Skip to main content
Top
Published in:

Open Access 01-12-2024 | Dysphagia | Research

Effect of segmental tongue function training on tongue pressure attributes in individuals with dysphagia after receiving radiotherapy for nasopharyngeal carcinoma

Authors: Fei Zhao, Chen Yang, Si-Ming Sun, Yao-Wen Zhang, Hong-Mei Wen, Zu-Lin Dou, Xiao-Mei Wei, Chun-Qing Xie

Published in: BMC Oral Health | Issue 1/2024

Login to get access

Abstract

Objective

This study aimed to assess the impact of segmental tongue function training on tongue pressure characteristics in nasopharyngeal carcinoma after radiotherapy(NPCR) patients who experience dysphagia. The findings of this research are crucial in understanding the potential benefits of tongue rehabilitation exercises for individuals with NPC patients. Hence, it is essential to explore the effects of this type of training on tongue pressure and its associated characteristics.

Methods

A group of eighteen NPCR dysphagia patients underwent a two-week segmental tongue function training. The researchers assessed their tongue motor function by measuring the tongue pressure (P) and endurance time (ET) in three different regions of the tongue-the anterior tongue region (TAR), central tongue region (TCR), and posterior tongue region (TPR). To gather accurate data, a new flexible tongue pressure sensor with 9 measuring sites arranged in a 3 × 3 configuration was used to measure the pressure exerted by the tongue on the palate. The measurements were taken both before and after the segmental tongue function training.

Results

The segmental tongue function training resulted in significant improvements in tongue pressure for the anterior(PTAR) and central(PTCR) parts of the tongue(P < 0.05). However, there was no significant change in tongue pressure for the posterior(PTPR) part of the tongue(P > 0.05). Additionally, there were no significant differences in the endurance time for each part of the tongue(P > 0.05).

Conclusions

Segmental tongue function training improved the PTAR and PTCR in NPCR dysphagia patients within 2 weeks, and the improvement gradually decreased from the anterior part of the tongue to the posterior part of the tongue. Meanwhile, there were no significant differences in PTPR and ET of between each part before and after treatment. This suggests that a longer duration weeks of training may be needed to improve the PTPR and ET in these patients, or alternatively, more targeted training programs could be designed.
Literature
1.
go back to reference Santa Cruz O, Tsoutsou P, Castella C, Khanfir K, Anchisi S, Bouayed S, Matzinger O, Ozsahin M. Locoregional Control and Toxicity in Head and Neck Carcinoma patients following helical tomotherapy-delivered intensity-modulated Radiation Therapy compared with 3D-CRT Data. Oncology. 2018;95(2):61–8.CrossRefPubMed Santa Cruz O, Tsoutsou P, Castella C, Khanfir K, Anchisi S, Bouayed S, Matzinger O, Ozsahin M. Locoregional Control and Toxicity in Head and Neck Carcinoma patients following helical tomotherapy-delivered intensity-modulated Radiation Therapy compared with 3D-CRT Data. Oncology. 2018;95(2):61–8.CrossRefPubMed
2.
go back to reference Szczesniak MM, Maclean J, Zhang T, Graham PH, Cook IJ. Persistent dysphagia after head and neck radiotherapy: a common and under-reported complication with significant effect on non-cancer-related mortality. Clin Oncol (R Coll Radiol). 2014;26(11):697–703.CrossRefPubMed Szczesniak MM, Maclean J, Zhang T, Graham PH, Cook IJ. Persistent dysphagia after head and neck radiotherapy: a common and under-reported complication with significant effect on non-cancer-related mortality. Clin Oncol (R Coll Radiol). 2014;26(11):697–703.CrossRefPubMed
3.
go back to reference Strojan P, Hutcheson KA, Eisbruch A, Beitler JJ, Langendijk JA, Lee AWM, Corry J, Mendenhall WM, Smee R, Rinaldo A, Ferlito A. Treatment of late sequelae after radiotherapy for head and neck cancer. Cancer Treat Rev. 2017;59:79–92.CrossRefPubMedPubMedCentral Strojan P, Hutcheson KA, Eisbruch A, Beitler JJ, Langendijk JA, Lee AWM, Corry J, Mendenhall WM, Smee R, Rinaldo A, Ferlito A. Treatment of late sequelae after radiotherapy for head and neck cancer. Cancer Treat Rev. 2017;59:79–92.CrossRefPubMedPubMedCentral
4.
go back to reference Chen YJ, Chen SC, Wang CP, Fang YY, Lee YH, Lou PJ, Ko JY, Chiang CC, Lai YH. Trismus, xerostomia and nutrition status in nasopharyngeal carcinoma survivors treated with radiation. Eur J Cancer Care (Engl). 2016;25(3):440–8.CrossRefPubMed Chen YJ, Chen SC, Wang CP, Fang YY, Lee YH, Lou PJ, Ko JY, Chiang CC, Lai YH. Trismus, xerostomia and nutrition status in nasopharyngeal carcinoma survivors treated with radiation. Eur J Cancer Care (Engl). 2016;25(3):440–8.CrossRefPubMed
5.
6.
go back to reference Van den Steen L, Vanderveken O, Vanderwegen J, Van Gestel D, Daisne JF, Allouche J, Delacroix L, Van Rompaey D, Beauvois S, Cvilic S, Mariën S, Desuter G, Vermorken JB, Van den Weyngaert D, Specenier P, Van Laer C, Peeters M, Van de Heyning P, Chantrain G, Lawson G, Lazarus C, De Bodt M, Van Nuffelen G. Feasibility of tongue strength measurements during (chemo)radiotherapy in head and neck cancer patients. Support Care Cancer. 2017;25(11):3417–23.CrossRefPubMed Van den Steen L, Vanderveken O, Vanderwegen J, Van Gestel D, Daisne JF, Allouche J, Delacroix L, Van Rompaey D, Beauvois S, Cvilic S, Mariën S, Desuter G, Vermorken JB, Van den Weyngaert D, Specenier P, Van Laer C, Peeters M, Van de Heyning P, Chantrain G, Lawson G, Lazarus C, De Bodt M, Van Nuffelen G. Feasibility of tongue strength measurements during (chemo)radiotherapy in head and neck cancer patients. Support Care Cancer. 2017;25(11):3417–23.CrossRefPubMed
7.
go back to reference Lazarus C. Tongue strength and exercise in healthy individuals and in head and neck cancer patients. Semin Speech Lang. 2006;27(4):260–7.CrossRefPubMed Lazarus C. Tongue strength and exercise in healthy individuals and in head and neck cancer patients. Semin Speech Lang. 2006;27(4):260–7.CrossRefPubMed
8.
go back to reference Van Nuffelen G, Van den Steen L, Vanderveken O, Specenier P, Van Laer C, Van Rompaey D, Guns C, Mariën S, Peeters M, Van de Heyning P, Vanderwegen J, De Bodt M. Study protocol for a randomized controlled trial: tongue strengthening exercises in head and neck cancer patients, does exercise load matter? Trials 2015, 16, 395. Van Nuffelen G, Van den Steen L, Vanderveken O, Specenier P, Van Laer C, Van Rompaey D, Guns C, Mariën S, Peeters M, Van de Heyning P, Vanderwegen J, De Bodt M. Study protocol for a randomized controlled trial: tongue strengthening exercises in head and neck cancer patients, does exercise load matter? Trials 2015, 16, 395.
9.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
11.
go back to reference Rogus-Pulia NM, Larson C, Mittal BB, Pierce M, Zecker S, Kennelty K, Kind A, Connor NP. Effects of Change in Tongue pressure and salivary Flow Rate on Swallow Efficiency following Chemoradiation Treatment for Head and Neck Cancer. Dysphagia. 2016;31(5):687–96.CrossRefPubMedPubMedCentral Rogus-Pulia NM, Larson C, Mittal BB, Pierce M, Zecker S, Kennelty K, Kind A, Connor NP. Effects of Change in Tongue pressure and salivary Flow Rate on Swallow Efficiency following Chemoradiation Treatment for Head and Neck Cancer. Dysphagia. 2016;31(5):687–96.CrossRefPubMedPubMedCentral
12.
go back to reference Clark HM. Specificity of training in the lingual musculature. J Speech Lang Hear Res. 2012;55(2):657–67.CrossRefPubMed Clark HM. Specificity of training in the lingual musculature. J Speech Lang Hear Res. 2012;55(2):657–67.CrossRefPubMed
13.
go back to reference Clark HM, O’Brien K, Calleja A, Corrie SN. Effects of directional exercise on lingual strength. J Speech Lang Hear Res. 2009;52(4):1034–47.CrossRefPubMed Clark HM, O’Brien K, Calleja A, Corrie SN. Effects of directional exercise on lingual strength. J Speech Lang Hear Res. 2009;52(4):1034–47.CrossRefPubMed
14.
go back to reference Steele CM, Bailey GL, Polacco RE, Hori SF, Molfenter SM, Oshalla M, Yeates EM. Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury. Int J Speech Lang Pathol. 2013;15(5):492–502.CrossRefPubMedPubMedCentral Steele CM, Bailey GL, Polacco RE, Hori SF, Molfenter SM, Oshalla M, Yeates EM. Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury. Int J Speech Lang Pathol. 2013;15(5):492–502.CrossRefPubMedPubMedCentral
15.
go back to reference Moffa A, Giorgi L, Carnuccio L, Cassano M, Montevecchi F, Baptista P, Casale M. New non-invasive electrical stimulation devices for treatment of snoring and obstructive sleep apnoea: a systematic review. Sleep Breath. 2023;27(1):103–8.CrossRefPubMed Moffa A, Giorgi L, Carnuccio L, Cassano M, Montevecchi F, Baptista P, Casale M. New non-invasive electrical stimulation devices for treatment of snoring and obstructive sleep apnoea: a systematic review. Sleep Breath. 2023;27(1):103–8.CrossRefPubMed
16.
go back to reference Wall LR, Ward EC, Cartmill B, Hill AJ. Physiological changes to the swallowing mechanism following (chemo)radiotherapy for head and neck cancer: a systematic review. Dysphagia. 2013;28(4):481–93.CrossRefPubMed Wall LR, Ward EC, Cartmill B, Hill AJ. Physiological changes to the swallowing mechanism following (chemo)radiotherapy for head and neck cancer: a systematic review. Dysphagia. 2013;28(4):481–93.CrossRefPubMed
17.
go back to reference Lazarus CL, Husaini H, Falciglia D, DeLacure M, Branski RC, Kraus D, Lee N, Ho M, Ganz C, Smith B, Sanfilippo N. Effects of exercise on swallowing and tongue strength in patients with oral and oropharyngeal cancer treated with primary radiotherapy with or without chemotherapy. Int J Oral Maxillofac Surg. 2014;43(5):523–30.CrossRefPubMed Lazarus CL, Husaini H, Falciglia D, DeLacure M, Branski RC, Kraus D, Lee N, Ho M, Ganz C, Smith B, Sanfilippo N. Effects of exercise on swallowing and tongue strength in patients with oral and oropharyngeal cancer treated with primary radiotherapy with or without chemotherapy. Int J Oral Maxillofac Surg. 2014;43(5):523–30.CrossRefPubMed
18.
go back to reference Mehraban-Far S, Alrassi J, Patel R, Ahmad V, Browne N, Lam W, Jiang Y, Barber N, Mortensen M. Dysphagia in the elderly population: a videofluoroscopic study. Am J Otolaryngol. 2021;42(2):102854.CrossRefPubMed Mehraban-Far S, Alrassi J, Patel R, Ahmad V, Browne N, Lam W, Jiang Y, Barber N, Mortensen M. Dysphagia in the elderly population: a videofluoroscopic study. Am J Otolaryngol. 2021;42(2):102854.CrossRefPubMed
19.
go back to reference Arevalo-Rodriguez I, Smailagic N, Roqué-Figuls M, Ciapponi A, Sanchez-Perez E, Giannakou A, Pedraza OL, Bonfill Cosp X, Cullum S. Mini-mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2021, 7 (7), Cd010783. Arevalo-Rodriguez I, Smailagic N, Roqué-Figuls M, Ciapponi A, Sanchez-Perez E, Giannakou A, Pedraza OL, Bonfill Cosp X, Cullum S. Mini-mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2021, 7 (7), Cd010783.
20.
go back to reference Purnami N, Mulyaningsih EF, Ahadiah TH, Utomo B, Smith A. Score of hearing handicap inventory for the Elderly (HHIE) compared to Whisper Test on Presbycusis. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 1):311–5.CrossRefPubMed Purnami N, Mulyaningsih EF, Ahadiah TH, Utomo B, Smith A. Score of hearing handicap inventory for the Elderly (HHIE) compared to Whisper Test on Presbycusis. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 1):311–5.CrossRefPubMed
21.
go back to reference Zhao F, Dou ZL, Xie CQ, Yang C, Wan GF, Zhang YW, Wen HM, Tang ZM. Effect of intensive Oropharyngeal training on Radiotherapy-related Dysphagia in Nasopharyngeal Carcinoma patients. Dysphagia. 2022;37(6):1542–9.CrossRefPubMed Zhao F, Dou ZL, Xie CQ, Yang C, Wan GF, Zhang YW, Wen HM, Tang ZM. Effect of intensive Oropharyngeal training on Radiotherapy-related Dysphagia in Nasopharyngeal Carcinoma patients. Dysphagia. 2022;37(6):1542–9.CrossRefPubMed
22.
go back to reference Fujiwara S, Fujiu-Kurachi M, Hori K, Maeda Y, Ono T. Tongue pressure production and Submental Surface Electromyogram activities during Tongue-hold swallow with different holding positions and tongue length. Dysphagia. 2018;33(4):403–13.CrossRefPubMed Fujiwara S, Fujiu-Kurachi M, Hori K, Maeda Y, Ono T. Tongue pressure production and Submental Surface Electromyogram activities during Tongue-hold swallow with different holding positions and tongue length. Dysphagia. 2018;33(4):403–13.CrossRefPubMed
23.
go back to reference Pae EK, Hyatt JP, Wu J, Chien P. Short-term electrical stimulation alters tongue muscle fibre type composition. Arch Oral Biol. 2007;52(6):544–51.CrossRefPubMed Pae EK, Hyatt JP, Wu J, Chien P. Short-term electrical stimulation alters tongue muscle fibre type composition. Arch Oral Biol. 2007;52(6):544–51.CrossRefPubMed
24.
go back to reference Balou M, Herzberg EG, Kamelhar D, Molfenter SM. An intensive swallowing exercise protocol for improving swallowing physiology in older adults with radiographically confirmed dysphagia. Clin Interv Aging. 2019;14:283–8.CrossRefPubMedPubMedCentral Balou M, Herzberg EG, Kamelhar D, Molfenter SM. An intensive swallowing exercise protocol for improving swallowing physiology in older adults with radiographically confirmed dysphagia. Clin Interv Aging. 2019;14:283–8.CrossRefPubMedPubMedCentral
25.
go back to reference Banda KJ, Chu H, Kao CC, Voss J, Chiu HL, Chang PC, Chen R, Chou KR. Swallowing exercises for head and neck cancer patients: a systematic review and meta-analysis of randomized control trials. Int J Nurs Stud. 2021;114:103827.CrossRefPubMed Banda KJ, Chu H, Kao CC, Voss J, Chiu HL, Chang PC, Chen R, Chou KR. Swallowing exercises for head and neck cancer patients: a systematic review and meta-analysis of randomized control trials. Int J Nurs Stud. 2021;114:103827.CrossRefPubMed
26.
go back to reference Yang S, Park JW, Min K, Lee YS, Song YJ, Choi SH, Kim DY, Lee SH, Yang HS, Cha W, Kim JW, Oh BM, Seo HG, Kim MW, Woo HS, Park SJ, Jee S, Oh JS, Park KD, Jin YJ, Han S, Yoo D, Kim BH, Lee HH, Kim YH, Kang MG, Chung EJ, Kim BR, Kim TW, Ko EJ, Park YM, Park H, Kim MS, Seok J, Im S, Ko SH, Lim SH, Jung KW, Lee TH, Hong BY, Kim W, Shin WS, Lee YC, Park SJ, Lim J, Kim Y, Lee JH, Ahn KM, Paeng JY, Park J, Song YA, Seo KC, Ryu CH, Cho JK, Lee JH, Choi. K. H., Clinical Practice Guidelines for Oropharyngeal Dysphagia. Ann Rehabil Med 2023, 47 (Suppl 1), S1-s26. Yang S, Park JW, Min K, Lee YS, Song YJ, Choi SH, Kim DY, Lee SH, Yang HS, Cha W, Kim JW, Oh BM, Seo HG, Kim MW, Woo HS, Park SJ, Jee S, Oh JS, Park KD, Jin YJ, Han S, Yoo D, Kim BH, Lee HH, Kim YH, Kang MG, Chung EJ, Kim BR, Kim TW, Ko EJ, Park YM, Park H, Kim MS, Seok J, Im S, Ko SH, Lim SH, Jung KW, Lee TH, Hong BY, Kim W, Shin WS, Lee YC, Park SJ, Lim J, Kim Y, Lee JH, Ahn KM, Paeng JY, Park J, Song YA, Seo KC, Ryu CH, Cho JK, Lee JH, Choi. K. H., Clinical Practice Guidelines for Oropharyngeal Dysphagia. Ann Rehabil Med 2023, 47 (Suppl 1), S1-s26.
27.
go back to reference Franciotti R, Di Maria E, D’Attilio M, Aprile G, Cosentino FG, Perrotti V. Quantitative measurement of swallowing performance using Iowa oral performance instrument: a systematic review and Meta-analysis. Biomedicines 2022, 10 (9). Franciotti R, Di Maria E, D’Attilio M, Aprile G, Cosentino FG, Perrotti V. Quantitative measurement of swallowing performance using Iowa oral performance instrument: a systematic review and Meta-analysis. Biomedicines 2022, 10 (9).
28.
go back to reference Carrera M, Barbé F, Sauleda J, Tomás M, Gómez C, Santos C, Agustí AG. Effects of obesity upon genioglossus structure and function in obstructive sleep apnoea. Eur Respir J. 2004;23(3):425–9.CrossRefPubMed Carrera M, Barbé F, Sauleda J, Tomás M, Gómez C, Santos C, Agustí AG. Effects of obesity upon genioglossus structure and function in obstructive sleep apnoea. Eur Respir J. 2004;23(3):425–9.CrossRefPubMed
29.
go back to reference Sanders I, Mu L, Amirali A, Su H, Sobotka S. The human tongue slows down to speak: muscle fibers of the human tongue. Anat Rec (Hoboken). 2013;296(10):1615–27.CrossRefPubMed Sanders I, Mu L, Amirali A, Su H, Sobotka S. The human tongue slows down to speak: muscle fibers of the human tongue. Anat Rec (Hoboken). 2013;296(10):1615–27.CrossRefPubMed
30.
go back to reference 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 Biol Sci Med Sci. 2000;55(11):M634–40.CrossRef 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 Biol Sci Med Sci. 2000;55(11):M634–40.CrossRef
31.
go back to reference Yoshikawa M, Fukuoka T, Mori T, Hiraoka A, Higa C, Kuroki A, Takeda C, Maruyama M, Yoshida M, Tsuga K. Comparison of the Iowa oral performance instrument and JMS tongue pressure measurement device. J Dent Sci. 2021;16(1):214–9.CrossRefPubMed Yoshikawa M, Fukuoka T, Mori T, Hiraoka A, Higa C, Kuroki A, Takeda C, Maruyama M, Yoshida M, Tsuga K. Comparison of the Iowa oral performance instrument and JMS tongue pressure measurement device. J Dent Sci. 2021;16(1):214–9.CrossRefPubMed
32.
go back to reference Carrara-de Angelis E, Feher O, Barros AP, Nishimoto IN, Kowalski LP. Voice and swallowing in patients enrolled in a larynx preservation trial. Arch Otolaryngol Head Neck Surg. 2003;129(7):733–8.CrossRefPubMed Carrara-de Angelis E, Feher O, Barros AP, Nishimoto IN, Kowalski LP. Voice and swallowing in patients enrolled in a larynx preservation trial. Arch Otolaryngol Head Neck Surg. 2003;129(7):733–8.CrossRefPubMed
33.
go back to reference Stål P, Marklund S, Thornell LE, De Paul R, Eriksson PO. Fibre composition of human intrinsic tongue muscles. Cells Tissues Organs. 2003;173(3):147–61.CrossRefPubMed Stål P, Marklund S, Thornell LE, De Paul R, Eriksson PO. Fibre composition of human intrinsic tongue muscles. Cells Tissues Organs. 2003;173(3):147–61.CrossRefPubMed
34.
go back to reference Grgic J, Homolak J, Mikulic P, Botella J, Schoenfeld BJ. Inducing hypertrophic effects of type I skeletal muscle fibers: a hypothetical role of time under load in resistance training aimed at muscular hypertrophy. Med Hypotheses. 2018;112:40–2.CrossRefPubMed Grgic J, Homolak J, Mikulic P, Botella J, Schoenfeld BJ. Inducing hypertrophic effects of type I skeletal muscle fibers: a hypothetical role of time under load in resistance training aimed at muscular hypertrophy. Med Hypotheses. 2018;112:40–2.CrossRefPubMed
35.
go back to reference Youmans SR, Stierwalt JA. Measures of tongue function related to normal swallowing. Dysphagia. 2006;21(2):102–11.CrossRefPubMed Youmans SR, Stierwalt JA. Measures of tongue function related to normal swallowing. Dysphagia. 2006;21(2):102–11.CrossRefPubMed
36.
go back to reference Yu M, Gao X. Tongue pressure distribution of individual normal occlusions and exploration of related factors. J Oral Rehabil. 2019;46(3):249–56.CrossRefPubMed Yu M, Gao X. Tongue pressure distribution of individual normal occlusions and exploration of related factors. J Oral Rehabil. 2019;46(3):249–56.CrossRefPubMed
37.
go back to reference Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am 2008, 19 (4), 691–707, vii. Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am 2008, 19 (4), 691–707, vii.
38.
go back to reference Shaw SM, Martino R. The normal swallow: muscular and neurophysiological control. Otolaryngol Clin North Am. 2013;46(6):937–56.CrossRefPubMed Shaw SM, Martino R. The normal swallow: muscular and neurophysiological control. Otolaryngol Clin North Am. 2013;46(6):937–56.CrossRefPubMed
39.
go back to reference Scardella AT, Krawciw N, Petrozzino JJ, Co MA, Santiago TV, Edelman NH. Strength and endurance characteristics of the normal human genioglossus. Am Rev Respir Dis. 1993;148(1):179–84.CrossRefPubMed Scardella AT, Krawciw N, Petrozzino JJ, Co MA, Santiago TV, Edelman NH. Strength and endurance characteristics of the normal human genioglossus. Am Rev Respir Dis. 1993;148(1):179–84.CrossRefPubMed
40.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
41.
go back to reference Zhao F, Zhang YW, Xie CQ, Yang C, Dou ZL, Wei XM. Characteristics of Tongue pressure measured by Novel Multisite Flexible sensors in nasopharyngeal carcinoma patients with Dysphagia. Arch Phys Med Rehabil. 2024;105(3):531–8.CrossRefPubMed Zhao F, Zhang YW, Xie CQ, Yang C, Dou ZL, Wei XM. Characteristics of Tongue pressure measured by Novel Multisite Flexible sensors in nasopharyngeal carcinoma patients with Dysphagia. Arch Phys Med Rehabil. 2024;105(3):531–8.CrossRefPubMed
42.
go back to reference Markov A, Hauser L, Chaabene H. Effects of concurrent strength and endurance training on measures of physical fitness in healthy middle-aged and older adults: a systematic review with Meta-analysis. Sports Med. 2023;53(2):437–55.CrossRefPubMed Markov A, Hauser L, Chaabene H. Effects of concurrent strength and endurance training on measures of physical fitness in healthy middle-aged and older adults: a systematic review with Meta-analysis. Sports Med. 2023;53(2):437–55.CrossRefPubMed
Metadata
Title
Effect of segmental tongue function training on tongue pressure attributes in individuals with dysphagia after receiving radiotherapy for nasopharyngeal carcinoma
Authors
Fei Zhao
Chen Yang
Si-Ming Sun
Yao-Wen Zhang
Hong-Mei Wen
Zu-Lin Dou
Xiao-Mei Wei
Chun-Qing Xie
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2024
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-024-05216-3