lack of movement condition.ObjectiveTo quantify the tongue's maximal strength and mobility under an experimental restriction of cervical mobility.MethodsThis cross‐sectional study recruited 33 healthy volunteers. We measured the tongue's mobility and maximal strength reached at the posterior, middle and anterior parts of the tongue; all were performed with and without neck immobilisation. A neck collar was used for the experimental restriction of cervical mobility.ResultsANOVA revealed no differences in tongue strength between cervical condition (p = 0.84), but differences were found among the three tongue areas' strength (p < 0.001), according to the post hoc results the posterior area of the tongue resulted significantly weaker compared to the anterior (with collar p = 0.006; without collar p = 0.01) and midparts (with collar p = 0.03; without collar p = 0.006). Significant differences were also found in the tongue's range of motion (ROM) between groups for the protraction (p = 0.02). A subclassification of the participants was made according to the greatest strength obtained with (CCI group) or without (WCI group) neck collar, or no difference (NC group). The analysis of variance showed significant changes in tongue strength between groups at the tongue's anterior area (F = 5.28; p = 0.01), middle area (F = 9.83; p < 0.001) and posterior area (F = 4.05; p = 0.02). The post hoc analyses showed strength in the middle area of the tongue changed between neck conditions, obtaining significantly greater results without the neck collar compared with those with the neck collar (p = 0.01; d = 1.10).ConclusionThe results of this study indicate a trend suggesting that posture induced by experimental cervical fixation may influence tongue strength, with a possible greater effect in the middle area of the tongue compared to the anterior and posterior areas; however, it affects tongue range of motion. These findings suggest that cervical posture could be an important factor to consider in clinical assessments and interventions involving tongue function. Nonetheless, a larger sample size and further studies are needed to draw more definitive conclusions and understand these potential associations.

IntroductionThe tongue is one of the most important organs in the swallowing process, since impaired tongue function can decrease swallowing effectiveness and safety. Therefore, assessing tongue function is essential to help determine and treat swallowing disorders.ObjectivesTo assess tongue strength and endurance in healthy Brazilian adults and to analyze likely variations related to age range and sex.MethodsIn total, 219 individuals > 18 years old, equally divided into age groups (18 to 39 years old, 40 to 60 years old, and > 60 years old, each group comprising 73 individuals), were assessed using the Iowa Oral Performance Instrument (IOPI) to measure tongue strength and endurance.ResultsTongue strength was significantly lower in older individuals (45.84 kilopascals [kPa]) than in the younger groups (54.16 kPa for young individuals and 54.36 kPa for middle-aged individuals). Similarly, tongue endurance was significantly lower in older individuals. Regarding sex, the assessed parameter only presented significant difference between men and women in the young adult group (men recorded tongue strength 10 kPa higher than that of women).ConclusionNormal values for tongue strength in the healthy Brazilian population were established. These values changed based on age group as older individuals presented lower tongue strength and endurance than younger ones. These results highlight the importance of taking age and sex into consideration when assessing tongue strength.

Generating adequate tongue pressure against the hard palate requires full-range mobility of the tongue. The study aimed to (1) determine the prevalence of restricted tongue mobility and ankyloglossia and (2) determine whether, in children with restricted tongue mobility, their condition also affects tongue pressure. A cross-sectional study of healthy 6-8-year-old children from primary schools in central Vietnam was conducted in 2019. Restricted tongue mobility and ankyloglossia were graded using the tongue range of motion ratio (TRMR), with the tongue-tip-to-incisive papillae (TIP) for the anterior tongue tip and lingual-palatal suction (LPS) for the posterior two-thirds of the tongue. Tongue strength and tongue endurance were measured by the Iowa Oral Pressure Instrument. Statistical analysis investigated the associations between tongue mobility and tongue pressure measurement. Five hundred twelve children (46.5% female, mean age 7.2 ± 0.2years) were assessed. The prevalence of anterior ankyloglossia and restricted mobility was 17.5%, with 16.2% cases of less than 50% mobility and 1.3% cases of less than 25% mobility. The prevalence of posterior ankyloglossia and restricted mobility with less than 30% mobility was 28.9%. Anterior restricted mobility was not a predictor of reduced tongue pressure. Posterior restricted mobility in LPS was independently associated with tongue strength but not tongue endurance. Restrictions of posterior tongue mobility in ankyloglossia are more frequent than restrictions in anterior tongue mobility. Reduced tongue strength is related to mobility and the severity of restrictions in the posterior tongue. These findings suggest that restricted posterior tongue mobility may affect tongue muscle weakness.

Purpose: This study examined lifespan changes in maximum tongue strength, swallowing time, and masseter activity during swallowing. It provides normative data with which to compare clinical assessments of orofacial myofunctional disorders (OMD) and oropharyngeal dysphagia (OPD). Method: 409 healthy participants without identified OMD or OPD (ages 5 – 79 years) provided instrumental measures of tongue strength and electromyographic measurements for oropharyngeal transit time and masseter activity during swallows of four boluses. Participants were placed in three broad age groups (5 – 15, 16 – 59, 60 – 79) for crosssectional analysis. Results: Differences were found between age groups for tongue strength, such that the youngest group had significantly lower anterior tongue strength than the other groups, and lower posterior tongue strength than the 16 – 59 age group. Anterior tongue strength was significantly greater for males than females; posterior tongue strength did not differ significantly between the sexes. The youngest group had longer oropharyngeal transit times than either of the two older groups for most boluses. Swallowing transit time decreased in duration across the age groups, from youngest to oldest, for the 2.5 cc pudding bolus. Both right and left masseters differed in activation among tasks and age groups. The oldest age group had consistently greater levels of activation of the right masseter, and all groups had greater activation for the cracker bolus. Spearman rank-order correlations largely confirmed the inferential statistics and provided evidence of a relationship between tongue weakness and increased oropharyngeal transit time. Conclusion: Maximum tongue pressure generation and oropharyngeal timing measures support a developmental hypothesis, with lower tongue strength and longer swallowing transit times for children ages 5 through 15. The smaller pudding bolus provided the greatest differentiation among the age groups, which may prove to be a functional indicator for clinical evaluation. These results are largely consistent with existing data for tongue strength and oropharyngeal swallowing transit times.

Differences in Tongue Strength Across Age and Gender: Is There a Diminished Strength Reserve?

The purpose of this study was to test the hypothesis that eating a meal reduces tongue strength and endurance in healthy old and young adults. It was predicted that older adults would show greater declines in tongue endurance while demonstrating higher perceived effort, longer meal durations, and clinical signs of swallowing difficulty. Twenty-two healthy adults were enrolled into 2 groups (ages 20-35 years and ages 65-82 years; 5 males and 6 females each). Maximum tongue strength (Pmax) and endurance (duration 50% of Pmax could be maintained) were measured twice at baseline and once postmeal. Subjects consumed half of a bagel with peanut butter, carrot sticks, and milk between measures. All subjects demonstrated reduced tongue strength and endurance postmeal. Young adults showed a greater decline in anterior tongue endurance compared with older adults (p=.05). There was no evidence that changes in tongue strength, perceived effort, or meal duration varied by age or gender. The 3 oldest subjects reported the highest effort and displayed signs of difficulty swallowing while dining. Young and old adults demonstrated reduced tongue strength and endurance after dining, but younger subjects showed greater declines in anterior tongue endurance, whereas older adults exhibited signs of swallowing difficulty.

This study examined the impact of maximum tongue strength (MTS) on implant stability, peri-implant bone density, and marginal bone loss (MBL) in the posterior mandible. Thirty patients (14 males, 16 females) received a total of 37 dental implants in the posterior mandible to support fixed single crowns. MTS was measured anteriorly and posteriorly, then pooled mean used for analysis. Implant stability was measured in implant stability quotient (ISQ) and peri-implant bone density was assessed using cone-beam computed tomography (CBCT) at 3 months post-surgery. Meanwhile the 1-year MBL was evaluated using periapical radiographs. Additionally, age, gender, body mass index (BMI) and implant characteristics were recorded. All implants remained functional at 1 year, with a 100% survival rate. The mean MTS was 56.4 ± 10.1kPa. MTS correlated positively with increased implant stability at 3 months post implant placement (rs=0.38, p = 0.02). Regression analysis showed that age (p = 0.02) and gender (p = 0.04) were significant predictors of ISQ, while MTS was not an independent predictor. General linear model analysis revealed that MTS interacted significantly with age (p = 0.04) and gender (p = 0.002), indicating that both factors modulated the relationship between MTS and early implant stability. No significant associations were observed between MTS and peri-implant bone density or 1-year MBL. MTS was associated with greater implant stability at 3 months in posterior mandibular implants. As this was a cohort study, no causal inference can be drawn. Measuring MTS may help clinicians identify patients at higher risk of reduced implant stability, supporting personalized risk assessment and treatment planning.

Four children with developmental verbal dyspraxia (DVD), and three children with inconsistent deviant phonological disorder were compared to age-matched control children on measures of tongue strength and endurance and lip movement. The instrument for measuring tongue strength was composed of an air-filled soft rubber bulb connected to a pressure transducer. Measurements of lip movement during speech and non-speech tasks were taken from a video-recording of the child's mouth, recorded using a Perspex grid overlay. The results indicated that the DVD subjects were poorer than the control children on all measures of tongue strength and endurance. While the inconsistent deviant children performed similarly to age-matched controls on the maximum tongue strength task, their performance on endurance and repetitive tasks fell between that of the DVD and control groups. The preliminary lip movement analysis suggested some deficit in control of lip movement for the DVD and inconsistent subjects. Overall the findings support the hypothesis that children with DVD and those with inconsistent deviant phonology have some form of motor impairment. The differential performance of the two subject groups on tongue strength and endurance tasks is in accordance with the hypothesis that DVD and inconsistent deviant phonology are distinct subgroups of developmental speech disorders. The need for further physiological investigation of the oro-motor skills of speech-impaired children is discussed.

Four children with developmental verbal dyspraxia (DVD), and three children with inconsistent deviant phonological disorder were compared to age-matched control children on measures of tongue strength and endurance and lip movement. The instrument for measuring tongue strength was composed of an air-filled soft rubber bulb connected to a pressure transducer. Measurements of lip movement during speech and non-speech tasks were taken from a video-recording of the child's mouth, recorded using a Perspex grid overlay. The results indicated that the DVD subjects were poorer than the control children on all measures of tongue strength and endurance. While the inconsistent deviant children performed similarly to age-matched controls on the maximum tongue strength task, their performance on endurance and repetitive tasks fell between that of the DVD and control groups. The preliminary lip movement analysis suggested some deficit in control of lip movement for the DVD and inconsistent subjects. Overall the findings support the hypothesis that children with DVD and those with inconsistent deviant phonology have some form of motor impairment. The differential performance of the two subject groups on tongue strength and endurance tasks is in accordance with the hypothesis that DVD and inconsistent deviant phonology are distinct subgroups of developmental speech disorders. The need for further physiological investigation of the oro-motor skills of speech-impaired children is discussed.

Background: Safe and efficient swallowing relies on adequate tongue strength and endurance. Thus, tongue strength and endurance assessments are essential for swallowing rehabilitation for individuals with swallowing difficulties due to tongue structure and function abnormalities. These tongue functions can be objectively measured using a standard device. However, in Thailand, assessing tongue strength and endurance using standard devices is not widespread in clinical practice due to the high cost of importing these devices. Objective: This study aimed to develop a precise, accurate, and reliable tongue function measurement device for the clinical assessment of tongue strength and endurance. Materials and methods: This study was divided into three phases: 1) Development of a tongue strength and endurance measurement device in a laboratory setting and administration of a satisfaction questionnaire, 2) Trial of the prototype device with six participants, and 3) Assessment of the test-retest reliability of the developed device and investigation of tongue strength and endurance values with twenty participants. Results: As a result of this development, a novel device for measuring tongue strength and endurance was obtained, which provides measurements in units of newtons (N) and kilopascals (kPa) for strength and seconds (s) for endurance. The device’s development cost was significantly lower compared to imported commercially available devices while maintaining the performance standards for medical measurement devices. This was demonstrated by its accuracy ranging from 96.40% to 100%, high precision with a Coefficient of Variation (% CV) of 0.90% to 4.21%, and moderate to excellent reliability with an Intraclass Correlation Coefficient (ICC) of 0.56 to 0.93. Furthermore, statistically significant differences (p&lt;0.01) were observed between genders, especially in anterior tongue strength. Conclusion: The tongue strength and endurance measurement device developed through this study can be utilized for clinical tongue function assessment, giving patients more access to objective evaluations of tongue strength and endurance at a lower examination cost.

This pilot study examines the effects of two types of tongue strengthening exercises on tongue function measures of strength and endurance in a group of 31 healthy young subjects. Subjects underwent baseline and 1 month post-baseline assessments of tongue function and were randomized to one of three groups, including: (1) no exercise; (2) exercise group receiving standard tongue strength exercises using a tongue depressor, and (3) exercise group receiving tongue strengthening exercises using the Iowa Oral Performance Instrument. Results revealed a significantly greater change in maximum tongue strength in the group that received any treatment compared with the group receiving no treatment (p = 0.04). Results provide support for the theory that tongue strengthening exercises improve tongue strength in healthy young subjects.