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Implementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study

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dc.description.abstractBackground: Tongue pressure is an effective index of swallowing function, and it decreases with aging and disease progression. Previous research has shown beneficial effects of swallowing exercises combined with myofunctional tongue-strengthening therapy on tongue function. Tongue exercises delivered through mobile health (mHealth) technologies have the potential to advance health care in the digital age to be more efficient for people with limited resources, especially older adults. Objective: The purpose of this study is to explore the immediate and long-term maintenance effects of an 8-week home-based mHealth app intervention with biweekly (ie, every 2 weeks) human mediation aimed at improving the swallowing tongue pressure in older adults. Methods: We developed an mHealth app intervention that was used for 8 weeks (3 times/day, 5 days/week, for a total of 120 sessions) by 11 community-dwelling older adults (10 women; mean age 75.7 years) who complained of swallowing difficulties. The app included a swallowing monitoring and intervention protocol with 3 therapy maneuvers: effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation. The 8-week intervention was mediated by biweekly face-to-face meetings to monitor each participant's progress and ability to implement the training sessions according to the given protocol. Preintervention and postintervention isometric and swallowing tongue pressures were measured using the Iowa Oral Performance Instrument. We also investigated the maintenance effects of the intervention on swallowing tongue pressure at 12 weeks postintervention. Results: Of the 11 participants, 8 adhered to the home-based 8-week app therapy program with the optimal intervention dosage. At the main trial end point (ie, 8 weeks) of the intervention program, the participants demonstrated a significant increase in swallowing tongue pressure (median 17.5 kPa before the intervention and 26.5 kPa after the intervention; P=.046). However, long-term maintenance effects of the training program on swallowing tongue pressure at 12 weeks postintervention were not observed. Conclusions: Swallowing tongue pressure is known to be closely related to dysphagia symptoms. This is the first study to demonstrate the effectiveness of the combined methods of effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation using mobile app training accompanied by biweekly human mediation in improving swallowing tongue pressure in older adults. The mHealth app is a promising platform that can be used to deliver effective and convenient therapeutic service to vulnerable older adults. To investigate the therapeutic efficacy with a larger sample size and observe the long-term effects of the intervention program, further studies are warranted. International registered report identifier (irrid): RR2-10.2196/19585.-
dc.publisherJMIR Publications Inc.-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleImplementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Rehabilitation Medicine (재활의학교실)-
dc.contributor.googleauthorHyangHee Kim-
dc.contributor.googleauthorNam-Bin Cho-
dc.contributor.googleauthorJinwon Kim-
dc.contributor.googleauthorKyung Min Kim-
dc.contributor.googleauthorMinji Kang-
dc.contributor.googleauthorYounggeun Choi-
dc.contributor.googleauthorMinjae Kim-
dc.contributor.googleauthorHeecheon You-
dc.contributor.googleauthorSeok In Nam-
dc.contributor.googleauthorSoyeon Shin-
dc.subject.keywordIowa Oral Performance Instrument-
dc.subject.keywordeffortful pitch glide-
dc.subject.keywordeffortful prolonged swallowing-
dc.subject.keywordeffortful tongue rotation-
dc.subject.keywordolder adults-
dc.subject.keywordswallowing disorders-
dc.subject.keywordswallowing maneuver-
dc.subject.keywordswallowing tongue pressure-
dc.contributor.alternativeNameKim, Hyang Hee-
dc.identifier.bibliographicCitationJMIR MHEALTH AND UHEALTH, Vol.8(10) : e22080, 2020-10-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers


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