Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury

Abstract

The purpose of this study was to measure treatment outcomes in a group of six adults with chronic dysphagia following acquired brain injury, who each completed 24 sessions of tongue-pressure resistance training, over a total of 11–12 weeks. The treatment protocol emphasized both strength and accuracy. Biofeedback was provided using the Iowa Oral Performance Instrument. Amplitude accuracy targets were set between 20–90% of the patient's maximum isometric pressure capacity. Single subject methods were used to track changes in tongue strength (maximum isometric pressures), with functional swallowing outcomes measured using blinded ratings of a standard pre- and post-treatment videofluoroscopy protocol. Improvements were seen in post-treatment measures of tongue pressure and penetration–aspiration. No improvements were seen in pharyngeal residues, indeed worsening residue was seen in some patients.

Keywords::

• Deglutition
• swallowing
• rehabilitation
• tongue
• manometry
• treatment
• intervention
• speech-language pathology.

Acknowledgements

The authors gratefully acknowledge assistance provided by Melanie Moore, Ashley Waito, and Tiffany Fei with data collection and processing. The authors acknowledge the support of the Toronto Rehabilitation Institute, which receives funding under the Provincial Rehabilitation Research Program from the Ministry of Health and Long-term Care in Ontario. The views expressed do not necessarily reflect those of the Ministry.

Declaration of interest: The authors report no conflicts of interest.

This material was based on work supported by operating and career award grants from the Canadian Institutes of Health Research (grants 69521, 82668, 84534, and 83888). Additional funding support was provided by the Toronto Rehabilitation Institute and an Ontario Ministry of Research and Innovation Early Researcher Award to the first author.