Reference Values for Healthy Swallowing Across the Range From Thin to Extremely Thick Liquids.

Purpose: Thickened liquids are frequently used as an intervention for dysphagia, but gaps persist in our understanding of variations in swallowing behavior based on incremental thickening of liquids. The goal of this study was to establish reference values for measures of bolus flow and swallowing p...

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Publicado en:Journal of Speech, Language & Hearing Research Vol. 62; no. 5; pp. 1338 - 1364
Autores principales: Steele, Catriona M., Peladeau-Pigeon, Melanie, Barbon, Carly A. E., Guida, Brittany T., Namasivayam-MacDonald, Ashwini M., Nascimento, Weslania V., Smaoui, Sana, Tapson, Melanie S., Valenzano, Teresa J., Waito, Ashley A., Wolkin, Talia S.
Formato: Artículo
Publicado: American Speech-Language-Hearing Association May2019
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2019
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      pub: American Speech-Language-Hearing Association
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        10.1044/2019_JSLHR-S-18-0448
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        atl: Reference Values for Healthy Swallowing Across the Range From Thin to Extremely Thick Liquids.
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          Steele, Catriona M.
          Peladeau-Pigeon, Melanie
          Barbon, Carly A. E.
          Guida, Brittany T.
          Namasivayam-MacDonald, Ashwini M.
          Nascimento, Weslania V.
          Smaoui, Sana
          Tapson, Melanie S.
          Valenzano, Teresa J.
          Waito, Ashley A.
          Wolkin, Talia S.
        affil:
          Swallowing Rehabilitation Research Laboratory, Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
          Department of Speech-Language Pathology, Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
          Department of Communication Sciences and Disorders, Adelphi University, New York, NY
          Faculdade de Medicina, University of São Paulo, Ribeirão Preto, Brazil
      su:
        Thickening agents
        Deglutition disorders
        Liquid diet
        Pharynx physiology
        Laryngeal physiology
        Fluoroscopy
        Time
        Viscosity
      sug:
        subj:
          Thickening agents
          Deglutition disorders
          Liquid diet
          Pharynx physiology
          Laryngeal physiology
          Fluoroscopy
          Time
          Viscosity
      ab: Purpose: Thickened liquids are frequently used as an intervention for dysphagia, but gaps persist in our understanding of variations in swallowing behavior based on incremental thickening of liquids. The goal of this study was to establish reference values for measures of bolus flow and swallowing physiology in healthy adults across the continuum from thin to extremely thick liquids. Method: A sex-balanced sample of 38 healthy adults underwent videofluoroscopy and swallowed 20% weight-to-volume concentration barium prepared in thin and slightly, mildly, moderately, and extremely thick consistencies using a xanthan gum thickener. Participants took comfortable sips and swallowed without a cue; sip volume was measured based on presip and postsip cup weights. A standard operating procedure (the ASPEKT method: Analysis of Swallowing Physiology: Events, Kinematics and Timing) was used to analyze videofluoroscopy recordings. Results: The results clarify that, for thin liquid sips (10-14 ml), a single swallow without clearing swallows is typical and is characterized by complete laryngeal vestibule closure, complete pharyngeal constriction, and minimal postswallow residue. Aspiration was not seen, and penetration was extremely rare. Bolus position at swallow onset was variable, extending as low as the pyriform sinuses in 37% of cases. With thicker liquids, no changes in event sequencing, laryngeal vestibule closure, pharyngeal constriction, or postswallow residue were seen. The odds of penetration were significantly reduced. A longer timing interval until onset of the hyoid burst movement was seen, with an associated higher bolus position at swallow onset. Other timing measures remained unaffected by changes in bolus consistency. Conclusion: The results include new reference data for swallowing in healthy adults across the range from thin to extremely thick liquids.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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