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Reliable Lip force measurement in healthy controls and in patients with stroke: methodological study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
2008 (English)In: Dysphagia (New York. Print), ISSN 0179-051X, E-ISSN 1432-0460, Vol. 23, no 3, 291-296 p.Article in journal (Refereed) Published
Abstract [en]

A prefabricated oral screen has shown promising results as a muscle self-training device to improve the lip function of stroke patients affected by oropharyngeal dysphagia. However, a technique for the measurement of lip muscle force, whether in healthy individuals or in stroke patients, is lacking. The present study was designed to (1) test the intra- and interreliability of lip force measurements by means of a newly devised Lip Force Meter, LF100, (2) determine a normal lower limit for lip force in newtons (N), and (3) ascertain the instrument's sensitivity and specificity. LF100 is a modified strain gauge for recording the ability of lips to withstand pressure from a predentally placed oral screen. Forty-two healthy controls and 22 stroke patients agreed to participate in the trial. The controls and patients were examined three times with the LF100, with 2-min rest intervals, twice by investigator MH and once by investigator MO. Intrainvestigator reliability with the LF100 proved excellent in both controls and patients: ICC was 0.83 and 0.90, respectively. Interinvestigator reliability was good or excellent in both groups: ICC was 0.71 and 0.91. There was a significant difference in lip force between controls and stroke patients (mean = 24.7 +/- 6.3 N and 9.5 +/- 5.5 N, p < ; 0.001). The sensitivity of LF100 was 91% and the specificity 95%. The cutoff level for normal lip force was 15 N. The LF100 showed itself to be a suitable and reliable instrument for measuring lip force.

Place, publisher, year, edition, pages
2008. Vol. 23, no 3, 291-296 p.
Keyword [en]
controls, lip force, reliability, sensitivity, specificity, stroke; deglutition, deglutition disorders
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96517DOI: 10.1007/s00455-007-9143-yISI: 000258673300011PubMedID: 18253790OAI: oai:DiVA.org:uu-96517DiVA: diva2:171118
Available from: 2007-11-23 Created: 2007-11-23 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Sensorimotor Brain Plasticity in Stroke Patients with Dysphagia: A Methodological Study on Investigation and Treatment
Open this publication in new window or tab >>Sensorimotor Brain Plasticity in Stroke Patients with Dysphagia: A Methodological Study on Investigation and Treatment
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims

The aims of the thesis were to validate investigation instruments for stroke patients with dysphagia, and to improve oropharyngeal dysphagia therapies.

Methods/Results

A Lip Force Meter, LF 100, affirmed excellent intra- and inter-reliability, sensitivity and specificity. Controls had significantly stronger lip force (LF) and swallowing capacity (SC) than stroke patients. A normal lower limit of LF was set to 15 Newton. Dysphagia symptoms improved in 7 stroke patients after a 5-week sensorimotor stimulation therapy comprising manual body and facial regulation in combination with palatal plate application. Impaired LF and impaired SC were parallel phenomena in 22 acute stroke patients and did not differ regardless of presence or absence of facial palsy. LF and SC improved and were parallel phenomena in 30 stroke patients and did not differ regardless of presence or absence of facial palsy, time lag between stroke attack and start of treatment, or age. SC was normalized in 19 of 30 dysphagia patients after a 5-8-week daily lip muscle self-training with an oral screen.

Conclusions

LF100 is an appropriate and reliable instrument for measuring lip force. Dysphagia improvement, by body and facial sensorimotor stimulation in combination with palatal plate application, or by training with an oral screen is excellent examples of brain plasticity and cortical reorganisation. . Swallowing capacity and lip force in stroke patients are parallel phenomena. A sub clinical facial paresis seems to be present in most stroke patients. Training with an oral screen can improve LF and SC in stroke patients with oropharyngeal dysphagia.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 79 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 299
Keyword
Otorhinolaryngology, Brain plasticity, Controls, Dysphagia, Deglutition, Facial palsy, Lip force, Muscle training, Orofacial regulation, Reliability, Sensitivity, Specificity, Stroke, Swallowing capacity, Otorhinolaryngologi
Identifiers
urn:nbn:se:uu:diva-8337 (URN)978-91-554-7042-5 (ISBN)
Public defence
2007-12-14, Baranysalen, University Hospital, Entrance 78-79, Uppsala, 13:00
Opponent
Supervisors
Available from: 2007-11-23 Created: 2007-11-23Bibliographically approved

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