Relationship between tongue elevating exercises and tongue pressure

抄録

The tongue plays a variety of roles in mastication and swallowing. It takes food into the mouth and mixes it with saliva to form a bolus during the preparation stage. It starts upward movement from its apex, pressing the hard palate from the front to the back and moving the bolus of food to the pharynx during the oral stage. The tongue increases the internal pressure of the pharynx and moves the bolus of food to the esophagus during the pharyngeal stage. Therefore, to enhance the swallowing function, it is important to evaluate the functional movement of the tongue. The methods of tongue muscle training currently available vary in their intensity, duration and frequency. We compared the effectiveness of tongue pressure and tongue control, focusing on the different muscle types (white and red muscle fibers) that are used for instantaneous and sustained exercise.　The subjects were nine elderly people, 4 males and 5 females with an average age 85±8 years who were able to understand and practice this training. The subjects were either residents of a special elderly nursing home or attended a daycare center for seniors.　They were divided into two groups and asked to perform tongue resistance training with a spoon. One group performed 10 rounds of tongue elevation at maximum tongue pressure (the 10 time group) and the other did one round of tongue elevation for 10 seconds at maximum tongue pressure (the 10 second group). The subjects did three sessions a day, three times a week for 8weeks, with about a minute break between training sessions. As an evaluation method, tongue pressure and oral diadochokinesis (ODK) were measured every 2weeks. ODK measured the three sounds [pa], [ta] and [ka] every 10seconds, and measured the total number of times the subject could articulate these sounds. The subjects were trained and measurements were done in a chair or a wheelchair in an upright sitting position without using a backrest and with the feet placed on the ground.　Tongue pressure rose significantly in both groups from the first appointment up until 4 weeks. After that it increased relatively slowly from 4to 8weeks. Following 8weeks of training, the tongue pressure of the 10 second group had increased significantly more than that of the 10 time group, and it was significantly greater at each time point up until 8weeks. The [pa], [ta] and [ka] sounds of the ODK for the 10 time group did not differ significantly at each time point. There was no significant difference in the [pa] and [ka] sounds in the 10 second group at each time point. However, the [ta] sound in the 10 second group increased significantly from the first appointment by 6 and 8 weeks. Our findings suggest that sustained training may increase tongue pressure and tongue skill more effectively than instantaneous training. (J Osaka Dent Univ 2019; 53: 31‐38)