Introduction: The tongue-hold swallow (THS) exercise has potential as a resistance exercise for the tongue and pharyngeal constrictor and suprahyoid muscles. We investigated tongue pressure and volume and quality of the geniohyoid muscle in community-dwelling older adults who performed the THS exercise. Methods: Thirty-three day care users (78.7 ± 8.0 years old) who were able to consume three meals orally (food oral intake level; FILS ≥7) were included. The participants swallowed saliva while positioning their tongue between the upper and lower incisors six times in each session, twice a day (conducted 3 days a week for 8 weeks). Subsequently, maximum tongue pressure, geniohyoid muscle cross-sectional area, and brightness before and after the exercise were measured. Results: Twenty-seven participants (81.8%) completed the 8-week exercise. One participant was excluded for missing data and another for receiving additional swallowing rehabilitation during this period. Totally, 25 participants (76.9 ± 7.7 years old) were analyzed. After the exercise, the maximal tongue pressure, geniohyoid muscle area, and muscle brightness showed no significant increase in the study population. Examining the data of the two groups based on tongue pressure revealed no statistically significant changes in muscle area or brightness of the geniohyoid muscle before and after the exercise. Regarding maximal tongue pressure, only the low tongue pressure group showed a significant increase after the exercise (p = 0.008). Conclusion: After 8 weeks of exercising, the low tongue pressure group showed a statistically significant increase in tongue pressure, suggesting the possibility that THS exercise with the appropriate exercise load strengthened tongue muscles. Conversely, the high tongue pressure group showed no statistically significant difference before and after exercise, indicating that the amount of exercise load could have been insufficient for the individuals in this group.

1.
Zhao
WT
,
Yang
M
,
Wu
HM
,
Yang
L
,
Zhang
XM
,
Huang
Y
.
Systematic review and meta-analysis of the association between sarcopenia and dysphagia
.
J Nutr Health Aging
.
2018
;
22
(
8
):
1003
9
.
2.
Tanaka
T
,
Takahashi
K
,
Hirano
H
,
Kikutani
T
,
Watanabe
Y
,
Ohara
Y
, et al
.
Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly
.
J Gerontol A Biol Sci Med Sci
.
2018
;
73
(
12
):
1661
7
.
3.
Tanaka
T
,
Hirano
H
,
Ikebe
K
,
Ueda
T
,
Iwasaki
M
,
Shirobe
M
, et al
.
Oral frailty five-item checklist to predict adverse health outcomes in community-dwelling older adults: a Kashiwa cohort study
.
Geriatr Gerontol Int
.
2023
;
23
(
9
):
651
9
.
4.
Fujiu
M
,
Logemann
JA
.
Effect of a tongue-holding maneuver on posterior pharyngeal wall movement during deglutition
.
Am J Speech Lang Pathol
.
1996
;
5
(
1
):
23
30
.
5.
Arakawa
I
,
Igarashi
K
,
Imamura
Y
,
Müller
F
,
Abou-Ayash
S
,
Schimmel
M
.
Variability in tongue pressure among elderly and young healthy cohorts: a systematic review and meta-analysis
.
J Oral Rehabil
.
2021
;
48
(
4
):
430
48
.
6.
Kern
M
,
Bardan
E
,
Arndorfer
R
,
Hofmann
C
,
Ren
J
,
Shaker
R
.
Comparison of upper esophageal sphincter opening in healthy asymptomatic young and elderly volunteers
.
Ann Otol Rhinol Laryngol
.
1999
;
108
(
10
):
982
9
.
7.
Cock
C
,
Omari
T
.
Systematic review of pharyngeal and esophageal manometry in healthy or dysphagic older persons (>60 years)
.
Geriatrics
.
2018
;
3
(
4
):
67
19
.
8.
Molfenter
SM
,
Amin
MR
,
Branski
RC
,
Brumm
JD
,
Hagiwara
M
,
Roof
SA
, et al
.
Age-related changes in pharyngeal lumen size: a retrospective MRI analysis
.
Dysphagia
.
2015
;
30
(
3
):
321
7
.
9.
Aminpour
S
,
Leonard
R
,
Fuller
SC
,
Belafsky
PC
.
Pharyngeal wall differences between normal younger and older adults
.
Ear Nose Throat J
.
2011
;
90
(
4
):
E1
5
.
10.
Fujishima
I
,
Fujiu-Kurachi
M
,
Arai
H
,
Hyodo
M
,
Kagaya
H
,
Maeda
K
, et al
.
Sarcopenia and dysphagia: position paper by four professional organizations
.
Geriatr Gerontol Int
.
2019
;
19
(
2
):
91
7
.
11.
Kunieda
K
,
Fujishima
I
,
Wakabayashi
H
,
Ohno
T
,
Shigematsu
T
,
Itoda
M
, et al
.
Relationship between tongue pressure and pharyngeal function assessed using high resolution manometry in older dysphagia patients with sarcopenia: a pilot study
.
Dysphagia
.
2021
;
36
(
1
):
33
40
.
12.
Stokely
SL
,
Peladeau-Pigeon
M
,
Leigh
C
,
Molfenter
SM
,
Steele
CM
.
The relationship between pharyngeal constriction and post-swallow residue
.
Dysphagia
.
2015
;
30
(
3
):
349
56
.
13.
Molfenter
SM
,
Steele
CM
.
The relationship between residue and aspiration on the subsequent swallow: an application of the normalized residue ratio scale
.
Dysphagia
.
2013
;
28
(
4
):
494
500
.
14.
Steele
CM
,
Peladeau-Pigeon
M
,
Barrett
E
,
Wolkin
TS
.
The risk of penetration-aspiration related to residue in the pharynx
.
Am J Speech Lang Pathol
.
2020 4
;
29
(
3
):
1608
17
.
15.
Hammer
MJ
,
Jones
CA
,
Mielens
JD
,
Kim
CH
,
McCulloch
TM
.
Evaluating the tongue-hold maneuver using high-resolution manometry and electromyography
.
Dysphagia
.
2014
;
29
(
5
):
564
70
.
16.
Oh
JC
.
Effects of tongue-hold swallows on suprahyoid muscle activation according to the relative tongue protrusion length in the elderly individuals
.
Dysphagia
.
2019
;
34
(
3
):
382
90
.
17.
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
.
18.
Byeon
H
.
Effect of the Masako maneuver and neuromuscular electrical stimulation on the improvement of swallowing function in patients with dysphagia caused by stroke
.
J Phys Ther Sci
.
2016
;
28
(
7
):
2069
71
.
19.
Omori
F
,
Fujiu-Kurachi
M
,
Hirata
A
,
Yamano
T
.
Effect of tongue-hold swallow on laryngeal elevation during swallowing in healthy older men
.
Cureus
.
2024
;
16
(
8
):
e68245
.
20.
Lee
KH
,
Jung
ES
,
Choi
YY
.
Effects of lingual exercises on oral muscle strength and salivary flow rate in elderly adults: a randomized clinical trial
.
Geriatr Gerontol Int
.
2020
;
20
(
7
):
697
703
.
21.
Logemann
JA
.
Evaluation and treatment of swallowing disorders
. 2nd ed.
Austin
:
PRO-ED, Inc
;
1998
.
22.
Shimizu
S
,
Hanayama
K
,
Metani
H
,
Sugiyama
T
,
Abe
H
,
Seki
S
, et al
.
Retest reliability of ultrasonic geniohyoid muscle measurement
.
Jpn J Compr Rehabil Sci
.
2016
;
7
:
55
60
.
23.
Mori
T
,
Izumi
S
,
Suzukamo
Y
,
Okazaki
T
,
Iketani
S
.
Ultrasonography to detect age-related changes in swallowing muscles
.
Eur Geriatr Med
.
2019
;
10
(
5
):
753
60
.
24.
Kiyomiya
Y
,
Fujiu-Kurachi
M
,
Hirata
A
,
Nakasone
W
,
Azuma
M
,
Kishida
S
, et al
.
Morphological and functional changes of the geniohyoid muscle in elderly patients after hip fracture surgery: comparison of ultrasound images with a focus on swallowing function
.
J Oral Rehabil
.
2024
;
51
(
5
):
870
8
.
25.
Ogawa
N
,
Mori
T
,
Fujishima
I
,
Wakabayashi
H
,
Itoda
M
,
Kunieda
K
, et al
.
Ultrasonography to measure swallowing muscle mass and quality in older patients with sarcopenic dysphagia
.
J Am Med Dir Assoc
.
2018
;
19
(
6
):
516
22
.
26.
Yoshida
M
,
Kikutani
T
,
Tsuga
K
,
Utanohara
Y
,
Hayashi
R
,
Akagawa
Y
.
Decreased tongue pressure reflects symptom of dysphagia
.
Dysphagia
.
2006
;
21
(
1
):
61
5
.
27.
Yamada
M
,
Arai
H
.
Long-term care system in Japan
.
Ann Geriatr Med Res
.
2020
;
24
(
3
):
174
80
.
28.
Kunieda
K
,
Ohno
T
,
Fujishima
I
,
Hojo
K
,
Morita
T
.
Reliability and validity of a tool to measure the severity of dysphagia: the Food Intake LEVEL Scale
.
J Pain Symptom Manage
.
2013
;
46
(
2
):
201
6
.
29.
Chen
LK
,
Woo
J
,
Assantachai
P
,
Auyeung
TW
,
Chou
MY
,
Iijima
K
, et al
.
Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment
.
J Am Med Dir Assoc
.
2020
;
21
(
3
):
300
7.e2
.
30.
Tsuga
K
,
Maruyama
M
,
Yoshikawa
M
,
Yoshida
M
,
Akagawa
Y
.
Manometric evaluation of oral function with a hand-held balloon probe
.
J Oral Rehabil
.
2011
;
38
(
9
):
680
5
.
31.
Izquierdo
M
,
Merchant
RA
,
Morley
JE
,
Anker
SD
,
Aprahamian
I
,
Arai
H
, et al
.
International exercise recommendations in older adults (ICFSR): expert consensus guidelines
.
J Nutr Health Aging
.
2021
;
25
(
7
):
824
53
.
32.
Aihara
K
,
Inamoto
Y
,
Kanamori
D
,
González-Fernández
M
,
Shibata
S
,
Kagaya
H
, et al
.
Effect of tongue-hold swallow on posterior pharyngeal wall using dynamic area detector computed tomography
.
J Oral Rehabil
.
2021
;
48
(
11
):
1235
42
.
33.
Aoyagi
Y
,
Ohashi
M
,
Ando
S
,
Inamoto
Y
,
Aihara
K
,
Matsuura
Y
, et al
.
Effect of tongue-hold swallow on pharyngeal contractile properties in healthy individuals
.
Dysphagia
.
2021
;
36
(
5
):
936
43
.
34.
Fujiu-Kurachi
M
,
Fujiwara
S
,
Tamine
K
,
Kondo
J
,
Minagi
Y
,
Maeda
Y
, et al
.
Tongue pressure generation during tongue-hold swallows in young healthy adults measured with different tongue positions
.
Dysphagia
.
2014
;
29
(
1
):
17
24
.
35.
Minakuchi
S
,
Tsuga
K
,
Ikebe
K
,
Ueda
T
,
Tamura
F
,
Nagao
K
, et al
.
Oral hypofunction in the older population: position paper of the Japanese Society of Gerodontology in 2016
.
Gerodontology
.
2018
;
35
(
4
):
317
24
.
36.
Ahtiainen
JP
,
Walker
S
,
Peltonen
H
,
Holviala
J
,
Sillanpää
E
,
Karavirta
L
, et al
.
Heterogeneity in resistance training-induced muscle strength and mass responses in men and women of different ages
.
Age
.
2016
;
38
(
1
):
10
.
37.
Csapo
R
,
Alegre
LM
.
Effects of resistance training with moderate vs. heavy loads on muscle mass and strength in the elderly: a meta-analysis
.
Scand J Med Sci Sports
.
2016
;
26
(
9
):
995
1006
.
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