典型发育儿童群体的口面部力量：Iowa口腔表现仪器与Tongueometer的比较

文献信息

中文摘要

目的： 基于压力的舌力量评估在吞咽困难管理中日益常见。然而，不同测压设备在同一任务中是否产生可比测量值，尤其是在儿科人群中，仍未充分阐明。本研究旨在使用Iowa口腔表现仪器（IOPI）和Tongueometer（TO）建立儿科人群舌、颊和唇力量的年龄和性别特异性参考值，并系统检查设备、年龄和性别对这些测量的影响，以及两种设备之间的一致性水平。
方法： 共纳入330名8-18岁典型发育儿童和青少年。对所有参与者，使用IOPI和TO测量前部和后部舌力量、颊力量以及唇（唇间）力量。使用混合析因方差分析检查设备、年龄和性别效应。使用描述性统计报告两种设备的年龄和性别特异性参考范围。使用Lin一致性相关系数（CCC）和Bland-Altman图评估设备间一致性，同时使用线性回归分析评估设备间关系。
结果： 在所有参数中，TO产生的压力值始终低于IOPI。此外，两种设备获得的所有测量之间的相关性为中至强。Lin CCC值表明所有测量的一致性较差，Bland-Altman分析显示设备间存在系统性偏倚。年龄对两种设备获得的舌、唇和颊力量测量具有强主效应，而性别效应通常有限，仅在测量的颊和唇力量中观察到。
结论： IOPI和TO在儿科人群中系统性地产生不同的压力值，不应互换使用。因此，本研究为两种设备提供了年龄和性别特异性参考值，以支持儿童和青少年舌及口面部力量测量的设备特异性解读。结果还表明，在儿童和青少年期，年龄是舌和口面部力量的更强决定因素，而非性别。

英文摘要

PURPOSE: Pressure-based assessments of tongue strength are becoming increasingly common in dysphagia management. However, whether different manometric devices produce comparable measurements for the same tasks, particularly in pediatric populations, remains insufficiently clarified. The purposes of this study were to establish age- and sex-specific reference values for tongue, buccal, and lip strength in a pediatric population using the Iowa Oral Performance Instrument (IOPI) and the Tongueometer (TO) and to systematically examine the effects of device, age, and sex on these measurements, as well as the level of agreement between the two devices.
METHOD: A total of 330 typically developing children and adolescents aged 8-18 years were included. For all participants, anterior and posterior tongue strength, buccal strength, and lip (interlabial) strength were measured using both the IOPI and TO. Device, age, and sex effects were examined using mixed factorial analyses of variance. Age- and sex-specific reference ranges for both devices were reported using descriptive statistics. The agreement between devices was assessed using Lin's concordance correlation coefficient (CCC) and Bland-Altman plots, while the relationship between devices was assessed using linear regression analysis.
RESULTS: Across all parameters, the TO consistently produced lower pressure values than the IOPI. Additionally, the correlation between all measurements obtained with both devices was moderate to strong. Lin's CCC values indicated poor agreement for all measurements, and Bland-Altman analyses demonstrated systematic bias between devices. Age had a strong main effect on tongue, lip, and buccal strength measurements obtained from both devices, whereas sex effects were generally limited and observed for buccal and lip strength measured.
CONCLUSIONS: The IOPI and TO systematically produce different pressure values in pediatric populations and should not be used interchangeably. Accordingly, this study provides age- and sex-specific reference values for both devices to support device-specific interpretation of tongue and orofacial strength measurements in children and adolescents. The results also indicate that age is a stronger determinant of tongue and orofacial strength during childhood and adolescence than sex.