Abstract

BackgroundCommercially available tools for measuring oro-lingual pressures during swallowing or isometric (tongue ‘pushing’) tasks have either poor, or unknown, psychometric properties (stability, reliability) which means their validity in a clinical setting is unknown. A new wireless tool, OroPress, has been designed to address the shortcomings of existing devices. In this pilot cohort study of normal adults (i.e., people without dysphagia), the face validity of OroPress was examined when it was used to measure oro-lingual pressures during (i) isometric tongue strength (ITS) tasks and (ii) isometric tongue endurance (ITE) tasks.The effects of gender on isometric oro-lingual data, captured using OroPress, were compared to published oro-lingual pressure data recorded using either the Kay Swallowing Workstation or the Iowa Oral Performance Instrument (aka commercial tools).MethodsThirty five adults (17 males, 18 females), were purposefully recruited at the University of Limerick (UL), Ireland. They attended one session at the university-based clinic where their oro-lingual pressures were recorded while undertaking two isometric tasks by speech and language therapy student clinicians. OroPress was used to capture tongue strength and tongue endurance pressures during two trials of each condition and data were downloaded and analysed post-hoc. An independent-samples t-test and an ANOVA were used to examine the effect of gender on ITS pressures (as data were normally distributed) and an independent-samples t-test was used for the effect of gender on ITE pressures (where data were not normally distributed).ResultsOroPress is a portable tool that was reported as being ‘easy to use’ by student SLT clinicians. The intra-oral sensor was reportedly comfortable and ‘felt non-invasive’ for participants. Data from 34 participants (16 males, 18 females) are reported.Males did not demonstrate significantly higher mean ITS pressures than females (P = 0.057), although this approached significance, and there was no gender effect for ITE oro-lingual pressure. These results were consistent with published data from studies where other tools have been used to measure ITS pressures.ConclusionsPreliminary face validity of OroPress as a tool for recording isometric oro-lingual pressures was supported. This new wireless tool shows promise for being a criterion standard for recording oro-lingual pressures during isometric tasks.

Highlights

  • IntroductionAvailable tools for measuring oro-lingual pressures during swallowing or isometric (tongue ‘pushing’) tasks have either poor, or unknown, psychometric properties (stability, reliability) which means their validity in a clinical setting is unknown

  • Available tools for measuring oro-lingual pressures during swallowing or isometric tasks have either poor, or unknown, psychometric properties which means their validity in a clinical setting is unknown

  • The Madison Oral Strengthening Therapeutic (MOST) device [16] has been developed to record oro-lingual pressure. These devices have been used to examine the effect of isometric tongue strength (ITS)- i.e., recorded maximal oro-lingual pressure reached during approximately one second of resistance [13] on an efficient and/or safe swallow [11,12,13,14,15,17]

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Summary

Introduction

Available tools for measuring oro-lingual pressures during swallowing or isometric (tongue ‘pushing’) tasks have either poor, or unknown, psychometric properties (stability, reliability) which means their validity in a clinical setting is unknown. Speech and language therapists (SLTs) use subjective methods to examine lingual control, e.g., by judging the force a patient applies when pushing their tongue against a tongue depressor held by the clinician [2] Such assessments have no established validity (the degree to which the tool measures what it is intended to measure [3]) or reliability (the extent to which a test or measurement is reproducible [4]), so their accuracy and clinical utility may be questioned. For this reason, researchers prefer to assess lingual control by examining isometric (pushing against a resistance) strength (force) and/or endurance (ability to sustain force over time) of the tongue, using instrumental oro-lingual pressure measurement devices [2]. By contrast, examining isometric tongue endurance (ITE)i.e., maximum oro-lingual pressure sustained over an extended time period [13]; as a representative measure of tongue function has received little attention [12]

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