Tongue Motor Recruitment During Exercise
Condition: Healthy
Study type: Interventional

Summary: 
      The prevalence of dysphagia may be as high as 22% in individuals over 50 years of age. There
      are few therapeutic options offered to these individuals. One more recent therapeutic option
      is Expiratory Muscle Strength Training (EMST), which has been used successfully to maintain
      or increase expiratory force generating pressures, cough function, and swallowing in a number
      of disease populations. Recently, the investigators have noted improvements in oral transit
      time during swallowing in individuals with Amyotrophic Lateral Sclerosis (ALS) that could
      potentially be attributed to improved base of tongue functioning and muscle activation.

      There has been one study that demonstrated that breathing training resulted in increased and
      prolonged submental (under the chin) muscle activation as evidenced by surface
      electromyography. However, no studies have investigated the activation of the tongue muscles
      during various swallowing and breathing exercises. A small needle electrode (fine wire EMG)
      is standard of care in diagnosing muscular diseases because it can determine amount of muscle
      recruitment for muscles throughout the body. This aim of this research study is to examine
      the effects of breathing exercises and swallowing exercises on tongue muscle activity in
      healthy adults.
    

Detailed description: 
      This study will measure tongue muscle activation using fine wire EMG placed into the tongue
      muscle (underneath the chin) during swallowing and breathing exercises. A neurologist trained
      in EMG will perform all procedures to ensure best placement and minimize discomfort of the
      participant. While the needle is in place, the participant will complete a series of
      swallowing tasks and breathing exercises using a small, handheld training device. All
      swallowing and breathing tasks will be viewed under x-ray in order to see the movement and
      timing of the tongue and swallowing muscles during each task. Participation in the study will
      take one, one-hour visit to the Shands Dental Tower lab spaces where all procedures will be
      completed.
    

Intervention name(s): Electromyography; Maximum expiratory pressure; Videofluoroscopy; Swallowing Tasks
Intervention type(s): Procedure; Procedure; Procedure; Behavioral
Intervention description(s): During the fine wire electromyography (EMG), the participant will be asked to complete breathing exercises at 50% and 75% of their maximum capacity (determined prior to fine wire EMG using manometry) to determine activation and recruitment of genioglossus muscle.; The participants' maximum expiratory pressure (MEP) will be assessed using a hand-held digital manometer (MP01, Micro Direct Inc.). The subject will be standing and while wearing a nose clip be asked to blow out as hard and fast as they can to determine their MEP. This will be completed a maximum of three times to obtain values within close range of one another.; Videofluoroscopy allows for time-synced, frame-by-frame data analysis for the specific measures taken during swallowing tasks.; These include: an anterior tongue press to the alveolar ridge (behind the front molars), a saliva swallow, a 10 mL barium swallow, a 10 mL barium "hard" swallow (i.e. swallowing with extra effort), and two breathing exercise trials at 50% MEP and 75% MEP.
Other intervention name(s): EMG; MEP; Videofluoroscopy and Barium
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Tongue; Genioglossus; genioglossus recruitment