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]

Abstract

OBJECTIVE:

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

DESIGN:

Prospective observational study.

SETTING:

General teaching hospital, rehabilitation unit

PARTICIPANTS:

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).

INTERVENTIONS:

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

MAIN OUTCOME MEASURES:

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.

RESULTS:

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).

CONCLUSIONS:

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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