Effect of visual biofeedback of posterior tongue movement on articulation rehabilitation in dysarthria patients.

Articulation is driven by various combinations of movements of the lip, tongue, soft palate, pharynx and larynx, where the tongue plays an especially important role. In patients with cerebrovascular disorder, lingual motor function is often affected, causing dysarthria. We aimed to evaluate the effect of visual biofeedback of posterior tongue movement on articulation rehabilitation in dysarthria patients with cerebrovascular disorder. Fifteen dysarthria patients (10 men and 5 women; mean age, 70.7 ± 10.3 years) agreed to participate in this study. A device for measuring the movement of the posterior part of the tongue was used for the visual biofeedback. Subjects were instructed to produce repetitive articulation of [ka] as fast and steadily as possible between a lungful with/without visual biofeedback. For both the unaffected and affected sides, the range of ascending and descending movement of the posterior tongue with visual biofeedback was significantly larger than that without visual biofeedback. The coefficient of variation for these movements with visual biofeedback was significantly smaller than that without visual biofeedback. With visual biofeedback, the range of ascent exhibited a significant and strong correlation with that of descent for both the unaffected and affected sides. The results of this study revealed that the use of visual biofeedback leads to prompt and preferable change in the movement of the posterior part of the tongue. From the standpoint of pursuing necessary rehabilitation for patients with attention and memory disorders, visualization of tongue movement would be of marked clinical benefit.

Dynamics of posterior tongue during pronunciation and voluntary tongue lift movement in young adults.

The lifting-up movement of the posterior part of the tongue to touch the palate, which is a requirement for performing physiological functions such as deglutition and speech, is an important phenomenon that is difficult to objectively evaluate. The purpose of this study was to develop a new modality to evaluate the tongue-lifting function, especially in the posterior part of the tongue, and to elucidate the dynamic properties of the tongue in normal subjects. Twenty-three healthy volunteers (9 men and 14 women; mean age, 27·6years) participated in this study. A new device was developed that could evaluate the up-down movement of the posterior part of the tongue in a non-invasive manner. The experimental tasks were as follows: (i) /a/ pronunciation for 1s followed by /ka/ pronunciation (a-ka task), (ii) /a/ pronunciation for 1s followed by /ga/ pronunciation (a-ga task) and (iii) /a/ pronunciation for 1s followed by a voluntary push-up movement of the posterior part of the tongue (a-lift task). Maximum upward velocity in the a-ga task was larger than that in the a-ka task (P<0·05). The a-lift task showed the highest tongue lift range among the three tasks, and the a-ga task showed a higher range than that of the a-ka task (P<0·05). This study revealed that precise quantification of the motility of the posterior part of the tongue, which would be useful in rehabilitation of articulation and/or swallowing, could be achieved using this new device in a non-invasive manner.