The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review.
Sana Smaoui, Amy Langridge, Catriona M Steele
PMID 31612288WHAT IT FOUND
Tongue strength training reliably increases tongue pressure, but evidence that this improves actual swallowing safety or efficiency is inconsistent.
Most included studies were small and had high risk of bias, so clinicians should not assume strength gains translate directly to safer swallowing.
Key findings
01Isometric tongue pressures improved significantly in the majority of studies assessing them, with anterior and posterior strength gains reported in most trials.
02Changes in swallowing safety (Penetration-Aspiration Scale) and efficiency (residue) were inconsistent; significant improvements were found in some studies but not others, and no significant differences were often found between experimental and control groups.
03The review could not perform a meta-analysis due to high heterogeneity in patient populations, training protocols, and swallowing assessment methods.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only seven studies were included, and most had small sample sizes (N=5 to 29). High risk of bias was found in most studies, particularly regarding blinding of participants and personnel. VFSS protocols were not standardized; frame rates were not reported, and stimuli varied widely, making comparisons difficult. Interventions often included components other than tongue training (e.g., effortful swallow, thermal tactile stimulation), making it hard to isolate the effect of tongue resistance alone. No meta-analysis was possible due to heterogeneity.
Declared interests
The paper reports 'Research Support, Non-U.S. Gov't' in publication types. No specific funding sources or author conflicts of interest are detailed in the provided text.
The easy way to misread this
Do not assume that improving tongue strength via exercises like the Iowa Oral Performance Instrument will directly improve swallowing safety or reduce aspiration. The review found that while strength gains are consistent, improvements in actual swallowing function on VFSS are inconsistent and not clearly superior to conventional therapy.