In 2021, BiSC Lab collaborated on a multisite study: “Determining an optimal delivery method for tongue strengthening during swallowing rehabilitation: Building a framework for clinical practice.” This study was funded by Encompass Health and led by PI Dr. Sarah Szynkiewicz at Samford University. Co-investigators include Dr. Erin Kamarunas at James Madison University, Dr. Teresa Drulia at Texas Christian University, Dr. Lindsay Griffin at Emerson College, and Dr. Mulheren at Case Western Reserve University. This study was supplementally funded by an internal award from the W. P. Jones Presidential Faculty Development Fund (PI: Mulheren). Three recent publications from this project included:

• Biofeedback and Exercise Load Affect Accuracy of Tongue Strength Exercise Performance (Kamarunas et al., 2024) –> This study investigated how the accuracy of tongue strength exercises (TSE) affects exercise outcomes, participant motivation, and adherence in typically aging individuals. Results showed that although exercise accuracy did not influence tongue strength outcomes, higher training accuracy was associated with higher participant confidence and adherence. This highlights the importance of personalized approaches in swallowing-rehabilitation programs.  

• A Comparison of Lingual Pressure Generation Measures Using Two Devices in Community-Dwelling, Typically Aging Adults: An Important Clinical Implication (Drulia et al. 2024) –> This study compared lingual pressure generation between the Tongueometer (TO) and the Iowa Oral Performance Instrument (IOPI) in typically aging adults across three measurement tasks. The results showed strong positive correlations between the two devices but the TO recorded lower pressure values than the IOPI. These results showed the need for device-specific normative values or conversion formulas for accurate clinical application.

• Flexibility for Intensity Dosing in Lingual Resistance Exercises: A Large Randomized Clinical Trial in Typically Aging Adults as Proof of Principle (Sznkiewicz et al., 2023) –> This study assessed how different intensity dosing during tongue exercises can affect tongue pressure generation, adherence and perceived effort in typically aging adults. Results from this study showed that even though all exercise protocols improved maximum isometric pressure (MIP), only maximum intensity with the biofeedback group showed significant gains in saliva swallow pressure. This suggests that tongue exercise protocols may be open to flexibility in dosing.