• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.91-99
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• 2020

Objective : The purpose of this study was to investigate the effects of the IOPI articulator strength training program on articulator(tongue and lip) muscle strength, numbers of /l, s, ʨ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates, and sequential motion rate changes in patients with spastic dysarthria. Methods : Three cases of patients with spastic dysarthria living in Jeju, Korea, were included in this study. A single subject design was selected to study changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates and sequential motion rates. Results : After the articulator strength training program was conducted on patients with spastic dysarthria, there were positive changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy on the alternate motion rates and sequential motion rates. Conclusion : Our findings suggest that IOPI articulator strength training program could be very useful for the most representative childeren with cerebral palsy if conducted in various subtypes of dysarthric patients and linked with articulatory function training with IOPI at home.

• Phonetics and Speech Sciences
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• v.6 no.2
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• pp.97-106
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• 2014

The purpose of this study was to (1) establish a Korean adult normative data for Iowa Oral Performance Instrument, (2) investigate the characteristics of maximal tongue and lip strength and tongue endurance scores according to age and gender, and (3) examine the correlation of those scores. The results showed that there were no significant differences of gender in maximal tongue strength and tongue endurance scores. But there were significant differences of age in maximal tongue and lip strength and tongue endurance scores. The data will provide an important database for speech language pathology with the purpose of diagnosis and treatment of tongue and lip dysfunction.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.156-166
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• 2017

The purpose of this study was to evaluate the effect of the tongue's maximum resistance training program on the accuracy of the tongue training program using the Iowa Oral Performance Instrument (IOPI) and to compare the effects of tongue muscle strength and spoken language function on objective function. The experiment was diagnosed with stroke hemiplegia divided into tongue pressure strength and accuracy training therapy group and the oromotor exercise therapy group Anterior Tongue Pressure(ATP), Posterior Tongue Pressure (PTP), and Posterior Tongue Pressure (PTP) were measured before and after the intervention to evaluate changes in tongue strength and verbal ability. Maximum Phonation Time (MPT). The results of this study are as follows. There was no significant difference in tongue strength and verbal function between training group and oral facial exercise group. There was no significant difference between tongue strength training and oral facial exercise group. Therefore, it was shown that the tongue pressure strength and accuracy training therapy group was not effective to improve tongue muscle strength and spoken language ability than the oromotor exercise therapy group.

• The Journal of the Korea Contents Association
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• v.16 no.11
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• pp.605-613
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• 2016

This study was investigated to effect of tongue strength and accuracy training (TSAT) on tongue strength, swallowing function, quality of life in chronic stroke patients with dysphagia. Eighteen chronic stroke patients with dysphagia participated in this study, and were allocated randomly to experimental(n=9) and control group(n=9). both group conducted to traditional dysphagia therapy, and experimental group was carried out additionally TSAT. TSAT performed using Iowa Oral Performance Instrument(IOPI), and was set up to 50%, 75%, 100% of maximum isometric tongue strength. Two groups received the treatment for five per weeks, eight weeks. Outcome measurements performed that Maximum Isometric Strength(MIS) was assessed by using IOPI for measure the tongue strength, and Swallowing Function Test(SFT) was used to assess the swallowing function. Swallowing-Quality of Life(SWAL-QOL) was used to evaluate quality of life related to swallow. In results of study, experimental group in comparison of change score between two group significantly improve than control group in anterior and posterior MIS, and SFT. SWAL-QOL was not significantly difference in both group. Based on thin study results, TSAT may be a effective intervention to improve on tongue strength, and swallowing function in chronic stroke patients with dysphagia.

• Phonetics and Speech Sciences
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• v.5 no.2
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• pp.11-22
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• 2013

The purpose of this study was to identify the relationship between the strength of the tongue/lip strength and speech production for dysarthric adults with cerebral palsy. The maximal tongue and lip strengths of 22 normal adults, 27 dysarthric adults (10 adults with mild dysarthria, 10 adults with moderate dysarthria, and 7 adults with severe dysarthria) were measured with Iowa Oral Performance Instrument (IOPI). The percentage of correct consonants (PCC) and speech intelligibility were calculated from the words and sentences spoken by the subjects. The results of the study are as follows: First, both the maximal tongue and the maximal lip strength differed significantly between the control group and the group with dysarthria. While the group with mild dysarthria did not show meaningful difference in maximal tongue and lip strengths from the control group, the group with moderate and severe dysarthria showed significantly weaker tongue and lip strength than the control group and the group with mild dysarthria. Second, the current study suggests the existence of a significant correlation between the maximal tongue and lip strength and the PCC and speech intelligibility within all subjects with dysarthria. These findings can serve as an effective foundation to diagnose dysarthria quickly and accurately. The results of this study also indicate that in addition to the maximal tongue strength, the maximal lip strength can prove to be an important index in predicting the speech intelligibility of dysarthric adults with cerebral palsy.

• Journal of Korean society of Dental Hygiene
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• v.19 no.2
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• pp.161-172
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• 2019

Objectives: This study aimed to analyze the correlation between oral function, oral environment, and brain cognitive function in the elderly. Methods: The subjects were 60 users of senior community center and elderly day care center. The survey was conducted from November to December 2018. Subjects were assessed by oral examination and myofunction test. Oral myofunction was measured using $IOPI^R$ and Lip de $Cum^R$. Survey data were analyzed using the statistical programs of PASW Statistics ver. 18.0. Results: Tongue muscle strength and lips muscle strength was higher in males than in females. The tongue and lip strengths were higher in the <81 years old group than the ${\geq}81$ years old group. Functional tooth analysis showed that there was a ${\geq}15$ teeth group ($40.91{\pm}7.36$) and a <15 teeth group ($32.52{\pm}7.14$). Lip muscle strength analysis showed that the ${\geq}15$ teeth group ($10.54{\pm}3.40$) was higher than the <15 teeth group ($8.20{\pm}2.41$, p<0.05). Tongue muscle strength, lumbar muscle strength, and functional tooth number were lower in the elderly subjects with mild cognitive impairment. Cognitive function was significantly correlated with functional tooth number (r=0.386, p<0.001), tongue strength (r=0.478, p<0.001), and lip strength (r=0.281, p<0.05). Tongue strength was significantly correlated with lip strength (r=0.360, p<0.001) and functional tooth number (r=0.633, p<0.001). Lip strength was significantly correlated with functional tooth number (r=0.376, p<0.001). Conclusions: These results showed that age and functional tooth number influenced oral muscle strength and that the number of functional teeth and oral muscle strength were low in the elderly with mild cognitive impairment. Oral myofunction training and oral care program are suggested to improve the quality of life of the elderly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.4
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• pp.221-228
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• 2017

Objectives: The purpose of this study was to establish normative data for healthy Korean adults by measuring the maximal strength and endurance scores of the tongue, lip, and cheek, and to examine correlations between these measurements. Materials and Methods: This study included 120 subjects that were divided into three groups according to age: young (20-39 years), middle-aged (40-59 years), and older (over 60 years); and by gender. Measurements were taken using the Iowa Oral Performance Instrument (IOPI). Results: The mean maximal tongue strengths were as follows: young men ($46.7{\pm}10.2kPa$) and women ($32.1{\pm}7.9kPa$), middle-aged men ($40.9{\pm}9.3kPa$) and women ($36.9{\pm}8.6kPa$), and older men ($35.2{\pm}9.0kPa$) and women ($34.5{\pm}6.9kPa$). The mean tongue endurance scores were: young men ($28.8{\pm}12.6$ seconds) and women ($20.8{\pm}13.5$ seconds), middle-aged men ($17.0{\pm}8.5$ seconds) and women ($15.3{\pm}5.2$ seconds), and older men ($15.8{\pm}6.7$ seconds) and women ($17.9{\pm}8.1$ seconds). The mean maximal lip strengths were: young men ($11.6{\pm}3.0kPa$) and women ($11.4{\pm}3.8kPa$), middle-aged men ($11.4{\pm}4.2kPa$) and women ($11.1{\pm}5.1kPa$), and older men ($14.5{\pm}3.9kPa$) and women ($11.7{\pm}2.6kPa$). The mean lip endurance scores were: young men ($41.1{\pm}23.9$ seconds) and women ($22.4{\pm}21.7$ seconds), middle-aged men ($24.3{\pm}10.3$ seconds) and women ($30.5{\pm}13.4$ seconds), and older men ($24.9{\pm}11.0$ seconds) and women ($12.8{\pm}7.6$ seconds). The mean maximal cheek strengths were: young men ($24.5{\pm}4.6kPa$) and women ($20.5{\pm}4.3kPa$), middle-aged men ($25.2{\pm}6.4kPa$) and women ($21.2{\pm}5.5kPa$), and older men ($22.4{\pm}5.3kPa$) and women ($18.0{\pm}4.8kPa$). The mean cheek endurance scores were: young men ($47.8{\pm}24.4$ seconds) and women ($43.9{\pm}25.0$ seconds), middle-aged men ($27.3{\pm}11.3$ seconds) and women ($20.0{\pm}14.6$ seconds), and older men ($21.7{\pm}14.5$ seconds) and women ($17.2{\pm}11.4$ seconds). Conclusion: The data collected in this study will provide an important database of standardized measurements for maximal strength and endurance scores of the tongue, lip and cheek in healthy, normal Koreans.

• The Journal of the Korea institute of electronic communication sciences
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• v.11 no.10
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• pp.995-1002
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• 2016

The aim of this study was investigated the effect of orofacial exercise program using smart phone on swallowing function and tongue strength in acute stroke patients with dysphagia. This study participated in sixteen acute stroke patients with dysphagia. All subjects allocated that randomized each eight patients in experimental and control groups. Subjects of both group received to conventional dysphagia therapy during 30 min/day, 5 times per week, for 4 weeks. Experimental group performed additionally that orofacial exercise program using smart phone, supervised under caregivers, during 30 min/day. The outcome measures were the IOPI(: Iowa Oral Performance Instrument), VR(: Vellecula Residue), PSR(: Pyriform Sinuses Residue), MIP(: Maximum Isometric Pressures). In results of study. Both group showed significant improvements after intervention in all assessments(p<.05). In comparison of change score between two groups, experimental group showed significant improvements than control group in PSR and MIP(p<.05). Orofacial exercise program using smart phone suggested that expected to positive effects the reduction of residue in pharynx and improvements of tongue strength in acute stroke patients with dysphagia.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.55-68
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• 2022

Objective : This review aimed to provide information for clinical application by confirming the principles and characteristics of the tool through a review of tongue movement and measurement tools for patients with swallowing disorders. Results : We identified 15 tools used as tongue exercises and measurement tools in the field of dysphagia. According to principle, the tools were classified as either a bulb sensor, resistive sensor sheet, mouthpiece with sensor, or other techniques. The bulb sensor was easy to use but had limitations in fixing the position when measuring tongue pressure. The resistive sensor sheet could be measured at a more stable position than the bulb sensor. A mouthpiece with a sensor could be used in an individual's oral cavity such that the position was fixed when measuring the tongue pressure. Other techniques had the advantage of being wireless and capable of sensing light. Conclusion : Based on this literature review, it is necessary to facilitate the selection of the best tool for quantitative tongue measurement in dysphagia. The review can also be used to develop a Korean tongue movement tool model that can be used in hospitals and community centers.

• Therapeutic Science for Rehabilitation
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• v.11 no.3
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• pp.7-22
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• 2022

Objectives : This study was a systematic review of tongue movements in stroke patients with dysphagia. This study aimed to provide a basis for verifying the effects of tongue movement and identifying the tendency of tongue movement. Methods : A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and flow chart. PubMed, MEDLINE, CINAHL, RISS, and e-articles databases were searched. A total of six documents were investigated, and the PEDro scale was used to evaluate the quality of the papers. Results : Three intervention methods were included in the six papers analyzed. Regarding the type of tongue exercise, three TPRT (Tongue to Palate Resistance Trainings) and two TSAT (Tongue Strength and Accuracy Training) were mediated through the IOPI (Iowa Oral Performance Instrument), and only one study applied TSE (Tongue Stretching Exercise). The treatment effects for each intervention implemented in the literature were confirmed to be effective. However, generalizability of findings is difficult because of the small sample size. Further, no significant difference was found between the experimental and control groups. Conclusions : This study can help occupational therapists provide efficient swallowing rehabilitation treatment by applying tongue exercises to stroke patients with dysphagia. More research should be conducted to determine the effects of tongue exercise.