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      Association between tongue pressure and oral status and activities of daily living in stroke patients admitted to a convalescent rehabilitation unit

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          Abstract

          Background

          Clarifying how tongue pressure in convalescent stroke patients affects oral condition and activities of daily living (ADL) is important for developing oral rehabilitation programs and for rehabilitation care to reacquire ADL.

          Objective

          To clarify how tongue pressure is associated with oral status, ADL, and nutritional status in stroke patients.

          Methods

          Sixty‐eight patients aged 77.9 ± 10.0 years participated. The Japanese version of the Oral Health Assessment Tool was used to evaluate oral status. Data such as the ADL index functional independence measure (FIM), nutritional intake method, serum albumin, and body mass index were extracted from medical records. To examine factors associated with tongue pressure, multiple regression analysis was performed adjusting for confounding factors. The level of statistical significance was set at p < .05.

          Results

          In recovery phase stroke patients, tongue pressure was significantly lower in the total assistance group than in the partial assistance/independent group. In addition, tongue pressure was significantly lower in tube feeding patients than in oral feeding patients. FIM cognition score was an independent factor that had a significant effect on tongue pressure.

          Conclusion

          These findings suggest that ADL status also affects tongue pressure, thus patients' ADL including the FIM cognition subscale should also be evaluated while measuring tongue pressure.

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          Most cited references22

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          Dysphagia after stroke: incidence, diagnosis, and pulmonary complications.

          To determine the incidence of dysphagia and associated pulmonary compromise in stroke patients through a systematic review of the published literature. Databases were searched (1966 through May 2005) using terms "cerebrovascular disorders," "deglutition disorders," and limited to "humans" for original articles addressing the frequency of dysphagia or pneumonia. Data sources included Medline, Embase, Pascal, relevant Internet addresses, and extensive hand searching of bibliographies of identified articles. Selected articles were reviewed for quality, diagnostic methods, and patient characteristics. Comparisons were made of reported dysphagia and pneumonia frequencies. The relative risks (RRs) of developing pneumonia were calculated in patients with dysphagia and confirmed aspiration. Of the 277 sources identified, 104 were original, peer-reviewed articles that focused on adult stroke patients with dysphagia. Of these, 24 articles met inclusion criteria and were evaluated. The reported incidence of dysphagia was lowest using cursory screening techniques (37% to 45%), higher using clinical testing (51% to 55%), and highest using instrumental testing (64% to 78%). Dysphagia tends to be lower after hemispheric stroke and remains prominent in the rehabilitation brain stem stroke. There is increased risk for pneumonia in patients with dysphagia (RR, 3.17; 95% CI, 2.07, 4.87) and an even greater risk in patients with aspiration (RR, 11.56; 95% CI, 3.36, 39.77). The high incidence for dysphagia and pneumonia is a consistent finding with stroke patients. The pneumonia risk is greatest in stroke patients with aspiration. These findings will be valuable in the design of future dysphagia research.
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            The structure and stability of the Functional Independence Measure.

            The Functional Independence Measure (FIM) records the severity of disability of rehabilitation patients. The necessarily curvilinear relationship between the finite range of recorded FIM raw scores and the conceptually infinite range of additive disability measures is resolved through Rasch analysis. The analysis of admission and discharge FIM ratings of 14,799 patients shows that the 18 FIM items define two statistically and clinically different indicators. Thirteen items define disability in motor functions. Five items define disability in cognitive functions. Additive measures for each indicator have the same characteristics at admission and discharge, so that these measures can be used to assess change in patient status.
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              Oral hypofunction in the older population: Position paper of the Japanese Society of Gerodontology in 2016

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                Author and article information

                Contributors
                r15fujii@fa.kyu-dent.ac.jp
                Journal
                Clin Exp Dent Res
                Clin Exp Dent Res
                10.1002/(ISSN)2057-4347
                CRE2
                Clinical and Experimental Dental Research
                John Wiley and Sons Inc. (Hoboken )
                2057-4347
                30 November 2023
                February 2024
                : 10
                : 1 ( doiID: 10.1002/cre2.v10.1 )
                : e825
                Affiliations
                [ 1 ] Division of Dentistry Fukuoka Rehabilitation Hospital Fukuoka Japan
                [ 2 ] Graduate School of Dentistry, Department of Oral Health Sciences Kyushu Dental University Kitakyushu Japan
                [ 3 ] Unit of Interdisciplinary Promotion, School of Oral Health Sciences, Faculty of Dentistry Kyushu Dental University Kitakyushu Japan
                Author notes
                [*] [* ] Correspondence Wataru Fujii, Unit of Interdisciplinary Promotion, School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, 2‐6‐1 Manazuru, Kokura‐kita, Kitakyushu 803‐8580, Japan.

                Email: r15fujii@ 123456fa.kyu-dent.ac.jp

                Author information
                http://orcid.org/0000-0003-3417-4415
                Article
                CRE2825
                10.1002/cre2.825
                10860403
                38037529
                1f2a13dd-b107-4fe2-8969-b2bd4c1cbf59
                © 2023 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 November 2023
                : 30 January 2022
                : 22 November 2023
                Page count
                Figures: 1, Tables: 3, Pages: 6, Words: 4201
                Funding
                Funded by: None
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                February 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.6 mode:remove_FC converted:12.02.2024

                activities of daily living,functional independence measure,oral status,tongue pressure

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