Optimal approaches for measuring tongue-pressure functional reserve

Area of Science:

• Swallowing biomechanics
• Gerontology
• Speech-language pathology

Background:

• Tongue-palate pressure is crucial for evaluating dysphagia.
• Maximum isometric tongue-palate pressures (MIPs) decrease with age and in dysphagia.
• Functional reserve (FR) quantifies the difference between MIPs and swallowing pressures, with reduced FR potentially indicating dysphagia risk.

Purpose of the Study:

• To compare various methods for calculating functional reserve (FR).
• To identify and recommend an optimal approach for measuring FR.
• To investigate the relationship between FR, age, and MIPs.

Main Methods:

• Collected tongue-palate pressure data from 78 healthy adults (aged 40-60 and >60).
• Measured anterior/posterior MIPs, regular (RESS) and effortful (ESS) saliva swallows, and water swallows.
• Calculated six different FR measures, exploring correlations with age and MIPs, and the impact of normalization.

Main Results:

• An optimal FR measure was identified as the difference between maximum MIP and mean saliva swallowing pressure.
• This optimal FR measure declines with age.
• When normalized to an individual's MIP range, the age-related decline in FR was no longer significant.

Conclusions:

• The optimal method for calculating functional reserve involves comparing maximum isometric tongue-palate pressure with mean saliva swallowing pressures.
• While FR declines with age, normalization to an individual's MIP range suggests that functional reserve may not inherently decrease in healthy aging.
• This finding has implications for understanding age-related changes in swallowing function and dysphagia risk assessment.