Effects of Tongue Strength Training on Mealtime Function in Long-Term Care

• Published in: American journal of speech-language pathology 2017-11, Vol.26 (4), p.1213-1224
• Main Authors: Namasivayam-MacDonald, Ashwini M, Burnett, Lynsey, Nagy, Ahmed, Waito, Ashley A, Steele, Catriona M
• Format: Article
• Language: English
• Subjects: Age Factors; Aged, 80 and over; Aging; Aging (Individuals); Analysis; Aspiration; Biofeedback, Psychology; Biomechanical Phenomena; Body Composition; Care and treatment; Cognition; Cognitive ability; Cognitive disorders; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - physiopathology; Cognitive Dysfunction - psychology; Cognitive Dysfunction - therapy; Communication Disorders; Dementia; Dysphagia; Eating; Endurance; Evidence Based Practice; Exercise; Feasibility Studies; Female; Geriatric Assessment; Geriatrics; Gerontology; Groups; Homes for the Aged; Humans; Institutional Research; Intervention; Isometric Contraction; Long term care; Long term health care; Male; Meals; Medicine; Methods; Muscle Strength; Nursing; Nursing Homes; Older Adults; Older people; Ontario; Outcome Measures; Outcomes of Treatment; Physiological aspects; Pressure; Proof of Concept Study; R&D; Recovery of Function; Research & development; Resistance Training - methods; Respite Care; Sarcopenia; Screening Tests; Severity of Illness Index; Speech; Speech Improvement; Statistical Analysis; Strength training; Task performance; Therapy; Time Factors; Tongue; Tongue - physiopathology; Traumatic brain injury; Treatment Outcome; Treatment outcomes; Variance analysis
• ISSN: 1058-0360; 1558-9110
• DOI: 10.1044/2017_ajslp-16-0186

The primary aim of this study was to determine the feasibility and effectiveness of an 8-week tongue-strengthening intervention protocol for seniors with mild to moderately severe cognitive impairment in the long-term care setting. Outcome measures of interest included tongue strength, mealtime duration, and food intake. In this pre-post group study of treatment outcomes, data were collected from 7 adults (aged 84-99 years). Participants were observed across a series of mealtimes to determine mealtime duration and intake before and after 16 treatment sessions. During therapy, participants performed isometric strength exercises and tongue pressure accuracy tasks using the Iowa Oral Performance Instrument (model number 2.1, IOPI Medical). Differences in tongue strength as a function of treatment were explored between the first 3 and final 3 sessions using univariate repeated-measures analysis of variance. Single-subject methods were used to explore baseline and posttreatment data for measures of mealtime function. Anterior and posterior tongue strength increased significantly with therapy. There were no changes in mealtime function. This study shows proof of concept that some older adults with cognitive impairment are able to participate in a tongue-strengthening intervention and achieve improvements in tongue strength. Failure to find evidence of associated changes of mealtime function suggests that mealtime measures may not be directly sensitive to changes in tongue strength.