Other Titles
Effects of Tongue Resistance and Strengthening Exercises in Elderly with Mild Cognitive Impairment: A Double-Blind Randomized Controlled Trial [Poster Title]
Abstract
Purpose: Frail older adults with mild cognitive impairment (MCI) often experience reduced tongue function, resulting in inefficient bolus transport and swallowing difficulties. Tongue resistance exercises (TRE) use isometric or isotonic movements against resistance to enhance tongue strength, while tongue strengthening exercises (TSE) involve repetitive, high-intensity movements to improve tongue pressure and swallowing coordination. This study aimed to evaluate the effects of a combined TRE + TSE program on tongue function, swallowing pressure, swallowing performance, and quality of life (QoL) in frail older adults with MCI.
Methods: A prospective, double-blind, three-arm randomized controlled trial was conducted. Participants (n = 89; mean age = 75.3 ± 6.9 years; 82% women) were randomly assigned to (i) TRE + TSE (n = 29), (ii) TRE alone (n = 30), or (iii) cheek-bulging exercises (active control, n = 30) for 12 weeks, followed by a 12-week booster program. Primary outcomes were tongue function measured using the Iowa Oral Performance Instrument (IOPI): anterior (ATS) and posterior (PTS) tongue strength, and anterior (ATE) and posterior (PTE) tongue endurance. Secondary outcomes included saliva (SSP) and effortful (ESP) swallowing pressure, oral-phase difficulty (DoP), number of repetitive saliva swallows (NRSS), and swallowing-related QoL (SWAL-QOL). Data were analyzed using a generalized estimating equation model.
Results: The combined TRE + TSE program significantly improved ATS (β = 9.5, 95% CI = 3.8–15.1), PTE (β = 9.7, 95% CI = 2.8–16.6), SSP (β = 8.9, 95% CI = 5.0–12.9), ESP (β = 12.1, 95% CI = 6.8–17.4), NRSS (β = 4.0, 95% CI = 2.7–5.3), and SWAL-QOL (β = 29.3, 95% CI = 22.4–36.2) compared with controls, with sustained NRSS and QoL improvements at 12-week follow-up. TRE alone improved ATS, SSP, ESP, NRSS, and SWAL-QOL immediately post-intervention, maintaining SSP, ESP, and QoL effects after the booster phase.
Conclusion: A combined tongue training program produced greater and longer-lasting improvements in tongue strength, swallowing pressure, and QoL than TRE alone. Booster training effectively sustained these benefits over time.
Notes
Putri AR, Chu YH, Chen R, et al. Prevalence of swallowing disorder in different dementia subtypes among older adults: a meta-analysis. Age Ageing. 2024;53(3):afae037.
Adams V, Mathisen BA, Baines SK, Lazarus CL, Callister R. A systematic review and Meta-analysis of measurements of tongue and hand strength and endurance using the Iowa Oral Performance Instrument (IOPI). Dysphagia. 2013;28:350-369. doi:10.1007/s00455-013-9451-3.
Fu CP. The reliability and validity of the swallowing quality of life questionnaire Taiwan version [doctoral dissertation]. Taipei, Taiwan: National Taipei University of nursing and health sciences; 2016. available from: https://ndltd.ncl.edu.tw/cgibin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22104NTCN0714003%22.&searchmode=basic. Accessed January 20, 2023.
Wang T, Tai J, Hu R, et al. Effect of tongue-pressure resistance training in poststroke dysphagia patients with oral motor dysfunction: A randomized controlled trial. Am J Phys Med Rehabil. 2022;101(12):1134-1138. doi:10.1097/PHM.0000000000001998.
Banda KJ, Chu H, Chen R, et al. Prevalence of oropharyngeal dysphagia and risk of pneumonia, malnutrition, and mortality in adults aged 60 years and older: A meta-analysis. Gerontology. 2022;68(8):841-53.
Sigma Membership
Lambda Beta at-Large
Type
Poster
Format Type
Text-based Document
Study Design/Type
Randomized Controlled Trial
Research Approach
Quantitative Research
Keywords:
Long-Term Care, Public and Community Health, Aged, Elderly, Tongue Function
Recommended Citation
Chou, Kuei-Ru, "Effects of Tongue Resistance and Strengthening Exercises in Elderly with MCI: A Double-Blind RCT" (2026). International Nursing Research Congress (INRC). 18.
https://www.sigmarepository.org/inrc/2026/posters_2026/18
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-21
Effects of Tongue Resistance and Strengthening Exercises in Elderly with MCI: A Double-Blind RCT
Toronto, Ontario, Canada
Purpose: Frail older adults with mild cognitive impairment (MCI) often experience reduced tongue function, resulting in inefficient bolus transport and swallowing difficulties. Tongue resistance exercises (TRE) use isometric or isotonic movements against resistance to enhance tongue strength, while tongue strengthening exercises (TSE) involve repetitive, high-intensity movements to improve tongue pressure and swallowing coordination. This study aimed to evaluate the effects of a combined TRE + TSE program on tongue function, swallowing pressure, swallowing performance, and quality of life (QoL) in frail older adults with MCI.
Methods: A prospective, double-blind, three-arm randomized controlled trial was conducted. Participants (n = 89; mean age = 75.3 ± 6.9 years; 82% women) were randomly assigned to (i) TRE + TSE (n = 29), (ii) TRE alone (n = 30), or (iii) cheek-bulging exercises (active control, n = 30) for 12 weeks, followed by a 12-week booster program. Primary outcomes were tongue function measured using the Iowa Oral Performance Instrument (IOPI): anterior (ATS) and posterior (PTS) tongue strength, and anterior (ATE) and posterior (PTE) tongue endurance. Secondary outcomes included saliva (SSP) and effortful (ESP) swallowing pressure, oral-phase difficulty (DoP), number of repetitive saliva swallows (NRSS), and swallowing-related QoL (SWAL-QOL). Data were analyzed using a generalized estimating equation model.
Results: The combined TRE + TSE program significantly improved ATS (β = 9.5, 95% CI = 3.8–15.1), PTE (β = 9.7, 95% CI = 2.8–16.6), SSP (β = 8.9, 95% CI = 5.0–12.9), ESP (β = 12.1, 95% CI = 6.8–17.4), NRSS (β = 4.0, 95% CI = 2.7–5.3), and SWAL-QOL (β = 29.3, 95% CI = 22.4–36.2) compared with controls, with sustained NRSS and QoL improvements at 12-week follow-up. TRE alone improved ATS, SSP, ESP, NRSS, and SWAL-QOL immediately post-intervention, maintaining SSP, ESP, and QoL effects after the booster phase.
Conclusion: A combined tongue training program produced greater and longer-lasting improvements in tongue strength, swallowing pressure, and QoL than TRE alone. Booster training effectively sustained these benefits over time.
Description
Focus: Clinical
Status: Completed Work/Project
Setting: National
This double-blind randomized controlled trial examined the effects of a combined tongue resistance and strengthening exercise program among frail older adults with mild cognitive impairment. The combined training significantly improved tongue strength, swallowing pressure, and swallowing-related quality of life compared with control or single training, with benefits maintained after booster sessions.