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. 2021 Dec;45(6):440-449.
doi: 10.5535/arm.21126. Epub 2021 Dec 31.

Decreased Maximal Tongue Protrusion Length May Predict the Presence of Dysphagia in Stroke Patients

Hyunchul Cho  1 , Jeong Se Noh  1 , Junwon Park  1 , Changwook Park  1 , No Dam Park  2 , Jun Young Ahn  3 , Ji Woong Park  1 , Yoon-Hee Choi  1 , Seong-Min Chun  1
Affiliations

Decreased Maximal Tongue Protrusion Length May Predict the Presence of Dysphagia in Stroke Patients

Hyunchul Cho et al. Ann Rehabil Med. 2021 Dec.

Abstract

Objective: To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients.

Methods: Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS).

Results: The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%.

Conclusion: There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.

Keywords: Deglutition disorders; Stroke; Videofluoroscopic swallowing study.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Measurement of tongue length parameters: (A) MTPL and (B) FTL using quick tongue-tie assessment tool. Ratio of MTPL to FTL was calculated by dividing MTPL by FTL. MTPL, maximal tongue protrusion length; FTL, free tongue length.
Fig. 2.
Fig. 2.
Correlation between MTPL and dysphagia scales. (A) Videofluoroscopic Dysphagia Scale (VDS). (B) Penetration-Aspiration Scale (PAS) score. (C) Functional Oral Intake Scale (FOIS). MTPL, maximal tongue protrusion length.
Fig. 3.
Fig. 3.
Correlation between RMF and dysphagia scales. (A) Videofluoroscopic Dysphagia Scale (VDS). (B) PenetrationAspiration Scale (PAS) score. (C) Functional Oral Intake Scale (FOIS). RMF, ratio of maximal tongue protrusion length to free tongue length.
Fig. 4.
Fig. 4.
Receiver operating characteristic curve of RMF for prediction of aspiration. RMF, ratio of maximal tongue protrusion length to free tongue length; AUC, area under the curve.
See this image and copyright information in PMC

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