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Reliability of Measurements of Tongue and Hand Strength and Endurance Using the Iowa Oral Performance Instrument with Healthy Adults

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Abstract

The purpose of this study was to investigate the reliability of tongue and handgrip strength and endurance measurements in healthy adults using the Iowa Oral Performance Instrument. Fifty-one healthy participants (21 males, 30 females; age range = 19–57 years) were tested on four occasions 1 week apart to determine test–retest reliability. The primary outcome measures were isometric tongue and handgrip strength (best of three trials) and sustained isometric endurance. Small increases (changes in group mean) in both anterior (1.7 %) and posterior (2.5 %) tongue strength and handgrip strength (5 %) between weeks 1 and 2 were observed with no change in subsequent weeks, suggesting that there is only a small learning effect for these measurements. The within-subject variation (mean-typical error expressed as a coefficient of variation [CV]) indicated higher than desirable initial variation for anterior (CV 10.8 %) and posterior (CV 11.8 %) tongue strength and handgrip strength (CV 15.2 %) but this was reduced in weeks 2–4. Intraclass correlation coefficients (ICC) indicated acceptable and improved reliability for both anterior (ICC 0.77–0.90) and posterior (ICC 0.79–0.86) tongue strength and handgrip strength (ICC 0.69–0.91) after week 1. Additional exploratory analyses were conducted with a subset of data to determine whether two values within 5 kPa (tongue) or 15 kPa (handgrip) provide superior strength reliability. Neither tongue nor hand endurance measurements were sufficiently reliable. These findings suggest that tongue and handgrip strength values demonstrate acceptable reliability, especially if familiarization is provided. Further investigation is needed to reduce sources of variability in tongue endurance measurements.

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References

  1. Youmans S, Stierwalt JAG. Measures of tongue function related to normal swallowing. Dysphagia. 2006;21(2):102–11. doi:10.1007/s00455-006-9013-z.

    Article  PubMed  Google Scholar 

  2. Crow HC, Ship JA. Tongue strength and endurance in different aged adults. J Gerontol Med Sci. 1996;51A(5):M247–50.

    Article  Google Scholar 

  3. Lazarus CL, Logemann JA, Pauloski BR, Rademaker AW, Larson CR, Mittal BB, Pierce M. Swallowing and tongue function following treatment for oral and oropharyngeal cancer. J Speech Lang Hear Res. 2000;43(4):1011–23.

    CAS  PubMed  Google Scholar 

  4. Nicosia MA, Hind JA, Roecker EB, Carnes M, Doyle J, Dengel GA, Robbins J. Age effects on the temporal evolution of isometric and swallowing pressure. J Gerontol A Biol Sci Med Sci. 2000;55(11):M634–40. doi:10.1093/gerona/55.11.M634.

    Article  CAS  PubMed  Google Scholar 

  5. Robbins J, Levine RL, Wood J, Roecker EB, Luschei ES. Age effects on lingual pressure generation as a risk factor for dysphagia. J Gerontol A Biol Sci Med Sci. 1995;50A(5):M257–62. doi:10.1093/gerona/50A.5.M257.

    Article  Google Scholar 

  6. Robin DA, Goel A, Somodi LB, Luschei ES. Tongue strength and endurance: Relation to highly skilled movements. J Speech Hear Res. 1992;35(6):1239–45.

    CAS  PubMed  Google Scholar 

  7. Robin DA, Somodi LB, Luschei ES. Measurement of tongue strength and endurance in normal and articulation disordered subjects. In: Moore CA, Yorkston KM, Beukelman DR, editors. Dysarthria and apraxia of speech: perspectives on management. Baltimore: Paul H Brookes Publishing Co; 1991. p. 173–84.

    Google Scholar 

  8. Solomon NP, Robin DA, Luschei ES. Strength, endurance, and stability of the tongue and hand in Parkinson disease. J Speech Lang Hear Res. 2000;43(1):256–67.

    CAS  PubMed  Google Scholar 

  9. Stierwalt JA, Robin DA, Solomon NP, Weiss AL, Max JE. Tongue strength and endurance: relation to the speaking ability of children and adolescents following traumatic brain injury. In: Robin DA, Yorkston K, Beukelman DR, editors. Disorders of motor speech: assessment, treatment, and clinical characterization. Baltimore: Brookes Publishing Co.; 1996. p. 241–56.

    Google Scholar 

  10. Stierwalt JA, Youmans SR. Tongue measures in individuals with normal and impaired swallowing. Am J Speech Lang Pathol. 2007;16(2):148–56.

    Article  PubMed  Google Scholar 

  11. Youmans SR, Stierwalt J, Clark HM. Measures of tongue function in healthy adults. Paper presented at the American Speech-Language-Hearing Association, Atlanta, GA, 2002.

  12. IOPI Medical LLC, Iowa Oral Performance Instrument: Users Manual; 17 Sep 2008. Available at http://www.iopimedical.com/.

  13. Steele CM, Bailey GL, Molfenter SM, Yeates EM. Rationale for strength and skill goals in tongue resistance training: A review. Perspect Swallow Swallow Disord. 2009;18(2):49–54. doi:10.1044/sasd18.2.49.

    Article  Google Scholar 

  14. Hopkins WG. Measures of reliability in sports medicine and science. Sports Med. 2000;30(1):1–15.

    Article  CAS  PubMed  Google Scholar 

  15. Solomon NP, Lorell DM, Robin DA, Rodnitzky RL, Luschei ES. Tongue strength and endurance in mild to moderate Parkinson’s disease. J Med Speech Lang Pathol. 1995;3(1):15–26.

    Google Scholar 

  16. Solomon NP. Changes in normal speech after fatiguing the tongue. J Speech Lang Hear Res. 2000;43(6):1416–28.

    CAS  PubMed  Google Scholar 

  17. Clark HM, Henson PA, Barber WD, Stierwalt JAG, Sherrill M. Relationships among subjective and objective measures of tongue strength and oral phase swallowing impairments. Am J Speech Lang Pathol. 2003;12(1):40–50.

    Article  PubMed  Google Scholar 

  18. Lazarus CL, Logemann JA, Pauloski BR, Rademaker AW, Helenowski IB, Vonesh EF, MacCracken E, Mittal BB, Vokes EE, Haraf DJ. Effects of radiotherapy with or without chemotherapy on tongue strength and swallowing in patients with oral cancer. Head Neck. 2007;29(7):632–7. doi:10.1002/hed.20577.

    Article  PubMed  Google Scholar 

  19. Neel AT, Palmer PM, Gass CA. Can IOPI be used to measure tongue pressure for speech sounds? J Med Speech Lang Pathol. 2008;16(1):235–41.

    Google Scholar 

  20. Solomon NP, Clark HM, Makashay MJ, Newman LA. Assessment of orofacial strength in patients with dysarthria. J Med Speech Lang Pathol. 2008;16:251–8.

    Google Scholar 

  21. Youmans S, Youmans G, Stierwalt JAG. Differences in tongue strength across age and gender: Is there a diminished strength reserve? Dysphagia. 2008;24(1):57–65. doi:10.1007/s00455-008-9171-2.

    Article  PubMed  Google Scholar 

  22. Palmer P, Neel A, Sprouls G, Morrison L. Swallow characteristics in patients with oculopharyngeal muscular dystrophy. J Speech Lang Hear Res. 2010;53(6):1567–78.

    Article  PubMed  Google Scholar 

  23. Neel AT, Palmer PM. Is tongue strength an important influence on rate of articulation in diadochokinetic and reading tasks? J Speech Lang Hear Res. 2011;55(1):235–46. doi:10.1044/1092-4388(2011/10-0258.

    Article  PubMed  Google Scholar 

  24. Chang C, Chen S, Ko JY, Lin YH. Early radiation effects on tongue function for patients with nasopharyngeal carcinoma: a preliminary study. Dysphagia. 2008;23(2):193–8. doi:10.1007/s00455-007-9128-x.

    Article  PubMed  Google Scholar 

  25. Gingrich LL, Stierwalt JAG, Hageman CF, LaPointe LL. Lingual propulsive pressures across consistencies generated by the anteromedian and posteromedian tongue by healthy young adults. J Speech Lang Hear Res. 2012;55(3):960–72.

    Article  PubMed  Google Scholar 

  26. Bohannon RW, Schaubert KL. Test–retest reliability of grip-strength measures obtained over a 12-week interval from community-dwelling elders. J Hand Ther. 2005;18(4):426–8. doi:10.1197/j.jht.2005.07.003.

    Article  PubMed  Google Scholar 

  27. Solomon NP, Munson B. The effect of jaw position on measures of tongue strength and endurance. J Speech Lang Hear Res. 2004;47(3):584–94.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Hopkins WG. A New View of Statistics: Precision of measurement, 2011. Available at http://sportsci.org/resource/stats/precision.html. Accessed 5 July 2012.

  29. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Mahwah: Erlbaum; 1988.

    Google Scholar 

  30. Hopkins WG. A new view of statistics, 2006. Available at http://www.sportsci.org/resource/stats/index.html. Accessed 5 July 2012.

  31. Palmer PM, Jaffe DM, McCulloch TM, Finnegan EM, Van Daele DJ, Luschei ES. Quantitative contributions of the muscles of the tongue, floor-of-mouth, jaw, and velum to tongue-to-palate pressure generation. J Speech Lang Hear Res. 2008;51(4):828–35.

    Article  PubMed  Google Scholar 

  32. Kays S, Hind J, Gangnon R, Robbins J. Effects of dining on tongue endurance and swallowing-related outcomes. J Speech Lang Hear Res. 2010;53(4):898–907.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Vitorino J. Effect of age on tongue strength and endurance scores of healthy Portuguese speakers. Int J Speech Lang Pathol. 2010;12(3):237–43. doi:10.3109/17549501003746160.

    Article  PubMed  Google Scholar 

  34. Clark HM, Solomon NP. Age and sex differences in orofacial strength. Dysphagia. 2012;27(1):2–9. doi:10.1007/s00455-011-9328-2.

    Article  PubMed  Google Scholar 

  35. Clark HM. Specificity of training in the lingual musculature. J Speech Lang Hear Res. 2012;55(2):657–67. doi:10.1044/1092-4388(2011/11-0045.

    Article  PubMed  Google Scholar 

  36. Clark HM. Neuromuscular treatments for speech and swallowing: a tutorial. Am J Speech Lang Pathol. 2003;12(4):400–15.

    Article  PubMed  Google Scholar 

  37. Hewitt A, Hind J, Kays S, Nicosia M, Doyle J, Tompkins W, Gangnon R, Robbins J. Standardized instrument for lingual pressure measurement. Dysphagia. 2008;23(1):16–25. doi:10.1007/s00455-007-9089-0.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Priority Research Centre in Physical Activity and Nutrition, Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia

    Valerie Adams & Robin Callister

  2. Faculty of Health Sciences, LaTrobe Rural Health School, LaTrobe University, Bendigo, VIC, 3552, Australia

    Bernice Mathisen

  3. Faculty of Health and Medicine, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia

    Surinder Baines

  4. Department of Otorhinolaryngology Head & Neck Surgery, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA

    Cathy Lazarus

  5. Thyroid Head and Neck Research Center, Thyroid Head and Neck Cancer (THANC) Foundation, Beth Israel Medical Center, 10 Union Square East Suite 5B, New York, NY, 10003, USA

    Cathy Lazarus

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  1. Valerie Adams
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  2. Bernice Mathisen
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  4. Cathy Lazarus
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  5. Robin Callister
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Correspondence to Robin Callister.

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Adams, V., Mathisen, B., Baines, S. et al. Reliability of Measurements of Tongue and Hand Strength and Endurance Using the Iowa Oral Performance Instrument with Healthy Adults. Dysphagia 29, 83–95 (2014). https://doi.org/10.1007/s00455-013-9486-5

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  • DOI: https://doi.org/10.1007/s00455-013-9486-5

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