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Arch Gerontol Geriatr. 2016 Sep-Oct;66:127-33. doi: 10.1016/j.archger.2016.05.009. Epub 2016 Jun 3.

Effects of tongue pressing effortful swallow in older healthy individuals.

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College of Arts and Sciences, Communication Sciences and Disorders, Illinois State University, 215F Fairchild Hall, Campus Box 4720, Normal, IL 61790-4720, USA. Electronic address:
Communication Sciences and Disorders, Ohio University, Athens, OH 45701-2979, USA. Electronic address:



The risk of swallowing disorders is increased for older individuals due to weak tongue and pharyngeal muscle strength. This study was appraised the value of a preventative approach by developing the tongue pressing effortful swallow (TPES) applied using a home-based and self-administered procedure. The TPES was developed by combining two swallowing exercises: tongue strengthening exercise and the effortful swallow. The purpose of this study was to examine the effects of the TPES on maximum tongue pressure and peak amplitude of submental muscle activity in older individuals.


27 older individuals (mean 73 years) performed a 4-week TPES. The exercise program was adapted to a home-based and self-administered procedure. The maximum tongue pressure was measured by the Iowa Oral Performance Instrument and peak amplitude of submental muscle activity by surface electromyography (sEMG). Statistical comparisons were made by a matched pairs t-test (p<0.05).


The results of this study showed that the TPES had statistically significant and positive effects on increasing maximum tongue pressure, but the peak amplitude of the submental sEMG did not differ between before and after exercises.


The TPES had a positive impact in older individuals. The TPES, a combining exercise, was possible because two exercises had common physiological events. The TPES was a more innovative and efficient approach than the tongue strengthening exercise alone. In addition, older individuals were able to perform the swallowing exercise at home and by themselves with little assistance. Future research needs to refine the TPES and apply it to patients with dysphagia.


Aging; Effortful swallow; Swallowing; Tongue exercise; Tongue strength

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