INTRODUCTION Patients with neurological and neuromuscular disorders (NNMD) frequently experience swallowing disorders that increase aspiration pneumonia risk and therefore require specialized diets or tube feeding. Diet type level usually is assessed by video fluoroscopic swallowing study (VFSS). To identify a simpler assessment method, we examined the association between diet type (based on the Functional Oral Intake Scale [FOIS]) diet type and maximum tongue pressure (MTP). METHODS From 2011-2020, FOIS diet type level and MTP were assessed in a sample of 927 patients. Of these patients, 186 had Parkinson's disease (PD), 69 had Parkinson-related disease (PRD), 61 had multiple system atrophy (MSA), 42 had spinocerebellar degeneration (SCD), 147 had amyotrophic lateral sclerosis (ALS), 180 had myotonic dystrophy type 1 (DM1), and 242 had Duchenne muscular dystrophy (DMD). VFSS was conducted while patients swallowed water and foods containing barium. MTP measurements were collected the same day. Participants' diet type level was adjusted based on the VFSS, with some participants requiring multiple examinations. Relationships between diet type level and MTP were tested using univariate and Spearman rank correlation analyses. RESULTS Mean MTP for the entire NNMD group (25.5 ± 13.1 kPa) was lower than that of healthy elderly individuals, as determined in previous reports. The highest MTP was found in the MSA group (32.2 ± 15.7 kPa) and the lowest in the DM1 group (19.1 ± 9.0 kPa). Diet type level was highest in the MSA group (5.8 ± 1.4) and lowest in the DMD group (5.2 ± 1.7). A significant correlation was observed between diet type level and MTP (R = 0.384, p < 0.001). The optimum MTP cutoff values-detected using ROC curves to predict a requirement to change to a dysphagia diet-was highest in the DMD group (29.0 kPa) and lowest in the ALS group (12.3 kPa). CONCLUSIONS The decision to change NNMD patients to a dysphagia diet can be made based on MTP. Modifying a patient's oral diet (FOIS level ≤ 5) should be considered for those with a MTP of 10-25 kPa, with the cutoff value varying by disease.

中文翻译：

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神经和神经肌肉疾病患者舌压与功能性口腔摄入量表饮食类型的关系

引言 神经和神经肌肉疾病 (NNMD) 患者经常出现吞咽障碍，这会增加吸入性肺炎的风险，因此需要专门的饮食或管饲。饮食类型水平通常通过视频透视吞咽研究 (VFSS) 进行评估。为了确定更简单的评估方法，我们检查了饮食类型（基于功能性口腔摄入量表 [FOIS]）饮食类型与最大舌压 (MTP) 之间的关联。方法 从 2011-2020 年，对 927 名患者的样本进行了 FOIS 饮食类型水平和 MTP 评估。在这些患者中，186 人患有帕金森病 (PD)，69 人患有帕金森相关疾病 (PRD)，61 人患有多系统萎缩症 (MSA)，42 人患有脊髓小脑变性 (SCD)，147 人患有肌萎缩侧索硬化症 (ALS)，180 人患有肌强直性营养不良1型（DM1），242 人患有杜氏肌营养不良症 (DMD)。VFSS 是在患者吞咽水和含钡食物时进行的。同一天收集 MTP 测量值。根据 VFSS 调整参与者的饮食类型水平，一些参与者需要多次检查。使用单变量和 Spearman 等级相关分析测试饮食类型水平和 MTP 之间的关系。结果 整个 NNMD 组的平均 MTP (25.5 ± 13.1 kPa) 低于健康老年人，如先前报告所述。MSA 组的 MTP 最高 (32.2 ± 15.7 kPa)，DM1 组的 MTP 最低 (19.1 ± 9.0 kPa)。饮食类型水平在 MSA 组中最高 (5.8 ± 1.4)，在 DMD 组中最低 (5.2 ± 1.7)。在饮食类型水平和 MTP 之间观察到显着相关性（R = 0.384，p < 0。001）。使用 ROC 曲线检测到的最佳 MTP 截断值以预测改变​​为吞咽困难饮食的需求，在 DMD 组中最高 (29.0 kPa)，在 ALS 组中最低 (12.3 kPa)。结论 可以根据 MTP 做出将 NNMD 患者改为吞咽困难饮食的决定。对于 MTP 为 10-25 kPa 的患者，应考虑调整患者的口服饮食（FOIS 水平 ≤ 5），临界值因疾病而异。