Objective: To investigate the influence of tongue-disability, age and gender on motor performance for a tongue training paradigm involving playing a computer game using the Tongue Drive System (TDS). Design: Two controlled observational studies. Setting: A neurorehabilitation center and a dental school. Participants: In Study 1, eleven tongue-disabled patients with symptoms of dysphagia and dysarthria and 11 age-and sex-matched controls participated in tongue training. In Study 2, 16 healthy elderly and 16 healthy young participants volunteered. Intervention: In study 1 and study 2, the tongue training lasted 30 min and 40 min respectively. The participants were instructed to play a computer game with the tongue using TDS. Main Outcome Measures: Motor performance was compared between groups in both studies. Correlation analyses were performed between age and relative improvement in performance. Subject-based reports of motivation, fun, pain and fatigue evaluated on 0-10 numerical rating scales (NRS) were compared between groups. Results: In study 1, tongue-disabled patients performed poorer than healthy controls (P=0.005) and with a trend of a gender difference (P=0.046). In study 2, healthy young participants performed better than healthy elderly (P<0.001) but there was no effect of gender (P=0.140). There was a significant negative correlation between age and relative improvement in performance (δ=-0.450, P=0.009). There were no significant differences in subject-based reports of motivation, fun, pain and fatigue between groups in any of the studies (P>0.094). Conclusions: The present study provided evidence that tongue-disability and age can influence behavioral measures of tongue motor performance. TDS may be a new adjunctive neurorehabilitation regime in treating tongue-disabled patients.
Archives of Physical Medicine and Rehabilitation, 2014, Vol 95, Issue 3, p. 524-530