Tongue Pressure and Grip Strength as Indicators of Persistent Dysphagia After Acute Stroke.
Miho Ohashi, Yoichiro Aoyagi, Tatsuya Iwasawa and 5 others
PMID 39466386WHAT IT FOUND
Low tongue pressure and grip strength measured within 48 hours of acute stroke admission independently predicted dysphagia persisting to discharge.
Skeletal muscle mass and stroke severity (NIHSS) did not. Early bedside measures of oral and general strength may help flag patients needing longer-term feeding or rehab planning.
Key findings
01Multiple logistic regression identified older age, lower tongue pressure, and lower grip strength on admission as independent predictors of dysphagia at discharge, while NIHSS, sex, and skeletal muscle mass index (SMI) were not significant.
02Patients with dysphagia at discharge had significantly lower mean tongue pressure (22.1 kPa) and grip strength (18.2 kg) compared to those without dysphagia (29.5 kPa and 24.6 kg, respectively).
03Dysphagia prevalence dropped from 53.3% on admission to 21.2% at discharge in the analyzed cohort.
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
Patients with severe consciousness impairment or higher cerebral dysfunction were excluded because they could not perform the tests, so the findings do not apply to the most severely affected stroke patients. The study was conducted at a single center in Japan, limiting generalizability to other populations or healthcare systems. Dysphagia was assessed only up to hospital discharge, so the study does not predict long-term swallowing outcomes beyond the acute phase. The exclusion criteria created a homogenous cohort, which may overestimate the utility of these predictors in a broader, more heterogeneous clinical population.
Declared interests
The study was funded by JSPS KAKENHI. No other conflicts of interest were declared.
The easy way to misread this
Do not assume that low skeletal muscle mass (sarcopenia) is the driver of persistent dysphagia. While muscle mass was lower in patients with dysphagia, it was not an independent predictor when adjusted for age and other factors. The strength measures (grip and tongue pressure), not the mass measure, were the significant predictors.