Effects of Maneuvers on Breathing-Swallowing Coordination and Swallowing Kinetics in Dysphagia Patients

Abstract

Objective: We monitored swallows before and after the 'humming swallow' and the 'forehead exercise' in dysphagia patients and evaluated whether these maneuvers were effective.Design: For the 'humming swallow', a modified version of the supraglottic swallow, the subject was instructed to inhale and hum before a swallow. For the forehead exercise, the subject was instructed to place his palm firmly on his forehead and push his forehead against his hand strongly. Each patient performed the maneuvers sequentially. The breathing-swallowing coordination and kinetics of swallowing were measured before and after each maneuver and during the humming swallow. Results:Choking was observed in 13 of 30 patients before the forehead exercise but only observed in two patients after the maneuver. The frequencies of inspiration before swallowing and inspiration after swallowing were greater when swallowing was accompanied by choking. In the humming swallow, the frequency of inspiration after swallowing tended to increase. Conclusion:None of the parameters associated with swallowing kinetics showed significant changes during the two maneuvers. The humming swallow maneuver may increase the frequency of inspiration after swallow, so caution should be exercised when this technique is applied to patients with food residues in the pharynx.