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Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease

PURPOSE: Dysphagia is a serious extra pulmonary manifestation of chronic obstructive pulmonary disease (COPD). However, the nature of abnormalities in swallowing physiology in COPD has yet to be clearly established. We explored the frequency of swallowing measures outside the healthy reference range...

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Autores principales: Mancopes, Renata, Peladeau-Pigeon, Melanie, Barrett, Emily, Guran, Andrea, Smaoui, Sana, Pasqualoto, Adriane Schmidt, Steele, Catriona M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Speech-Language-Hearing Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582841/
https://www.ncbi.nlm.nih.gov/pubmed/33105085
http://dx.doi.org/10.1044/2020_JSLHR-20-00154
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author Mancopes, Renata
Peladeau-Pigeon, Melanie
Barrett, Emily
Guran, Andrea
Smaoui, Sana
Pasqualoto, Adriane Schmidt
Steele, Catriona M.
author_facet Mancopes, Renata
Peladeau-Pigeon, Melanie
Barrett, Emily
Guran, Andrea
Smaoui, Sana
Pasqualoto, Adriane Schmidt
Steele, Catriona M.
author_sort Mancopes, Renata
collection PubMed
description PURPOSE: Dysphagia is a serious extra pulmonary manifestation of chronic obstructive pulmonary disease (COPD). However, the nature of abnormalities in swallowing physiology in COPD has yet to be clearly established. We explored the frequency of swallowing measures outside the healthy reference range in adults with COPD. METHOD: Participants were 28 adults aged 41–79 years (18 men, 20 women) with stable COPD. Disease severity was classified as GOLD (Global Initiative For Chronic Obstructive Lung Disease) Stages 1 (4%), 2 (25%), 3 (53%), and 4 (18%). Participants underwent a videofluoroscopy and swallowed 20% w/v thin barium in, followed by 20% w/v mildly, moderately, and extremely thick barium prepared with a xanthan gum thickener. Blinded duplicate ratings of swallowing safety, efficiency, kinematics, and timing were performed according to the ASPEKT method (Analysis of Swallowing Physiology: Events, Kinematics and Timing). Comparison data for healthy adults aged < 60 years were extracted from an existing data set. Chi-square and Fisher's exact tests compared the frequencies of measures falling < 1 SD/ > 1 SD from mean reference values (or < the first or > the third quartile for skewed parameters). RESULTS: Participants with COPD did not display greater frequencies of penetration–aspiration, but they were significantly more likely (p < .05) to display incomplete laryngeal vestibule closure (LVC), longer time-to-LVC, and shorter LVC duration. They also displayed significantly higher frequencies of short upper esophageal sphincter opening, reduced pharyngeal constriction, and pharyngeal residue. CONCLUSION: This analysis reveals differences in swallowing physiology in patients with stable COPD characterized by impaired safety related to the mechanism, timing, and duration of LVC and by impaired swallowing efficiency with increased pharyngeal residue related to poor pharyngeal constriction.
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spelling pubmed-85828412021-11-17 Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease Mancopes, Renata Peladeau-Pigeon, Melanie Barrett, Emily Guran, Andrea Smaoui, Sana Pasqualoto, Adriane Schmidt Steele, Catriona M. J Speech Lang Hear Res Speech PURPOSE: Dysphagia is a serious extra pulmonary manifestation of chronic obstructive pulmonary disease (COPD). However, the nature of abnormalities in swallowing physiology in COPD has yet to be clearly established. We explored the frequency of swallowing measures outside the healthy reference range in adults with COPD. METHOD: Participants were 28 adults aged 41–79 years (18 men, 20 women) with stable COPD. Disease severity was classified as GOLD (Global Initiative For Chronic Obstructive Lung Disease) Stages 1 (4%), 2 (25%), 3 (53%), and 4 (18%). Participants underwent a videofluoroscopy and swallowed 20% w/v thin barium in, followed by 20% w/v mildly, moderately, and extremely thick barium prepared with a xanthan gum thickener. Blinded duplicate ratings of swallowing safety, efficiency, kinematics, and timing were performed according to the ASPEKT method (Analysis of Swallowing Physiology: Events, Kinematics and Timing). Comparison data for healthy adults aged < 60 years were extracted from an existing data set. Chi-square and Fisher's exact tests compared the frequencies of measures falling < 1 SD/ > 1 SD from mean reference values (or < the first or > the third quartile for skewed parameters). RESULTS: Participants with COPD did not display greater frequencies of penetration–aspiration, but they were significantly more likely (p < .05) to display incomplete laryngeal vestibule closure (LVC), longer time-to-LVC, and shorter LVC duration. They also displayed significantly higher frequencies of short upper esophageal sphincter opening, reduced pharyngeal constriction, and pharyngeal residue. CONCLUSION: This analysis reveals differences in swallowing physiology in patients with stable COPD characterized by impaired safety related to the mechanism, timing, and duration of LVC and by impaired swallowing efficiency with increased pharyngeal residue related to poor pharyngeal constriction. American Speech-Language-Hearing Association 2020-11 2020-10-26 /pmc/articles/PMC8582841/ /pubmed/33105085 http://dx.doi.org/10.1044/2020_JSLHR-20-00154 Text en Copyright © 2020 The Authors https://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Speech
Mancopes, Renata
Peladeau-Pigeon, Melanie
Barrett, Emily
Guran, Andrea
Smaoui, Sana
Pasqualoto, Adriane Schmidt
Steele, Catriona M.
Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease
title Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease
title_full Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease
title_fullStr Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease
title_full_unstemmed Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease
title_short Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease
title_sort quantitative videofluoroscopic analysis of swallowing physiology and function in individuals with chronic obstructive pulmonary disease
topic Speech
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582841/
https://www.ncbi.nlm.nih.gov/pubmed/33105085
http://dx.doi.org/10.1044/2020_JSLHR-20-00154
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