Functional Lingual Pressure Thresholds for Swallowing Safety and Efficiency Impairments in Amyotrophic Lateral Sclerosis.
Raele Robison, Lauren DiBiase, James P Wymer and 1 others
PMID 35907088WHAT IT FOUND
In 30 people with ALS, tongue pressure at or below 43 kPa flagged unsafe swallowing, and at or below 46 kPa flagged inefficient swallowing.
These thresholds help screen for risk, but the test is not precise enough to replace imaging.
Key findings
01A maximum tongue pressure of 43 kPa or less identified unsafe swallowing with 94% sensitivity.
02A maximum tongue pressure of 46 kPa or less identified inefficient swallowing with 85.7% sensitivity.
03The study found inefficient swallowing in 70% of participants and unsafe swallowing in 56.7%.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was small (30 participants), which limits how much these thresholds can be trusted for all patients with ALS. The study was cross-sectional, so it cannot show when these thresholds are crossed during disease progression. The tests had relatively low area under the curve values, meaning tongue pressure alone is not a highly accurate predictor of swallowing status. Specificity was modest (61.5% for safety, 55.6% for efficiency), so many patients with low tongue pressure may not actually have the corresponding swallowing impairment.
The easy way to misread this
Do not use a tongue pressure score of 43 or 46 kPa to diagnose swallowing impairment. The test has low specificity, meaning many people with low scores do not have the impairment, and it cannot replace instrumental evaluation for confirming diagnosis.