Respiratory-swallowing coordination in normal subjects: Lung volume at swallowing initiation

McFarland, David H.; Martin‐Harris, Bonnie; Fortin, Annie Joëlle; Humphries, Kate; Hill, Elizabeth G.; Armeson, Kent

doi:10.1016/j.resp.2016.09.004

Cited by 46 publications

(60 citation statements)

References 63 publications

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“…Percentage of time the phase followed a swallow (%) cough reflex under the circumstances of a possible penetration/aspiration in large bolus volume. This inference is supported by earlier reports of Hegland, Huber, Pitts, and Sapienza (2009) and McFarland, Martin-Harris, Fortin, Humphries, Hill, and Armeson (2016) that found higher lung volume at initiation of thin-liquid swallows [42,43]. This protective mechanism is operational irrespective of head position, as suggested by the findings of this study.…”

Section: Discussionsupporting

confidence: 91%

The Effect of Chin-Down Position and Bolus Volume on Swallow-Induced Respiratory Measures in Young Healthy Adults

Krishnan

Goswami

2019

SN Compr. Clin. Med.

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Though head positioning strategies are widely used in the rehabilitation of swallowing dysfunction, little is yet known about its effect on the respiratory-swallow interaction. We hypothesised that a chin-down positioning would alter the respiratory behaviour in healthy young individuals. In a within-group study, we compared the characteristics of nasal airflow and its coordination with swallow events before, after, and during the swallow of liquid in a group of 30 young healthy individuals. The measures were obtained with simultaneous recording of surface electromyography, nasal airflow, and swallow sound recording during spontaneous drinking of 5, 15, and 20 ml water. Duration of swallowing apnoea (SAD) and the slope (Spre & Spost), duration (Dpre & Dpost), and direction (Expiration/Inspiration) of respiratory phases surrounding the apnoea were obtained. The statistical comparisons revealed that chin-down position significantly prolonged breathing arrest (SAD) and pharyngeal transit time (event interval) during swallow. The Dpost of large volume swallows were shorter indicating a quick resumption of breathing, indicating high post-swallow respiratory demand. The other statistically significant differences in various event intervals suggested the influence of chin-down position and bolus volume on the oral and pharyngeal transit time. Also, there was an increase in the incidence of inspiratory swallows in the chin-down position with large bolus volumes. We conclude that the chin-down position can provide longer airway decoupling but may increase the respiratory demand during swallows. Use of smaller bolus volumes should be recommended for chin-down swallows in persons with respiratory distress and dysphagia.

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Section: Discussionsupporting

confidence: 91%

The Effect of Chin-Down Position and Bolus Volume on Swallow-Induced Respiratory Measures in Young Healthy Adults

Krishnan

Goswami

2019

SN Compr. Clin. Med.

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“…As have been reported by others, an instruction of, “cough like there is something in your throat” produces a robust and reliable response [45]. Common for cued swallow is, have the participant hold the bolus in their mouth and swallow when prompted/ready [46], however McFarland, [18] demonstrated that cueing can have a significant effect on LV during swallow.…”

Section: Discussionmentioning

confidence: 93%

Strategies for the Integration of Cough and Swallow to Maintain Airway Protection in Humans

Huff

Reed

Smith

et al. 2018

Lung

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“…McFarland et al [14] found that swallows occur at a specific lung volume. Therefore, the humming maneuver might have made some subjects miss the optimal timing of swallowing.…”

Section: Humming Swallow Maneuvermentioning

confidence: 99%

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

Oku¹

2017

Phys Med Rehabil Int

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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.

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Respiratory-swallowing coordination in normal subjects: Lung volume at swallowing initiation

Cited by 46 publications

References 63 publications

The Effect of Chin-Down Position and Bolus Volume on Swallow-Induced Respiratory Measures in Young Healthy Adults

The Effect of Chin-Down Position and Bolus Volume on Swallow-Induced Respiratory Measures in Young Healthy Adults

Strategies for the Integration of Cough and Swallow to Maintain Airway Protection in Humans

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

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