Table of Contents
Overview of the TongueFit Device and App Features
The TongueFit system is an innovative tool designed to measure tongue strength and endurance, consisting of two interconnected components: hardware and software. The hardware component includes a manometer device and two variations of bulb sizes, specifically crafted to cater to the unique anatomical characteristics of pediatric patients. The materials used for the bulbs and tubes are biobased polyurethane and polylactic acid, both of which have passed rigorous toxicity testing at the Stem Cells and Tissue Engineering Research Centre, ensuring safety for intraoral use. Toxicity testing was conducted using human stem cells, with results indicating a cell death percentage of less than 16%, thereby confirming the nontoxic nature of these components (1).
The software aspect of the TongueFit includes a dedicated mobile application that allows users to measure tongue strength and endurance, track measurement results, access historical data, and engage in game-based exercises in the Bahasa language. The assessment of tongue strength involves strategically positioning the bulb anteromedial on the tongue, instructing the patient to elevate their tongue against the palate with maximum effort. This measurement is repeated three times, and the highest recorded value is utilized as a reference for endurance evaluation and exercise therapy. Tongue endurance is evaluated by having the patient sustain tongue elevation against the palate at 40%-60% of their maximum strength for as long as possible (1).
Figure 1. The hardware components of TongueFit.
- (A) The manometer
- (B) The body of the TongueFit, which includes the manometer hardware, an on/off button, a tube connector, and a charging port
- (C) The tongue bulb with two different sizes: the 2-cm bulb (right) and the 3-cm bulb (left)
Figure 2. The TongueFit app.
- (A) Opening page
- (B) Tongue strength test
- (C) Tongue endurance test
- (D) Tongue strength and endurance chart result
The assessment of tongue strength and endurance is performed prior to therapy to establish baseline values, which serve as a reference for exercise prescriptions using the TongueFit device. The exercise protocol incorporates both strengthening and endurance components, adhering to the FITT principle (frequency, intensity, time, and type). Strengthening exercises are conducted at an intensity of 60%-80%, while endurance exercises are maintained at 40%-60% of maximum tongue strength, each lasting 15 minutes with 30 repetitions per session (1).
Methodology for Measuring Tongue Strength and Endurance
The methodology employed within the TongueFit system for measuring tongue strength and endurance follows a systematic approach. Initial measurements are conducted prior to any therapeutic interventions to establish a baseline. The device itself utilizes a calibrated manometer, which measures air pressure differences when the tongue exerts force on the bulb.
Measurement Procedure
- Tongue Strength Test: The bulb is positioned on the tongue, and the participant is instructed to push against the palate with maximum strength. This action generates a pressure reading that is recorded.
- Tongue Endurance Test: The participant is then asked to maintain a position of 40%-60% of their maximum strength for as long as possible, allowing for an assessment of endurance.
The exercise regimen is personalized based on these measurements, and the results are logged into the accompanying app for tracking progress over time. This approach not only facilitates real-time feedback but also enhances user engagement through game-like elements incorporated within the app interface (1).
Validity Testing of TongueFit Against Standard Manometer
In a comparative study, the validity of the TongueFit device was tested against a standard manometer (SNDWAY SW-512C), which is recognized as the gold standard for measuring air pressure differences. The study included both bulb sizes, a 2-cm bulb intended for children under six years of age and a 3-cm bulb for older children and adults. Experimental conditions were designed to evaluate the accuracy of the TongueFit in measuring tongue strength against the standard manometer across three different testing scenarios.
The findings indicated a negligible mean difference of 0.005 kPa between the two devices, signifying a high level of agreement. The analysis further revealed a perfect agreement value (ρC=1), corroborating the accuracy of measurements obtained with the TongueFit device. Additionally, the Bland-Altman analysis showed consistent agreement across both bulb sizes (1).
Table 1. Comparative Validity Testing Results
| Measurement Comparisons | Mean Difference (kPa) | ρC Value |
|---|---|---|
| TongueFit vs Standard Manometer | 0.005 | 1.000 |
| 2-cm Bulb | 0.005 | 1.000 |
| 3-cm Bulb | 0.005 | 0.999 |
The results of this study confirm that TongueFit is a valid alternative for measuring tongue strength and endurance, providing accurate and reliable measurements comparable to those obtained using a standard manometer. This advancement is particularly significant in clinical settings where accurate assessment is crucial for effective treatment planning in pediatric rehabilitation (1).
Importance of Tongue Strength in Pediatric Rehabilitation
Tongue strength plays a pivotal role in various aspects of pediatric health, particularly in the context of eating, swallowing, and speech development. Assessment of tongue strength is essential because it directly influences a child’s ability to perform these fundamental functions. Insufficient tongue strength can lead to difficulties in feeding, increased risk of aspiration, and challenges in speech articulation.
In pediatric rehabilitation, the TongueFit system provides practitioners with a practical tool to quantify and track tongue strength and endurance over time. This capability enables tailored interventions that can significantly enhance the quality of life for children experiencing feeding difficulties or developmental delays.
Clinical Implications
- Targeted Interventions: By accurately measuring tongue strength, clinicians can develop personalized exercise regimens that address specific weaknesses.
- Monitoring Progress: The ability to track improvements provides critical data that can inform treatment adjustments and optimize outcomes.
- Enhanced Rehabilitation Protocols: Incorporation of the TongueFit system into rehabilitation programs aligns with evidence-based practices, ensuring that interventions are grounded in measurable outcomes (1).
Future Directions for TongueFit in Clinical Applications
The TongueFit system holds promise for expanding its application in clinical settings beyond pediatric rehabilitation. Future research may explore its utility in various populations, including adults with dysphagia, neurological conditions, or post-operative recovery scenarios.
Potential Areas for Exploration
- Expanding Age Range: Investigating the effectiveness of TongueFit in measuring tongue strength across different age groups, including adults and the elderly.
- Integration with Other Therapeutic Modalities: Exploring how the TongueFit system can be used in conjunction with other therapies such as speech therapy or occupational therapy to enhance patient outcomes.
- Telehealth Applications: Developing remote monitoring capabilities that allow clinicians to assess and guide patients through the TongueFit app, improving access to care for individuals in underserved regions.
As the healthcare landscape continues to evolve, the integration of innovative technologies like TongueFit can play a crucial role in enhancing patient care and outcomes in rehabilitation settings (1).
FAQ
What is the TongueFit system?
The TongueFit system is a device designed to measure tongue strength and endurance through a combination of hardware (manometer and bulbs) and software (mobile app).
How does the TongueFit app work?
The app allows users to measure tongue strength, track results, and engage in game-based exercises to encourage participation in rehabilitation.
What is the significance of tongue strength in children?
Tongue strength is critical for feeding, swallowing, and speech development, influencing a child’s overall health and quality of life.
How valid is the TongueFit compared to traditional methods?
Studies have shown that the TongueFit device provides measurements that are highly comparable to those obtained using standard manometers, confirming its validity for clinical use.
What are the future applications of TongueFit?
Future applications may include use in adult dysphagia rehabilitation, integration with other therapies, and telehealth capabilities for remote monitoring.
References
- Daduang, J., Nopkuesuk, N., Klamrak, A., Nabnueangsap, J., Narkpuk, J., Rahman, S. S., Saengkun, Y., Janpan, P., Soonkum, T., Sitthiwong, P., Jangpromma, N., Kulchat, S., Choowongkomon, K., Patramanon, R., Chaveerach, A., Teeravechyan, S. (2023). A New, Portable Orofacial Manometer for Measuring Tongue Strength and Endurance in Children: Laboratory-Based Validity Study. Journal of Medical Internet Research. https://doi.org/10.2196/68967