Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 7, 2014
   Pages 1127 — 1142

Abstract — Perceptual and instrumental assessments of orofacial muscle tone in dysarthric and normal speakers

Angela M. Dietsch, PhD;1–2* Nancy Pearl Solomon, PhD;1 Laura A. Sharkey, BA, BS;1,3 Joseph R. Duffy, PhD;4 Edythe A. Strand, PhD;4 Heather M. Clark, PhD4

1National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD; 2Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD; 3Department of Hearing and Speech Sciences, University of Maryland, College Park, MD; 4Department of Neurology, Mayo Clinic, Rochester, MN

Abstract — Clinical assessment of orofacial muscle tone is of interest for differential diagnosis of the dysarthrias, but standardized procedures and normative data are lacking. In this study, perceptual ratings of tone were compared with instrumental measures of tissue stiffness for facial, lingual, and masticatory muscles in 70 individuals with dysarthria. Perceptual and instrumental tone data were discordant and failed to discriminate between five dysarthria types. These results raised concerns about the validity of Myoton-3 stiffness measures in the orofacial muscles. Therefore, a second study evaluated contracted and relaxed orofacial muscles in 10 neurotypical adults. Results for the cheek, masseter, and lateral tongue surface followed predictions, with significantly higher tissue stiffness during contraction. In contradiction, stiffness measures from the superior surface of the tongue were lower during contraction. Superior-to-inferior tongue thickness was notably increased during contraction. A third study revealed that tissue thickness up to ~10 mm significantly affected Myoton-3 measures. Altered tissue thickness due to neuromuscular conditions like spasticity and atrophy may have undermined the detection of group differences in the original sample of dysarthric speakers. These experiments underscore the challenges of assessing orofacial muscle tone and identify considerations for quantification of tone-related differences across dysarthria groups in future studies.

Key words: dysarthria, motor speech assessment, muscle tone, Myoton, neurological disorders, orofacial muscles, rigidity, spasticity, stiffness, tissue thickness, tongue, viscoelastic properties.


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This article and any supplementary material should be cited as follows:
Dietsch AM, Solomon NP, Sharkey LA, Duffy JR, Strand EA, Clark HM. Perceptual and instrumental assessments of orofacial muscle tone in dysarthric and normal speakers. J Rehabil Res Dev. 2014;51(7):1127–42.
http://dx.doi.org/10.1682/JRRD.2013.07.0167
ResearcherID/ORCID: Angela M. Dietsch, PhD: H-6552-2013
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