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Effects of Oropharyngeal Strengthening Exercise (OSE) on Tongue Strength, Submental Muscle Activity, and Quality of Life in a Healthy Elderly Population

Park, Taeok
http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1427303150

Abstract Details

2015, Doctor of Philosophy (PhD), Ohio University, Speech-Language Pathology (Health Sciences and Professions).
Current swallowing interventions focus on rehabilitation in patients with dysphagia using compensatory and rehabilitation strategies. Studies evaluative the effectiveness of a preventative approach for those with a high risk for swallowing disorders are lacking. The risk of swallowing disorders is increased for older individuals. Many older individuals show weak tongue strength and reduced swallowing ability. Is it possible to improve their tongue strength and quality of life using a preventative swallowing intervention? This investigation begins with this question and hypothesizes that a preventative swallowing intervention will have a positive effect, because a strengthening exercise for swallowing muscles would increase muscular and swallowing reserve in older individuals. This investigation evaluates the value of a preventative approach by developing oropharyngeal strengthening exercise (OSE) applied using home-based and self-administered procedures. The OSE combined two swallowing exercises: tongue strengthening exercise and effortful swallow. The conceptual framework of the OSE is based on neuroadaptation, which implies the adaptive modification of the neurological system through training. The OSE may lead to neuromuscular adaptive modifications of swallowing physiology in older individuals. Specifically, changes through the OSE may include increases in the firing rate of motor units with increasing strength related to oropharyngeal swallowing muscles such as the tongue. The purpose of this study was to examine the effects of the OSE on (a) maximum tongue pressure as measured by the Iowa Oral Performance Instrument (IOPI), (b) peak amplitude of submental surface electromyography (sEMG), and (c) swallowing quality of life as measured by the SWAL-QOL in 27 healthy older individuals who had a mean age of 73 years old (range 58-85 years old) after 4 weeks of the OSE. The results of this study showed that the OSE had statistically significant and positive effects on increasing maximum tongue pressure and swallowing quality of life, but there was no difference in peak amplitude of submental sEMG after a 4-week OSE. Maximum tongue pressure increased from 41 kPa to 47 kPa after a 4-week OSE. On the swallowing quality of life questionnaires, participants perceived that physical symptoms related to swallowing were statistically significantly improved after a 4-week OSE. Particularly, frequency of choking during eating was statistically significantly reduced after a 4-week OSE. This investigation highlighted a new intervention to prevent swallowing disorders in older individuals. There were positive impacts of the OSE on objective and subjective measures. This investigation introduced a new swallowing intervention by combining two swallowing treatment exercises: tongue strengthening exercises and the effortful swallow. Combining these exercises was possible because the two exercises have a common physiological event, namely, pressing the tongue hard into the palate at the initiation of oral swallowing. The OSE was devised to be a more robust approach than the tongue strengthening exercise alone. In addition, OSE home-based and self-administered approach was both efficient and cost effective. Older individuals were able to perform the swallowing exercise at home independently, with only modest assistance such as a weekly call and email. Future research needs to refine the OSE and apply it to patients with dysphagia.
Youngsun Kim (Advisor)
Jennifer Horner (Committee Member)
John McCarthy (Committee Member)
Susan Williams (Committee Member)
112 p.
Speech Therapy
Swallowing exercise; Tongue strength exercise; effortful swallow; older individuals

Recommended Citations

Citations

  • Park, T. (2015). Effects of Oropharyngeal Strengthening Exercise (OSE) on Tongue Strength, Submental Muscle Activity, and Quality of Life in a Healthy Elderly Population [Doctoral dissertation, Ohio University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1427303150

    APA Style (7th edition)

  • Park, Taeok. Effects of Oropharyngeal Strengthening Exercise (OSE) on Tongue Strength, Submental Muscle Activity, and Quality of Life in a Healthy Elderly Population. 2015. Ohio University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1427303150.

    MLA Style (8th edition)

  • Park, Taeok. "Effects of Oropharyngeal Strengthening Exercise (OSE) on Tongue Strength, Submental Muscle Activity, and Quality of Life in a Healthy Elderly Population." Doctoral dissertation, Ohio University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1427303150

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Ohio University and OhioLINK.