Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: Three case reports

Erin M Yeates¹, Sonja M Molfenter¹, Catriona M Steele^1,2,3,4

¹Toronto Rehabilitation Institute, Toronto, Canada; ²Department of Speech-Language Pathology, University of Toronto, Toronto, Canada; ³Canadian Institutes of Health Research New Investigator in Aging; ⁴Bloorview Kids Rehab, Toronto, Canada

Abstract: Dysphagia, or difficulty swallowing, often occurs secondary to conditions such as stroke, head injury or progressive disease, many of which increase in frequency with advancing age. Sarcopenia, the gradual loss of muscle bulk and strength, can place older individuals at greater risk for dysphagia. Data are reported for three older participants in a pilot trial of a tongue-pressure training therapy. During the experimental therapy protocol, participants performed isometric strength exercises for the tongue as well as tongue pressure accuracy tasks. Biofeedback was provided using the Iowa Oral Performance Instrument (IOPI), an instrument that measures tongue pressure. Treatment outcome measures show increased isometric tongue strength, improved tongue pressure generation accuracy, improved bolus control on videofluoroscopy, and improved functional dietary intake by mouth. These preliminary results indicate that, for these three adults with dysphagia, tongue-pressure training was beneficial for improving both instrumental and functional aspects of swallowing. The experimental treatment protocol holds promise as a rehabilitative tool for various dysphagia populations.

Keywords: speech-language pathology, dysphagia, rehabilitation, aging, strength, accuracy