Tongue Pressure Production Research Articles

Effects of tongue pressure sensor sheet on the signal waveform of laryngeal movement produced by bend sensor during deglutition

To evaluate the effects of the application of tongue pressure sensor sheet on the signal waveform of laryngeal movement produced by the bend sensor during deglutition. Twelve adult male subjects were recruited to perform a single swallow of 5 ml water when sitting on the dental chair with upright position. The data recorded by bend sensor was obtained with attaching tongue pressure sensor sheet simultaneously or not. Then the measured parameters by bend sensor with or without concurrent application of tongue pressure sensor sheet were compared. There were no significant differences between the same time point on the signal waveform produced by bend sensor whether concurrently attaching tongue pressure sensor sheet or not (P > 0.05). Additionally, we found no statistical significances between matched phases on the signal waveform recorded by bend sensor with or without application of tongue pressure sensor sheet (P > 0.05). The findings in this study suggest us that the usage of tongue pressure sensor sheet exerted no influences on the waveform of the laryngeal movement produced by bend sensor during deglutition, facilitating us to further apply tongue pressure sensor sheet and bend sensor simultaneously to record tongue pressure production and hyoid activity during deglutition.

Role of tongue pressure production in oropharyngeal swallow biomechanics

The tongue is important for orofacial movements, including swallowing. Although numerous studies have focused on tongue pressure against the palate, its physiological role has not been fully evaluated. The tongue pressure generation may have the temporal coordination with the swallowing relational organs. The aim of this study was to clarify the physiological mechanisms of tongue pressure and to investigate the temporal relationship among tongue pressure, supra-hyoid muscle activity, and videofluorographic (VF) images during swallowing. Fifteen healthy young subjects participated. Tongue pressure measured using a sensor sheet with five channels, electromyographic EMG, and VF was recorded synchronously during 4-ml barium swallowing. Swallowing behavior in VF images with and without the sensor sheet was compared. Furthermore, the temporal relationship between events measured from tongue pressure, EMG, and VF was evaluated. Swallowing behavior on VF images was not affected by placement of the sensor sheet. Tongue pressure at the posterio-lateral point of the hard palate tended to have biphasic peaks. Tongue pressure production with a monophasic pattern appeared during the same period as the second peak in the biphasic pattern. The onset of tongue pressure was later than the start of hyoid movement and onset of EMG, and offset was observed between the hyoid at the up-forward position and reposition. Onset of tongue pressure at the anterior area was correlated with the start of slight hyoid elevation. Offset of tongue pressure at the posterio-lateral points was strongly time locked with the hyoid at the up-forward position. The present results suggested the temporal coordination of tongue pressure generation with the swallowing-related organs. That is, the tongue pressure was produced for bolus propulsion, and was closely related to hyoid movement temporally during swallowing. These results may contribute to clarify the clinical state with the disorder of tongue kinetics.

Effect of the Effortful Swallow and the Mendelsohn Maneuver on Tongue Pressure Production against the Hard Palate

Although effortful swallow and the Mendelsohn maneuver are commonly used in dysphagia rehabilitation, little is known about their effects on tongue-palate pressure production. The purpose of this study was to investigate the effects of effortful swallow and the Mendelsohn maneuver on tongue pressure production. Fourteen healthy volunteers (10 men, 4 women; age range=21-41years) participated. Tongue pressures during dry swallow, water swallow, effortful swallow, and the Mendelsohn maneuver were measured using a sensor sheet system with five measurement points on the hard palate. Sequential order, duration, maximal magnitude, and the integrated value of tongue pressure at each measurement point were compared among the four tasks. Onset of tongue pressure at the posterior-circumferential parts occurred first in the Mendelsohn maneuver; that at the anterior-median part was earlier than at other parts in the effortful swallow. At all measurement points, tongue pressure duration was significantly longer in the Mendelsohn maneuver than in other tasks. Effortful swallow was most effective in increasing tongue pressure. The integrated value of tongue pressure at the posterior-circumferential parts in the Mendelsohn maneuver and at the median parts in the effortful swallow showed a tendency to increase. These results suggest that tongue pressure increases along a wide part of the hard palate in effortful swallow because the anchor of tongue movement is emphasized at the anterior part of the hard palate. The Mendelsohn maneuver provides prolonged and accentuated tongue-palate contact at the posterior-circumferential parts, which might be important for hyoid-laryngeal elevation during swallowing.

嚥下時舌圧発現と喉頭運動の協調性

嚥下時舌圧発現と喉頭運動の協調性

Tongue pressure production while swallowing water and pudding and during dry swallow using a sensor sheet system

The tongue assumes an important role in bolus formation and transportation to the oropharynx and in retaining pharyngeal pressure during mastication and swallowing. Although the state of tongue-palate contact during swallowing is thought to change with bolus type, the details of these changes have yet to be clarified under normal physiological conditions. The purpose of this study was to examine the effect of bolus type on tongue pressure production against the hard palate during swallowing. Tongue pressures during swallowing 10 mL of water and 10 g of pudding and during dry swallow were measured with a sensor sheet system with five measurement points to evaluate normal physiological swallowing in 10 healthy dentate individuals. There was a common pattern in the sequential order of tongue pressure generation among the three swallowing conditions: tongue pressure was generated significantly earlier at the anterior-median part, followed by the posterior parts. During swallowing pudding and dry swallow, the duration of tongue pressure tended to increase at all channels except for the posterior-median part. The maximal magnitude of tongue pressure was significantly higher when swallowing pudding than when swallowing water at all channels except for the posterior-median part. The integrated value of tongue pressure was significantly higher when swallowing pudding than when swallowing water at all channels except for the posterior-median part. From these results, it was considered the tongue changed the sequential order, the duration and the magnitude of tongue pressure production according to the swallowing conditions (liquid swallowing, semisolid swallowing, dry swallow).

Differences in biomechanical features of tongue pressure production between articulation and swallow

Summary The purpose of this study was to compare the tongue pressure against the hard palate during the articulation of a monosyllable with that during swallowing. The participants were 20 healthy adults without swallowing or articulation disorder (10 men and 10 women, mean age ± standard deviation: 22·5 ± 0·9 years). Tongue pressure during articulation of [ki] (articulatory pressure) and during dry swallowing (swallowing pressure) was recorded by a 0·1-mm-thick sensor sheet with five measuring points attached to the hard palate. Biomechanical parameters such as maximal magnitude, duration, integrated value and slope gradient were compared between articulatory pressure and swallowing pressure at each measuring point. Although swallowing pressure was produced at each measuring point, articulatory pressure was found only in the posterior circumferential parts of the hard palate and was smaller in magnitude (14·9-16·7% of swallowing pressure) and integrated value, which meant the amount of work by tongue pressing (7·0-7·9%), shorter in duration (26·6-31·8%) and shallower in slope gradient, which meant the speed of tongue pressing (26·9-27·4%). Maximal magnitude was closely correlated with duration (R(2) = 0·386) and slope gradient (R(2) = 0·843) for articulatory pressure. These results first show the biomechanical differences between articulation and swallowing in terms of tongue contact with the hard palate. The findings suggest that tongue pressure measurement might be a useful investigation for patients with tongue motor disorder.

Relationship between Tongue Pressure and Dysphagia in Stroke Patients

Background: Although poststroke dysphagia is an important issue for determining prognosis, the pathophysiology of oral-phase dysphagia has yet to be clarified due to a lack of adequate devices and protocols. The present study investigated the relationships between swallowing pressure production by the tongue and dysphagia in stroke patients using a newly developed method of tongue pressure measurement with a sensor sheet system. Methods: Subjects were 64 stroke patients, including 30 patients with dysphagia. A T-shaped sensor sheet with 5 measuring points was attached to the hard palate to record tongue pressure while swallowing 5 ml of water. The average maximal magnitude and incidence of abnormalities such as asynchronous and/or polyphasic patterns in tongue pressure waves in 5 locations were compared between patients with and without dysphagia. Results: The average maximal tongue pressure was significantly smaller in patients with dysphagia than in those without dysphagia. Asynchronous and polyphasic patterns showed a sensitivity of 63 and 87%, and a specificity of 91 and 71%, respectively, for identifying patients with dysphagia. Conclusion: Tongue pressure production during swallowing appears closely related to poststroke dysphagia. Tongue pressure measurement appears useful for evaluating the pathophysiology of oral-phase dysphagia in stroke patients.

Age-related Changes in Tongue Pressure during Swallowing

Although swallowing movement is known to change with aging, age-related differences in the tongue pressure for propelling a bolus from the oral cavity into the pharynx have yet to be investigated in a physiological condition. We hypothesized that tongue pressure during swallowing changed with aging and, using a 0.1-mm-thick sensor sheet with 5 measuring points, measured it while a 15-mL quantity of water was swallowed by young and elderly dentate individuals. Both groups showed a similar order of tongue pressure production at each point. However, the elderly group showed longer duration at each point, lower maximal magnitude in the anterio-median part of the hard palate, and higher magnitude in the circumferential parts of the hard palate than the young group. These results provide the first quantitative evidence of the age-related changes in tongue movement during natural swallowing, which could be attributed to muscle weakening and morphological changes in the oropharynx.

Involvement of Sensory Input from Anterior Teeth in Deglutitive Tongue Function

Swallowing is a reflex that receives sensory information from the peripheral nerves and from the cerebral cortex. The aim of the present study was to investigate whether the sensory input from anterior teeth affects the functional characteristics of tongue pressure applied against the hard palate during swallowing. Subjects were eight healthy volunteers. Tongue pressure against the hard palate during swallowing 10 ml of water was measured under two conditions: preanesthesia and postanesthesia of anterior teeth. The sensory deprivation of anterior teeth was performed by periodontal anesthesia. Tongue pressure was measured using a multiple tactile array sensor (MTAS) with eight sensor channels arranged in tandem. The duration of the tongue pressure production during swallowing was increased under periodontal anesthesia. In addition, the maximum tongue pressure and the pressure integral during swallowing were decreased under periodontal anesthesia, in particular at the anterior region of the palate. These findings indicate that sensory input from anterior teeth, including periodontal mechanoreceptor, affects the deglutitive tongue pressure and duration and provides peripheral feedback to modulate some aspects of the neurophysiologic control of deglutitive tongue movement.

Application of Tongue Pressure Measurement to Rehabilitation of Dysphagic Patients with Prosthesis

Tongue plays an important role by making contact with palate in swallowing. This study was aimed for investigating the utility of originally developed measuring system of tongue pressure in the rehabilitation of dysphagic patients with prosthesis. Subject was a 68 years old male post-surgical laryngeal cancer patient who underwent percutaneus endoscopic gastrostomy because of dysphagia. Tongue pressure during dry swallow was recorded by using our original sensor sheet system (Nitta, Japan) with five measuring points (Chs.1-5) attached on the palatal surface of maxillary denture (RPD). Tongue impression was taken by his maxillary denture and the palatal contour was changed into palatal augmentation prosthesis (PAP), then tongue pressure with PAP was recorded and compared with that with RPD. Magnitude of tongue pressure on median line (CHs.1-3) of palatal surface of RPD was nearly 0 and that on the circumferential part (Chs.4 and 5) had laterality. In PAP, however, magnitude of tongue pressure on the median line increased and showed normal pattern (Ch.1>Ch.2>Ch.3) and that on the circumferential part showed no laterality. Improvement of the tongue pressure production described by our system might contribute to the bolus transport in oral phase of swallowing.

Tongue pressure against hard palate during swallowing in post‐stroke patients

The tongue plays an important role in swallowing by contacting the palate. The aim of the present study was to investigate the characteristics of tongue pressure production during swallowing in post-stroke patients using a newly developed sensor sheet. Ten post-stroke inpatients with hemiplegia and five healthy volunteers participated in this study. Magnitude of tongue pressure during a dry swallow was measured using a newly developed sensor sheet comprising five sensors applied directly to the palate or to the palatal surface of a maxillary denture using denture adhesive. Swallowing ability was evaluated by measuring the time taken to swallow 30 ml of water. The magnitude of tongue pressure was compared between the post-stroke patients and healthy subjects as well as between each measuring point in both groups. The relationship between tongue pressure and swallowing ability and that between tongue pressure and state of occlusal support were also examined. The magnitude of tongue pressure in the post-stroke patients was smaller than that of the healthy subjects at the measuring points along the median line (Welch test, p < 0.05), larger in the non-paralysed side than in the paralysed side (two-way ANOVA, p < 0.05), and was influenced by swallowing ability and occlusal support (Welch test, p < 0.05). Measurement of the magnitude of tongue pressure shows promise as a simple, non-invasive and quantitative method by which tongue activity in post-stroke patients, in whom swallowing ability is a concern, could be evaluated.