Toronto Rehabilitation Institute â University Health Network, Toronto, Canada; 2. University of Toronto, Toronto, Canada; 3. Bloorview Research Institute ...
The effect of tongue strength on meal consumption in long term care: A pilot study Ashwini M.
1, 2 Namasivayam ,
Catriona M.
1, 2, 3 Steele
and Heather
4, 5 Keller
1. Toronto Rehabilitation Institute – University Health Network, Toronto, Canada; 2. University of Toronto, Toronto, Canada; 3. Bloorview Research Institute, Holland Bloorview Kids Rehab, Toronto, Canada; 4. University of Waterloo, Waterloo, Canada; 5. Schlegel-UW Research Institute for Aging, Waterloo, Ontario
Introduction
Results
Conclusions
As many as 74% of residents in long-term care (LTC) have swallowing difficulties1. Food intake may also be affected by fatigue. As fatigue sets in during mealtimes, the strength of the tongue may decline. In this pilot study, we explored the relationship between tongue strength and time to complete a meal.
Two participants out of 12 showed clinical signs of concern on the STAND: • 0 participants showed difficulties on the pureed challenge (applesauce); • 0 participants showed difficulties on the dry (saliva) swallow challenge; • 2 participants showed difficulty on the 3 oz. water swallowing challenge: • 1 of these 2 participants showed swallowing difficulties at meals and also had reduced tongue strength (mean: 13 kPa, maximum: 17kPa).
• There is a clear disparity in tongue strength between those who display clinical signs of swallowing difficulty at mealtimes and those who do not.
Purpose To determine whether tongue strength in elderly residents in a LTC facility is associated with: ∙ Signs of swallowing impairment on a modified version of the Screening Test for Acute Neurological Dysphagia (STAND)2; ∙ Length of time to eat a meal; ∙ Signs of swallowing impairment during meals, measured using the Edinburgh Feeding Evaluation in Dementia Scale (EdFED)3; ∙ Grams of food consumed.
Participants& Methods • Twelve adults (5 male, 7 female; mean age: 85, range 6599) were recruited from a long term care facility (LTC). • The IOPI (Iowa Oral Performance Instrument) was used to collect maximum anterior isometric tongue pressures and saliva swallow pressures. • Swallow screening was completed using 3 puree swallows, 2 dry swallows and a 3 oz. water swallow. • Meal observations were performed at 3 different meals (breakfast, lunch and dinner). Any overt signs of swallowing difficulties were noted. • Time in minutes to finish each meal was recorded. • Pre- and post-meal plate weights were used to calculate the amount of food eaten in grams.
The 4 residents who displayed swallowing difficulties at mealtimes had lower tongue strength (mean: 17 kPa, 95% confidence interval: 7-27) than those without swallowing difficulties (mean: 37 kPa, 95% CI: 29-44; p
