Stroke tongue
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Stroke and Tongue Function: Insights from Recent Research
Effortful Swallowing Training (EST) for Tongue Strength and Swallowing Function
Effortful Swallowing Training (EST) has been shown to significantly improve tongue strength and swallowing function in stroke patients with dysphagia. A study involving stroke patients demonstrated that those who underwent EST exhibited greater improvements in both anterior and posterior tongue strength compared to a control group that performed saliva swallowing exercises. Additionally, the EST group showed notable enhancements in the oral phases of the Videofluoroscopic Dysphagia Scale (VDS).
Tongue-to-Palate Resistance Training (TPRT) for Dysphagia
Tongue-to-Palate Resistance Training (TPRT) has also been effective in improving tongue strength and oropharyngeal swallowing function in stroke patients. In a controlled trial, participants who engaged in TPRT showed significant improvements in both anterior and posterior tongue strength, as well as better scores in the oral and pharyngeal phases of the VDS, compared to those who only received traditional dysphagia therapy.
Tongue Pressure and Swallowing Ability
The measurement of tongue pressure against the hard palate during swallowing provides valuable insights into the swallowing abilities of post-stroke patients. Research indicates that post-stroke patients generally exhibit lower tongue pressure compared to healthy individuals, and this reduced pressure is associated with impaired swallowing ability. The study also found that tongue pressure was higher on the non-paralyzed side of the tongue, suggesting a compensatory mechanism.
Tongue Stretching Exercises (TSE) for Oromotor Function
Tongue Stretching Exercises (TSE) have been shown to improve tongue motility and oromotor function in stroke patients with dysphagia. A randomized controlled trial revealed that patients who performed TSE demonstrated significant improvements in tongue motility, bolus formation, tongue-to-palate contact, and oral transit time, compared to a control group.
Comparing Tongue Resistance Training Protocols
A study comparing two different tongue resistance training protocols found that both methods significantly improved tongue strength and reduced vallecular residue with thin liquids in post-stroke patients. However, no significant differences were observed in oral bolus control or penetration-aspiration scores between the two protocols, indicating that both approaches are effective for enhancing tongue strength but may not directly impact other aspects of swallowing function.
Tongue Hygiene and Function in Acute Stroke
Maintaining tongue hygiene and function is crucial for managing prognosis in acute stroke patients. Structural equation modeling (SEM) analysis has shown a strong relationship between tongue function and swallowing function, although no direct statistical relationship was found between tongue hygiene and tongue function. This underscores the importance of focusing on tongue function to improve feeding and swallowing outcomes.
Lingual Hemiparalysis and Tongue Shape
Stroke-induced lingual hemiparalysis affects the grooving of the tongue but not its symmetry. Research using ultrasound to investigate tongue shape during speech production found that stroke patients had significantly reduced midlingual concavity, which could impact speech acceptability and intelligibility.
Tongue Stimulation in Neurorehabilitation
Tongue stimulation has emerged as a novel method for inducing neuroplasticity and improving motor recovery in stroke patients. Studies have shown its effectiveness in enhancing balance and motor functions, suggesting that it could be a valuable addition to neurorehabilitation protocols.
Predicting Pneumonia Using Tongue Pressure Measurements
Low tongue pressure is a significant predictor of pneumonia in acute stroke patients. A study found that patients with lower tongue pressure were more likely to develop pneumonia, highlighting the importance of regular tongue pressure assessments to identify at-risk individuals and implement timely interventions.
Tongue Manipulation for Speech Improvement
Tongue manipulation techniques, such as pulling and massage, have been shown to improve speech function in acute ischemic stroke patients with aphasia. Clinical observations indicate that these methods are effective, safe, and well-tolerated, making them a promising option for speech rehabilitation in stroke patients.
Conclusion
Recent research underscores the critical role of tongue strength and function in the rehabilitation of stroke patients. Various training and therapeutic interventions, including EST, TPRT, TSE, and tongue manipulation, have demonstrated significant benefits in improving swallowing and speech functions. Regular assessment and targeted interventions can enhance recovery outcomes and reduce complications such as pneumonia in stroke patients.
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