Background: 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

Passive task-related (TR) fatigue caused by monotonous driving can negatively affect driving safety by impairing driver alertness and performance. This study aims to evaluate the effectiveness of a motion seat system on the driver’s passive TR fatigue in terms of driving performance, physiological response, and subjective fatigue by using automotive and physiological sensors those applicable to on-road driving environment. Twenty drivers (5 females and 15 males; age = 38.5 ± 12.2) with more than two years of driving experience participated in an on-road experiment with two driving conditions: driving in the static seat condition during the first half of the driving session and then in the static (static–static, SS) or motion seat (static–motion, SM) condition during the second half. The SM condition showed significantly lower passive TR fatigue by 4.4~56.5% compared to the SS condition in terms of the standard deviation of velocity, percentage of eyelid closure rate (PERCLOS), and the ratio of low- to high-frequency power (LF/HF) of electrocardiography signals. The drivers rated significantly lower subjective state changes of overall fatigue, mental fatigue, passive TR fatigue, drowsiness, and decreased concentration in the SM condition than those in the SS condition. The findings of the study support the use of a motion seat system can be an effective countermeasure to reduce passive TR fatigue.

Existing swallowing evaluation methods using X-ray or endoscopy are qualitative. The present study develops a swallowing monitoring and assessment system (SMAS) that is nonintrusive and quantitative. The SMAS comprises an ultrasonic Doppler sensor array, a microphone, and an inertial measurement unit to measure ultrasound signals originating only from swallowing activities. Ultrasound measurements were collected for combinations of two viscosity conditions (water and yogurt) and two volume conditions (3 mL and 9 mL) from 24 healthy participants (14 males and 10 females; age = 30.5 ± 7.6 years) with no history of swallowing disorders and were quantified for 1st peak amplitude, 2nd peak amplitude, peak-to-peak (PP) time interval, duration, energy, and proportion of two or more peaks. The peak amplitudes and energy significantly decreased by viscosity and the PP time interval and duration increased by volume. The correlation between the time measures were higher (r = 0.78) than that of the amplitude measures (r = 0.30), and the energy highly correlated with the 1st peak amplitude (r = 0.86). The proportion of two or more peaks varied from 76.8% to 87.9% by viscosity and volume. Further research is needed to examine the concurrent validity and generalizability of the ultrasonic Doppler sensor-based SMAS.

An investigation of comprehensive service requirements and their importance across various stakeholders is needed to develop systematic swallowing healthcare services. The present study examined the service requirements and their importance in developing comprehensive swallowing healthcare services from diverse stakeholders, including healthy seniors, individuals at risk, patients, guardians, and medical professionals, within the context of dysphagia. A series of survey-based interviews with 35 participants from the 5 stakeholder groups identified a comprehensive array of requirements pertinent to swallowing healthcare. Subsequently, a larger survey of 125 participants was administered using a 7-point Likert scale to evaluate the perceived importance of the identified requirements. A total of 46 distinct requirements were identified across the prevention/screening, evaluation/diagnosis, and treatment/training stages of swallowing healthcare. Accessibility, customization, usability, practicality, and information availability were features commonly identified across the three stages. Evaluation of the importance of these requirements yielded ratings ranging from 5.0 to 6.6. Significantly higher ratings were found for requirements associated with the evaluation/diagnosis and treatment/training stages, underscoring the stakeholder groups’ pronounced preference for services directed at these specific stages of the healthcare continuum. The study offers insights into the multifaceted requirements of stakeholders in swallowing healthcare, emphasizing the necessity for personalized, easily accessible, and comprehensive services. These findings serve as a foundational framework on targeted interventions and tailored services designed to address the diverse requirements of stakeholders for swallowing healthcare.

BACKGROUND 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 RR2-10.2196/19585