A Pilot Assessment of Concurrent Validity and Comparative Reference Values for the Tongueometer Tongue Pressure Manometer

Abstract

Purpose: Objective measures of lingual strength are used in both clinical practice and research to provide information regarding the ability of the tongue to contribute to safe and efficient swallowing. The Iowa Oral Performance Instrument (IOPI) is the most frequently used tongue pressure manometer and is considered to be the gold standard. The Tongueometer device was developed to circumvent IOPI shortcomings including bulb slippage, cost, and patient utility. As such, the aims of this pilot study were to examine the validity of the Tongueometer and to obtain comparative adult reference values. Method: Using the Tongueometer, participants completed three trials of anterior and posterior maximum isometric lingual pressure and regular effort saliva swallow tasks. Moreover, 41% of participants also completed all trials using the IOPI. Independent-samples t tests compared maximum means between the IOPI and Tongueometer. Concurrent validity was assessed using Lin's concordance correlations. Associations were evaluated using independent-samples t tests (sex) and Pearson correlation coefficient (age). Results: Seventy-six healthy participants (48 women, 28 men) with no history of swallowing difficulty were included in the study ( M age = 50 ± 21). Across all lingual pressure task measures, mean maximum Tongueometer measures strongly correlated with corresponding IOPI measures (anterior: concordance correlation coefficient [CCC] = 0.74, p < .000; posterior: CCC = 0.81, p < .000; swallow: CCC = 0.62, p < .000). Tongueometer and IOPI mean anterior maximum isometric lingual pressures were not statistically different, whereas posterior lingual pressures and pressures elicited during swallowing were statistically different ( p < .01). A significant negative correlation was found between age and maximum anterior tongue pressure ( r = −.43, p < .01). No significant association of sex on maximum tongue pressure was observed. Conclusion: Overall, this pilot research suggests that the Tongueometer is a valid tool for clinical use in measuring lingual strength and swallowing function.