, Volume 28, Issue 3, pp 350–369 | Cite as

A Systematic Review and Meta-analysis of Measurements of Tongue and Hand Strength and Endurance Using the Iowa Oral Performance Instrument (IOPI)

  • Valerie Adams
  • Bernice Mathisen
  • Surinder Baines
  • Cathy Lazarus
  • Robin Callister
Review Article


The purpose of this systematic review was to examine the evidence for the use of the Iowa Oral Performance Instrument (IOPI) to measure strength and endurance of the tongue and hand in healthy populations and those with medical conditions. A systematic search of the scientific literature published since 1991 yielded 38 studies that addressed this purpose. The IOPI was used primarily for tongue strength (38 studies) and endurance (15 studies) measurement; relatively few studies measured hand strength (9 studies) or endurance (6 studies). The majority of the studies identified used the IOPI as an evaluation tool, although four used it as an intervention tool. Half the studies were conducted in healthy people, primarily adults. Most of the other participants had disorders with dysphagia, primarily Parkinson’s disease or head or neck cancer. Age and gender, as well as a number of medical conditions, influence the values of tongue and hand strength. There is sufficient evidence to support the use of the IOPI as a suitable tool for measuring tongue strength and endurance and as an assessment tool for intervention studies, and there is growing support for its use to assess hand strength and endurance in healthy and clinical populations.


Tongue strength Iowa Oral Performance Instrument Systematic review Meta-analysis Deglutition Deglutition disorders 


Conflict of interest

The authors have no competing interests to declare and no author had any paid consultancy or any other conflict of interest. This material was unfunded at the time of manuscript preparation.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Valerie Adams
    • 1
  • Bernice Mathisen
    • 2
  • Surinder Baines
    • 3
  • Cathy Lazarus
    • 4
  • Robin Callister
    • 1
  1. 1.Priority Research Centre in Physical Activity and Nutrition, School of Biomedical Sciences and Pharmacy, Faculty of HealthThe University of NewcastleCallaghanAustralia
  2. 2.LaTrobe Rural Health School, Faculty of Health SciencesLaTrobe UniversityBendigoAustralia
  3. 3.School of Health Sciences, Faculty of HealthThe University of NewcastleCallaghanAustralia
  4. 4.Department of Otorhinolaryngology Head & Neck SurgeryAlbert Einstein College of Medicine of Yeshiva University, and Thyroid Head and Neck Cancer (THANC) Foundation, Beth Israel Medical CenterNew YorkUSA

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