Viscosity effects on EMG activity in normal swallow

Reimers-Neils, Lynn; Logemann, Jerilyn A.; Larson, Charles R.

doi:10.1007/bf00714596

Cited by 164 publications

(133 citation statements)

References 20 publications

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“…This result supports the clinical data that was reported that the pharyngeal transit time for dysphagic swallows was longer than for healthy swallows (ClavÉ et al, 2006). However, since thickened fluids have higher yield stresses than unthickened fluids, the individuals still need to generate at least a minimum pressure to propel the bolus through the mouth in the oral space (Reimers-Neils et al, 1994).…”

Section: Discussionsupporting

confidence: 88%

“…Individuals with dysphagia are known to have lower tongue pressure than healthy individuals, thus increased the transit time in the pharyngeal phase. However, individuals with dysphagia still need to generate enough pressure to propel the bolus through the mouth in the oral phase and for ease of swallowing (how much effort is required to swallow the bolus) (Reimers-Neils et al, 1994). Additionally, in this simplified physical model, it was observed that mass residue was not significantly influenced by the roller estimated pressure which means the mass residue in the pharynx is not dependent on whether the bolus is swallowed by healthy individuals or individuals with dysphagia.…”

Section: Resultsmentioning

confidence: 87%

“…It has been reported that prescription of thickened fluids has become one of the most common recommendations made by clinicians to address the effects of dysphagia (Mills, 2008, Steele et al, 2014a. Thickened fluids flow slowly, allowing better oral and pharyngeal coordination and thus enhance safe swallowing (Reimers-Neils et al, 1994).…”

Section: Project Backgroundmentioning

confidence: 99%

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Understanding the Rheological Parameters of Thickened Fluids for Dysphagia Sufferers

Hadde¹

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An abnormality of swallowing food or fluid, known as dysphagia is a major issue throughout the world. Thickened fluids are commonly used in the medical management of individuals who suffer dysphagia, allowing for better oral and pharyngeal coordination and increasing the cohesiveness of the fluid. This reduces the risk of aspiration associated with bolus fracture while swallowing. Thickened fluids have been used for many years in healthcare centres and at home to provide nutrition and hydration to individuals with dysphagia. However, it is not always easy to obtain the correct consistency of thickened fluids. Fluids that are too thin may result in pneumonia, while over-thickened fluids may result in aspiration due to residue possibly inhaled from pharyngeal stasis. Variabilities in the consistency of thick fluids can be due to type of thickeners, solid content, serving temperature and differences in dispersing media.In Australia the consistency of thickened fluids is routinely assessed by evaluating their flow characteristics through a fork. This method is subjective. Although, several more reliable measuring devices are available to measure the thickness of the fluid, these devices are not suitable for the application of dysphagia management. For example, a rheometer can be used to accurately measure the viscosity of the fluid, but this device is not affordable for the healthcare industry. In contrast, the Line Spread Test is an affordable device to measure the thickness of the fluid, but the current investigation found it was potentially unreliable as many factors may influence the results of the measurement.A study of the rheological and material property characteristics of thickened fluids is needed to understand the behaviour of these fluids to allow patients to receive a consistent level of thickened fluids. The development of objective measurement guidelines for the three levels of thickened fluids for the Australian National Standards and a suitable measuring technique is also needed. This project therefore had three main objectives: (a) to rheologically characterise the behaviour of thickened fluids, considering a wide range of thickeners, fluids and serving conditions, (b) to determine which rheological parameter(s) are important for the application of dysphagia management, and (c) to obtain design guidelines for a reliable, inexpensive measuring device to accurately measure the relevant rheological parameter(s) of thickened fluids for the application of dysphagia management.The rheological properties of thickened fluids were examined in shear deformation to observe the effect of temperature, pH, fluid components (e.g. protein, fat and minerals) and type of thickener on the rheological parameters of thickened fluids. The rheological properties of thickened fluids across four available commercial thickener products and a range of types of fluids were iii | P a g e characterised and compared. Studies confirmed significant variabilities in rheological parameters between thickener products and disp...

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Section: Discussionsupporting

confidence: 88%

Section: Resultsmentioning

confidence: 87%

Section: Project Backgroundmentioning

confidence: 99%

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Understanding the Rheological Parameters of Thickened Fluids for Dysphagia Sufferers

Hadde¹

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“…Similarly to a previous study 24 using EMG, the activity of the suprahyoid muscles started at the earliest stage in this study. Subsequently, tongue contact was observed in the anterior region of the palate, followed by the anterior-lateral region and the posterior-lateral region.…”

Section: Order Of Onset Of Emg Activity Of the Suprahyoid Muscles Andsupporting

confidence: 63%

Temporal Changes in Swallowing Function Caused by a Palate Covering

Furuya

Suzuki

et al. 2008

Prosthodont Res. Pract.

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Use of prostheses such as complete dentures is often avoided in dysphagia rehabilitation for the elderly due to the effects of the palate covering. However, the influence of the palate covering is relieved over a short time (approximately 7 days), suggesting that the commonly used approach should be reconsidered. AbstractPurpose: The purpose of this study was to elucidate the temporal relationship between habituation to a palate covered by a prosthesis and swallowing function. Materials and methods: Ten healthy adults were selected as subjects. Tongue pressure on an experimental palatal plate with four pressure sensors was recorded simultaneously with surface electromyography measurements of suprahyoid muscles during swallowing of 3 ml of water. Measurements were performed 6 times: immediately after placement of the experimental palatal plate (Day 0), and on Day 1, Day 3, Day 7, Day 10, and Day 14. Temporal changes were analyzed in terms of the order of EMG activity and tongue pressure, and the duration for total swallowing (DTS), oral preparatory stage (DOPS), oral stage (DOS), and pharyngeal stage (DPS). Results: Onset of activity of the suprahyoid muscles was observed significantly earlier in all regions compared to onset of tongue pressure. Onset of tongue pressure in the posterior region was significantly delayed compared to onset of tongue pressure in another region. These results remained constant over the measurement period. DTS and DOS were significantly shortened on and after Days 3 and 7, respectively, compared to the respective values on Day 0. DOPS was significantly shortened on Day 7, compared to Day 0 and 1. DPS showed no significant change over time. Conclusion:The time required for swallowing shows a tendency to decrease over time as a subject becomes accustomed to a palate covering. This was mainly due to shortening of the oral stage.

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“…Regular fluids require excellent muscle control and accurate timing between the swallowing system and the breathing system. Thickened fluids slow the act of swallowing and by doing so enhance safe swallowing [1]. Understanding the behaviour of these thickened fluids has important clinical implications.…”

Section: Introductionmentioning

confidence: 99%

The Measurement of Thickened Liquids Used for the Management of Dysphagia

Nicholson¹,

Torley²,

Cichero³

2008

AIP Conference Proceedings

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Abstract. Dysphagia is a condition where a person has difficulty in swallowing. This can lead to reduced dietary intake, dehydration and malnutrition and also aspiration of material into the lungs and asphyxiation. Using thickened fluids slow the act of swallowing and by doing so enhance safe swallowing. A common method of thickening drinks is to use a powdered thickener, but this can lead to problems in ensuring that the consistency of the degree of thickening appropriate to an individual is maintained by those making up the fluids. There is also no assurance that the thickness of thickened liquids is consistent across commercial manufacturers. In this field viscosity is typically measured using a Line Spread Test, with the resulting viscosities being described by such terms as nectar-honey-or pudding-thick. This test is prone to many variations in operating conditions and so cannot provide accurate reproducible data. In this paper we have used conventional rheology (dynamic oscillatory using a couette cell) to provide quantitative measurement of the development in thickness of various beverages as a fianction of time. It was found fruit juices typically required less thickener and milk more to achieve the same thickness, but that the degree of thickening varied non-linearly with addition level.

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Viscosity effects on EMG activity in normal swallow

Cited by 164 publications

References 20 publications

Understanding the Rheological Parameters of Thickened Fluids for Dysphagia Sufferers

Understanding the Rheological Parameters of Thickened Fluids for Dysphagia Sufferers

Temporal Changes in Swallowing Function Caused by a Palate Covering

The Measurement of Thickened Liquids Used for the Management of Dysphagia

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