DGR 5 - May 2017

DGR 5 - May 2017


Total Duration: 1:28:00

Video: 1

Dysphagia Grand Rounds 5

Article: A Randomized Trial Comparing Two Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia

Authors: Catriona M. Steele, Mark T. Bayley, Melanie Peladeau-Pigeon, Ahmed Nagy, Ashwini M. Namasivayam, Shauna L. Stokely, and Talia Wolkin

Journal: Dysphagia. 2016;31(3):452-461

Download DGR 5 article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871779/

The objective of this study was to compare the outcomes of two tongue resistance training protocols. One protocol (“Tongue-Pressure Profile Training”) emphasized the pressure-timing patterns that are typically seen in healthy swallows by focusing on gradual pressure release and saliva swallowing tasks. The second protocol (“Tongue-Pressure Strength and Accuracy Training”) emphasized strength and accuracy in tongue-palate pressure generation and did not include swallowing tasks. A prospective, randomized, parallel allocation trial was conducted. Of 26 participants who were screened for eligibility, 14 received up to 24 sessions of treatment. Outcome measures of posterior tongue strength, oral bolus control, penetration-aspiration and vallecular residue were made based on videofluoroscopy analysis by blinded raters. Complete data were available for 11 participants. Significant improvements were seen in tongue strength and post-swallow vallecular residue with thin liquids, regardless of treatment condition. Stage Transition Duration (a measure of the duration of bolus presence in the pharynx prior to swallow initiation, which had been chosen to capture impairments in oral bolus control) showed no significant differences. Similarly, significant improvements were not seen in median scores on the Penetration-Aspiration Scale. This trial suggests that tongue strength can be improved with resistance training for individuals with tongue weakness following stroke. We conclude that improved penetration-aspiration does not necessarily accompany improvements in tongue strength, however tongue-pressure resistance training does appear to be effective for reducing thin liquid vallecular residue.

DGR 5: Comparing Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia | May 2017
In this webinar, Dr. Ianessa Humbert and Dr. Catriona Steele discuss the utility of tongue-pressure resistance training protocols in post-stroke dysphagia. Speech-language pathologist Rinki Varindani Desai poses questions at the end of the webinar and discusses the clinical implications of this study with these eminent dysphagia researchers.