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Tongue Pressure Production and Submental Surface Electromyogram Activities During Tongue-Hold Swallow with Different Holding Positions and Tongue Length

  • Shigehiro Fujiwara
  • Masako Fujiu-Kurachi
  • Kazuhiro Hori
  • Yoshinobu Maeda
  • Takahiro Ono
Original Article


Our previous study regarding the tongue-hold swallow (THS) demonstrated that the tongue-to-palate contact during THS could be influenced by the maximum tongue protrusion length (MTPL) of individual subjects, resulting in two different patterns of pressure generation. The present study further analyzed the influence of MTPL on the tongue pressure production along with submental surface electromyography (sEMG) during THS, in order to establish an index to better control THS effects. Tongue pressure using a sensor sheet system and concurrent submental sEMG activities were measured during swallowing tasks in 18 healthy young adults. Task conditions comprised THS at two different degrees of tongue protrusion and dry swallow. Tongue pressures and sEMG activities were compared among three task conditions, and correlations of MTPL with tongue pressure were also investigated. Additionally, a ROC curve was used to find a cut-off value for MTPL to predict changes (increases and decreases) in tongue pressure during THS. The duration and the amount of submental muscle activity increased concurrently during THS. Two trends were shown on the change in tongue pressure at the posterior-circumferential part of the hard palate during THS compared to dry swallow; the maximal magnitude and the integrated value of tongue pressure increased in some subjects, while these values decreased in others. Thirty-two millimeters was found to be the cut-off value of MTPL, which distinguishes increase/decrease pattern of tongue pressure with sensitivities of 60.0–85.7%. The present finding suggests that more reliable THS effects should be attainable using MTPL to set the tongue-hold position.


Tongue-hold swallow Swallowing Tongue Pressure sEMG Dysphagia 



This study was supported by the Global COE Program “In Silico Medicine” at Osaka University.

Compliance with Ethical Standards

Conflict of interest

None of the authors have financial or other relationships that would influence the assessment of the data or that would constitute a conflict of interest.


  1. 1.
    Fujiu M, Logemann JA. Effect of a tongue-holding maneuver on posterior pharyngeal wall movement during deglutition. Am J Speech Lang Pathol. 1996;5:23–30.CrossRefGoogle Scholar
  2. 2.
    Kahrilas PJ, Logemann JA, Lin S, Ergun GA. Pharyngeal clearance during swallowing: a combined manometric and videofluoroscopic study. Gastroenterology. 1992;103:128–36.CrossRefPubMedGoogle Scholar
  3. 3.
    Saigusa H, Yamashita K, Tanuma K, Saigusa M, Niimi S. Morphological studies for retrusive movement of the human adult tongue. Clin Anat. 2004;17:93–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Hammer Michael J, Jones Corrine A, Mielens Jason D, Kim Chloe H, McCulloch Timothy M. Evaluating the tongue-hold maneuver using high-resolution manometry and electromyography. Dysphagia. 2014;29:564–70.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Lazarus C, Logemann JA, Song CW, Rademaker AW, Kahrilas PJ. Effects of voluntary maneuvers on tongue base function for swallowing. Folia Phoniatr Logop. 2002;54:171–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Doeltgen SH, Witte U, Gumbley F, Huckabee ML. Evaluation of manometric measures during tongue-hold swallows. Am J Speech Lang Pathol. 2008;18:65–73.CrossRefPubMedGoogle Scholar
  7. 7.
    Umeki H, Takasaki K, Enatsu K, Tanaka F, Kumagami H, Takahashi H. Effects of a tongue-holding maneuver during swallowing evaluated by high-resolution manometry. Otolaryngol Head Neck Surg. 2009;141:119–22.CrossRefPubMedGoogle Scholar
  8. 8.
    Fujiu-Kurachi M, Fujiwara S, Tamine K, Kondo J, Minagi Y, Maeda Y, Hori K, Ono T. Tongue pressure generation during tongue-hold swallows in young healthy adults measured with different tongue positions. Dysphagia. 2014;29:17–24.CrossRefPubMedGoogle Scholar
  9. 9.
    Hori K, Ono T, Tamine K, Kondo J, Hamanaka S, Maeda Y, Dong J, Hatuda M. Newly developed sensor sheet for measuring tongue pressure during swallowing. J Prosthodont Res. 2009;5:28–32.CrossRefGoogle Scholar
  10. 10.
    Akobeng AK. Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr. 2007;96:644–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Ono T, Hori K, Nokubi T. Pattern of tongue pressure on hard palate during swallowing. Dysphagia. 2004;19:259–64.CrossRefPubMedGoogle Scholar
  12. 12.
    Tamine K, Ono T, Hori K, Kondoh J, Hamanaka S, Maeda Y. Age-related changes in tongue pressure during swallowing. J Dent Res. 2010;89:1097–101.CrossRefPubMedGoogle Scholar
  13. 13.
    Dodds WJ, Taylor AJ, Stewart ET, Kern MK, Logemann JA, Cook IJ. Tipper and dipper types of oral swallow. Am J Roentgenol. 1989;153:1197–9.CrossRefGoogle Scholar
  14. 14.
    Dodds WJ, Stewart ET, Logemann JA. Physiology and radiology of the normal oral and pharyngeal phase of swallowing. Am J Roentgenol. 1990;154:953–63.CrossRefGoogle Scholar
  15. 15.
    Palmer JB, Hiiemae KM, Liu J. Tongue-jaw linkages in human feeding. Arch Oral Biol. 1997;6:429–41.CrossRefGoogle Scholar
  16. 16.
    Steele CM, Van Lieshout PH. Use of electromagnetic midsagittal articulography in the study of swallowing. J Speech Lang Hear Res. 2004;47:342–52.CrossRefPubMedGoogle Scholar
  17. 17.
    Steele CM, Van Lieshout P. Tongue movements during water swallowing in healthy young and older adults. J Speech Lang Hear Res. 2009;52:1255–67.CrossRefPubMedGoogle Scholar
  18. 18.
    Stepp Cara E. Surface electromyography for speech and swallowing systems: measurement, analysis, and interpretation. J Speech Lang Hear Res. 2012;55:1232–46.CrossRefPubMedGoogle Scholar
  19. 19.
    Palmer PM, Luschei ES, Jaffe D, McCulloch TM. Contributions of individual muscles to the submental surface electromyogram during swallowing. J Speech Lang Hear Res. 1999;42:1378–91.CrossRefPubMedGoogle Scholar
  20. 20.
    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;51:828–35.CrossRefPubMedGoogle Scholar
  21. 21.
    Yeates EM, Steele CM, Pelletier CA. Tongue pressure and submental surface electromyography measures during noneffortful and effortful saliva swallows in healthy women. Am J Speech Lang Pathol. 2010;19:274–81.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Shigehiro Fujiwara
    • 1
  • Masako Fujiu-Kurachi
    • 2
  • Kazuhiro Hori
    • 1
  • Yoshinobu Maeda
    • 3
  • Takahiro Ono
    • 1
  1. 1.Division of Comprehensive ProsthodonticsNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  2. 2.Graduate School of RehabilitationNiigata University of RehabilitationMurakamiJapan
  3. 3.Department of Prosthodontics, Gerodontology and Oral RehabilitationOsaka University Graduate School of DentistrySuitaJapan

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