Changes of timing variables in swallowing of boluses with different viscosities in patients with dysphagia

Lee SI, Yoo JY, Kim M, Ryu JS.

Arch Phys Med Rehabil. 2012 Aug 1. [Epub ahead of print]



To evaluate the timing of the swallowing process and the effect of bolus viscosity on swallowing.


Prospective observational study.


General teaching hospital, rehabilitation unit


We enrolled 82 dysphagic patients in a videofluoroscopic swallowing study (VFSS) from Jan 13, 2009 to Oct 22, 2009. Based on VFSS results, we classified patients as “thin fluid-aspirators” (n = 40) or as “non-aspirators” (n = 42).


Swallowing of a 5 mL thick bolus and a 5 mL thin bolus in all patients.


Kinematic analysis of various variables during the swallowing process (pharyngeal phase), including epiglottis contact with the bolus, laryngeal elevation, pharyngeal constriction, and upper esophageal sphincter opening.


In both groups, the thin bolus arrived at the vallecular pouch earlier than the thick bolus. During swallowing of the thick bolus, the thin fluid-aspirators had a delayed latency of upper esophageal sphincter opening (LUEO), delayed laryngeal elevation to peak level (LPLE), and significantly longer rise time of laryngeal elevation (LPLE-LLE).


Our results indicate clear differences in the degree of adaptation to bolus viscosity between patients classified as thin fluid-aspirators and as non-aspirators. These differences were mainly in activities of laryngeal elevators rather than pharyngeal constrictors.

Copyright © 2012 the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.


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