Park et al. (2015)(1515 Park JS, Kim HJ, Oh DH. Effect of tongue strength training using the Iowa Oral Performance Instrument in stroke patients with dysphagia. J Phys Ther Sci. 2015;27(12):3631-4. http://dx.doi.org/10.1589/jpts.27.3631. PMid:26834320. http://dx.doi.org/10.1589/jpts.27.3631...
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27 adults with post-stroke dysphagia. |
-Tongue pressure against the palate using IOPI (tip and dorsum), maintaining 80% of 1 MR for 2 s. |
10 series with 5 repetitions (anterior + posterior)/day, 5x/week, for 4 weeks, |
-IOPI (maximum anterior and posterior pressure) |
-Anterior pressure: |
-Increase in the anterior portion in EG and CG. |
South Korea |
EG = 15 individuals, m = 67.3±10.6 years, 6 men (exercises + dysphagia therapy). |
minimum 30-s intervals between repetitions. |
-Videofluoroscopy |
EG: 18.9±6.7 kPa (before) and 20.7±6.6 kPa (after); |
-Increase in the posterior portion in EG. |
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CG = 14 individuals, m = 65.8±11.5 years, 7 men (dysphagia therapy) |
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CG: 22±5.7 kPa (before) and 22.9±5.4 kPa (after). |
-Improved oral phase of swallowing in EG and CG and pharyngeal phase of swallowing in EG. |
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-Posterior pressure: |
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EG: 16.2±4.7 kPa (before) and 18.5±4.1 kPa: (after); |
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CG: 17.3±4.3 kPa (before) and 17.7±4.36 kPa (after). |
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Byeon |
48 adults with post-stroke dysphagia. |
-Tongue protrusion, tongue lifting, and tongue lowering. |
Exercises performed for 30 minutes a day, 5x/week, for 3 weeks. |
-IOPI (lifting pressure and protrusion pressure, lip pressure and cheek pressure) |
-Anterior tongue pressure |
-Increased anterior tongue lifting pressure in EG and CG. |
(2016)(1616 Byeon H. Effect of orofacial myofunctional exercise on the improvement of dysphagia patients’ orofacial muscle strength and diadochokinetic rate. J Phys Ther Sci. 2016;28(9):2611-4. http://dx.doi.org/10.1589/jpts.28.2611. PMid:27799705. http://dx.doi.org/10.1589/jpts.28.2611...
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EG = 23 individuals, m = 62.5±6.5 years, 8 men (exercises + tactile thermal stimulation). |
-Massage on the cheeks and neck, lip closure and protrusion, cheek inflation and sucking, and tongue protrusion, lifting, and lowering. |
-Praat (diadochokinesia) |
EG: 20.8±13.2 kPa (before) and 26.8±14.3 kPa (after) |
-Improved diadochokinesia in EG. |
South Korea |
CG = 25 individuals, m = 64.1±7.1 years, 6 men (tactile thermal stimulation). |
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CG: 18.5±11.5 kPa (before) and 21.5±10.8 kPa (after). |
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Kim et al. (2017)(1717 Kim HD, Choi JB, Yoo SJ, Chang MY, Lee SW, Park JS. Tongue-to-palate resistance training improves tongue strength and oropharyngeal swallowing function in subacute stroke survivors with dysphagia. J Oral Rehabil. 2017;44(1):59-64. http://dx.doi.org/10.1111/joor.12461. PMid:27883209. http://dx.doi.org/10.1111/joor.12461...
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35 individuals with post-stroke dysphagia |
-Tongue counter-resistance exercise against the palate (anterior and posterior region). |
30x/day, 5x/week, for 4 weeks. |
-IOPI (maximum anterior and posterior tongue pressure) |
-Anterior pressure |
-Increased anterior and posterior tongue pressure in EG in 4 weeks. |
South Korea |
EG1 = 18 individuals, m = 62.2±11 years, 11 men (tongue force exercises + traditional dysphagia therapy). |
-Videofluoroscopy (functional swallowing assessment - Videofluoroscopic Dysphagia Scale and Rosenbek’s penetration-aspiration scale) |
EG: 32.7±10.8 kPa (before) and 41.9±9.5 kPa (after); |
-Increased anterior and posterior tongue pressure in relation to CG. |
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CG = 17 individuals, m = 59.3±10.2, 8 men (traditional dysphagia therapy). |
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GC: 29.6±10.4 kPa (before) and 32.5±10.2 kPa (after). |
-Improved oral and pharyngeal phases of swallowing in EG and CG. |
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-Posterior pressure |
-Improved oral and pharyngeal phases of swallowing EG in relation to CG. |
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EG: 28.1±7.6 kPa (before) and 39.1±7.8 kPa (after) |
-Improvement on the penetration-aspiration scale in EG and CG. |
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CG: 26.6±9.1 kPa (before) and 31.4±9.7 kPa (after). |
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Byeon |
21 individuals with post-stroke dysarthria |
EG and CG: pressing the IOPI bulb against the palate, exerting 50%, 75%, and 100% of the maximum tongue force; 4 series with 5 repetitions. |
30min/day, 5x/week, for 4 weeks. |
-IOPI (maximum tongue pressure); |
-Anterior pressure |
-EG had greater maximum tongue force than CG. |
(2018)(1818 Byeon H. Is the combined application of tongue pressure training and tongue base exercise more effective in improving the strength of tongue and lips in Korean patients with flaccid dysarthria? Indian J Public Health. 2018;9(11):1041-7. http://dx.doi.org/10.5958/0976-5506.2018.01594.2. http://dx.doi.org/10.5958/0976-5506.2018...
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EG = 10 individuals, m = 65.85±9.23 years (tongue pressure exercises + tongue exercises). |
EG: (i) Lifting the tip of the tongue and sustaining it for 5 s; (ii) lifting the tip of the tongue against a spatula and sustaining it for 5 s; (iii) lateralizing the tongue and sustaining it for 5 s to the right and 5 s to the left. |
-Percentage of correctly articulated consonants. |
EG: 10.7±9.8 kPa (before) and 20.8±16.9 kPa (after); |
-No differences were found in the percentage of correctly articulated consonants between EG and CG. |
South Korea |
CG = 11 individuals, m = 67.03±7.60 (tongue pressure exercises) |
(iv) lateralizing the tongue against a spatula and sustaining it for 5 s to the right and 5 s to the left; (v) protruding the tongue for 5 s and protruding the tongue against a spatula for 5 s. |
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CG: 11.4±8.1 kPa (before) and 17.9±15.1 (after). |
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Hsiang et al. (2019)(2525 Hsiang CC, Chen AW, Chen CH, Chen MK. Early postoperative oral exercise improves swallowing function among patients with oral cavity cancer: a randomized controlled trial. Ear Nose Throat J. 2019;98(6):E73-80. http://dx.doi.org/10.1177/0145561319839822. PMid:31088304. http://dx.doi.org/10.1177/01455613198398...
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50 adults with oral cavity and/or oropharyngeal cancer submitted to tumor resection surgery during a recent post-operational period (48 men, m = 56.2±8.8 years). |
-Tongue, lip, and mandible mobility exercises: Sustaining maximum structure extension for 1-2 s, then relaxing. |
Exercises performed 10x/session, |
-Videofluoroscopy (Rosenbek’s penetration-aspiration scale and oral cavity and pharyngeal residues) |
Not assessed |
-Improvement on the penetration-aspiration scale in EG. |
China |
EG = 25 (exercises) |
-Tongue resistance exercises: counter-resistance against a spatula for 5 s. |
3 sessions/day, for 12 weeks. |
-Decreased amounts of nectar, honey, and pudding consistency residues in EG. |
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CG = 25 (changes in body posture and food consistency) |
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Park et al. (2019)(1919 Park HS, Oh DH, Yoon T, Park JS. Effect of effortful swallowing training on tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia: a double-blind, randomized controlled trial. Int J Lang Commun Disord. 2019;54(3):479-84. http://dx.doi.org/10.1111/1460-6984.12453. PMid:30693627. http://dx.doi.org/10.1111/1460-6984.1245...
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24 adults with post-stroke dysphagia. |
-Effortful swallowing training: pressing the tongue firmly against the palate while contracting the neck muscle and swallowing as strongly as possible. |
Exercises performed 10x/session, |
-IOPI (maximum anterior and posterior pressure) |
-Anterior pressure: |
-Increased anterior pressure in EG and CG. |
South Korea |
EG = 12 individuals, m = 66.5±9.5 years, 6 men (effortful swallowing + dysphagia therapy). |
3 sessions/day, for 4 weeks. |
-Videofluoroscopy (functional swallowing assessment - (Videofluoroscopic Dysphagia Scale) |
EG: 20.8±4.3 kPa (before) and 27.6±4.3 kPa (after); |
-Increased posterior pressure in EG and CG. |
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CG = 12 individuals, m = 64.8±11.2 years, 5 men (dysphagia therapy) |
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CG: 21.2±5.8 kPa (before) and 23.1±5.4 kPa (after). -Posterior pressure: |
-Improved oral and pharyngeal phases of swallowing in EG and CG. |
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EG: 16.6±5.0 kPa (before) and 23.2±5.4 kPa (after); |
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CG: 16.7±4.4 kPa (before) and 18.2±4.5 kPa (after). |
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