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The effects of tongue pressure strength and accuracy training on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia: a preliminary randomized clinical trial

Moon, Jong-Hoona,*; Hahm, Suk-Chanc,*; Won, Young Sikd,†; Cho, Hwi-Youngb,†

International Journal of Rehabilitation Research: September 2018 - Volume 41 - Issue 3 - p 204–210
doi: 10.1097/MRR.0000000000000282
Original articles

Tongue pressure strength and accuracy training (TPSAT) has been proposed as an intervention to improve dysphagia. However, the effects of TPSAT on dysphagia in subacute stroke patients remain unclear. The aim of this study was to investigate the effects of TPSAT on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia. Sixteen subacute stroke patients were assigned randomly to two groups: the TPSAT group (n=8) or the control group (n=8). In the former, both TPSAT and traditional dysphagia therapies were performed for 30 min each per day; in the latter, only traditional dysphagia therapy was performed for 30 min twice a day. Both groups performed each daily intervention five times per week for 8 weeks. To assess the tongue pressure strength, maximum isometric tongue pressures (MIPs) of the anterior and posterior tongue using the Iowa Oral Performance Instrument were measured before and after the intervention. Mann Assessment of Swallowing Ability (MASA) and Swallowing-Quality of Life (SWAL-QOL) were also used to assess the swallowing function and quality of life, respectively. TPSAT with traditional dysphagia therapy significantly improved MASA, SWAL-QOL, and MIPs both anteriorly and posteriorly, and traditional dysphagia therapy significantly increased MASA, SWAL-QOL, and MIPs anteriorly (P<0.05). The TPSAT group showed a significant improvement in anterior and posterior MIPs and tongue movement score in MASA compared with the control group (P<0.05). Our findings suggest that TPSAT may significantly improve dysphagia management in subacute stroke patients.

Departments of aOccupational Therapy, Graduate School

bPhysical Therapy, Gachon University, Incheon

cGraduate School of Integrative Medicine, CHA University, Seongnam

dDepartment of Occupational Therapy, Shinsung University, Dangjin, Republic of Korea

*Jong-Hoon Moon and Suk-Chan Hahm contributed equally to the writing of this article as co-first author.

† Young Sik Won and Hwi-Young Cho contributed equally to the writing of this article.

Correspondence to Hwi-Young Cho, PhD, PT, Department of Physical Therapy, College of Health Science, Gachon University, 191 Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea Tel: +82 328 204 560; fax: +82 328 204 420; e-mail:

Received October 11, 2017

Accepted March 10, 2018

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