The clinical impact of the tongue pressure measurement and the novel preoperative training program with the tongue strength training device.

Abstract

Objectives: In cardiovascular surgery, frailty is a risk for postoperative dysphagia. This study investigated the effect of preoperative training on strengthening the tongue muscle and its clinical impact.

Methods: Patients scheduled for cardiovascular surgery between 2022 and 2024 who underwent preoperative tongue pressure measurement were included. Preoperative tongue muscle training was conducted using the novel device Pecopanda.

Results: Forty-two patients who purchased the Pecopanda and received preoperative training were assigned to the training group, and 66 patients without training or with maintained tongue pressure were assigned to the non-training group. Low tongue pressure below 30 kPa was observed in 44.4% of patients. Age was 76 (71-81) years in the training group and 70 (59-75) years in the non-training group. Change in tongue pressure pre- to post-operation was 0.2 (IQR: -1.3 to 7.0) kPa in the training group, and -2.2 (IQR: -4.4 to -0.5) kPa in the non-training group. Multiple regression analysis showed that changes in tongue pressure pre- and post-operation tended to be greater in the training group (β  =  1.342, 95% CI: -0.825 to 3.509). Logistic regression analysis suggested a trend towards a protective association between preoperative tongue training and deglutition diets or tube feeding at refeeding (OR = 0.81, 95% CI: 0.26 to 2.48). All patients in the training group were discharged home without the need for deglutition diets and tube feeding.

Conclusions: Preoperative training with simple tongue exercises may increase tongue pressure and support clinical outcomes in patients with low tongue pressure.