From Bench to Bedside: Evaluating a Low-Cost Tongue Pressure Device Prototype for Clinical and Community Use

A bstract Aim: This study evaluated the test–retest reliability, concurrent validity, and usability of the Chulalongkorn University Prototype Tongue Pressure Instrument (CUPTI), a novel low-cost manometer for maximum tongue strength (MTS) measurement, in comparison to the standard Iowa Oral Performance Instrument (IOPI). Materials and Methods: Sixty healthy adults (20–80 years) were randomized into two groups in a cross-over design. Participants underwent MTS assessment using both devices. Reliability was assessed through intraclass correlation coefficients, while concurrent validity was evaluated through Pearson correlation and Bland–Altman analysis. Effect size (Cohen’s d ) was used to assess discriminative ability. Measurement time was compared using a paired t test, and multivariable regression was conducted to assess demographic associations. Results: Both CUPTI and IOPI demonstrated excellent test–retest reliability (ICC > 0.95). CUPTI consistently recorded lower MTS values, with a mean bias of –8.12 kPa (limit of agreement: –2.52 to 18.76 kPa). A strong correlation ( r = 0.93, P < 0.001) was observed between devices. The effect size of 0.61 indicated a moderate, clinically meaningful difference. CUPTI required slightly more time than IOPI for MTS assessment ( P = 0.005). Age was the only significant predictor of MTS ( P = 0.034). Conclusion: CUPTI is a valid and reliable alternative to IOPI, offering affordability and accessibility for clinical and community dysphagia screening. Its performance supports implementation in resource-constrained settings and home-based rehabilitation.