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Respiratory-Swallow Coordination and Its Relationship With Pharyngeal Residue, Penetration, and Aspiration in People With Parkinson's Disease.

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Title: Respiratory-Swallow Coordination and Its Relationship With Pharyngeal Residue, Penetration, and Aspiration in People With Parkinson's Disease.
Authors: Curtis, James A.1 yrj9003@med.cornell.edu, Borders, James C.2, Kiefer, Brianna3, Alcalay, Roy N.4,5, Huber, Jessica E.6, Troche, Michelle S.2
Source: Journal of Speech, Language & Hearing Research. Nov2024, Vol. 67 Issue 11, p4314-4338. 25p.
Subject Terms: *Data analysis, *Comparative studies, *Inter-observer reliability, Plethysmography, Nasal cavity, Statistical models, Cross-sectional method, Respiration, Functional assessment, Parkinson's disease, Respiratory aspiration, Descriptive statistics, Pharynx, Odds ratio, Lung volume measurements, Endoscopic gastrointestinal surgery, Statistics, Deglutition, Data analysis software, Deglutition disorders
Geographic Terms: United States
Abstract: Purpose: Respiratory-swallow coordination (RSC) frequently changes in people with Parkinson's disease (PwPD). Little is known about how these changes relate to impairments in swallowing safety (penetration and aspiration) and efficiency (pharyngeal residue). Therefore, the aims of this study were to assess the relationships between RSC, pharyngeal residue, penetration, and aspiration in PwPD. Method: Twenty-four PwPD were recruited to undergo simultaneous assessment of RSC, swallowing safety, and swallowing efficiency. RSC was assessed using respiratory inductive plethysmography and nasal airflow and included measurements of respiratory pause duration, respiratory phase patterning, and lung volume during swallowing. Swallowing safety and efficiency were assessed using flexible endoscopic evaluation of swallowing, analyzed using the Visual Analysis of Swallowing Efficiency and Safety, and included measurements of pharyngeal residue, penetration, and aspiration. All data were blindly analyzed, with 20% of the data repeated for interrater reliability assessment. Multilevel statistical models were used to examine the relationships between RSC and swallowing. Results: A total of 812 swallows were analyzed from 24 participants. Only 33.4% of swallows exhibited the typical exhale-swallow-exhale pattern. Additionally, 95% of participants exhibited abnormal swallow function. More severe hypophar-yngeal residue ratings were associated with inhaling before the swallow compared to exhaling before the swallow. Additionally, more severe events of penetration and aspiration were associated with (a) inhaling before the swallow compared to exhaling before the swallow, (b) inhaling after the swallow compared to exhaling after the swallow, and (c) longer swallow-related respiratory pause durations. Inhaling after the swallow exhibited the strongest relationship with impairments in swallowing safety when compared to all other RSC variables. Conclusions: RSC exhibited significant relationships with pharyngeal residue, penetration, and aspiration in these PwPD. Clinicians should attend to RSC when assessing swallowing in PwPD. Future research is needed to examine if training an exhale-swallow-exhale pattern can be used to improve disordered swallowing in PwPD. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Respiratory-Swallow Coordination and Its Relationship With Pharyngeal Residue, Penetration, and Aspiration in People With Parkinson's Disease.
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  Data: <searchLink fieldCode="AR" term="%22Curtis%2C+James+A%2E%22">Curtis, James A.</searchLink><relatesTo>1</relatesTo><i> yrj9003@med.cornell.edu</i><br /><searchLink fieldCode="AR" term="%22Borders%2C+James+C%2E%22">Borders, James C.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Kiefer%2C+Brianna%22">Kiefer, Brianna</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Alcalay%2C+Roy+N%2E%22">Alcalay, Roy N.</searchLink><relatesTo>4,5</relatesTo><br /><searchLink fieldCode="AR" term="%22Huber%2C+Jessica+E%2E%22">Huber, Jessica E.</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Troche%2C+Michelle+S%2E%22">Troche, Michelle S.</searchLink><relatesTo>2</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Speech%2C+Language+%26+Hearing+Research%22">Journal of Speech, Language & Hearing Research</searchLink>. Nov2024, Vol. 67 Issue 11, p4314-4338. 25p.
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  Data: *<searchLink fieldCode="DE" term="%22Data+analysis%22">Data analysis</searchLink><br />*<searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br />*<searchLink fieldCode="DE" term="%22Inter-observer+reliability%22">Inter-observer reliability</searchLink><br /><searchLink fieldCode="DE" term="%22Plethysmography%22">Plethysmography</searchLink><br /><searchLink fieldCode="DE" term="%22Nasal+cavity%22">Nasal cavity</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+models%22">Statistical models</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22Respiration%22">Respiration</searchLink><br /><searchLink fieldCode="DE" term="%22Functional+assessment%22">Functional assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Parkinson's+disease%22">Parkinson's disease</searchLink><br /><searchLink fieldCode="DE" term="%22Respiratory+aspiration%22">Respiratory aspiration</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Pharynx%22">Pharynx</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink><br /><searchLink fieldCode="DE" term="%22Lung+volume+measurements%22">Lung volume measurements</searchLink><br /><searchLink fieldCode="DE" term="%22Endoscopic+gastrointestinal+surgery%22">Endoscopic gastrointestinal surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Deglutition%22">Deglutition</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Deglutition+disorders%22">Deglutition disorders</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: Respiratory-swallow coordination (RSC) frequently changes in people with Parkinson's disease (PwPD). Little is known about how these changes relate to impairments in swallowing safety (penetration and aspiration) and efficiency (pharyngeal residue). Therefore, the aims of this study were to assess the relationships between RSC, pharyngeal residue, penetration, and aspiration in PwPD. Method: Twenty-four PwPD were recruited to undergo simultaneous assessment of RSC, swallowing safety, and swallowing efficiency. RSC was assessed using respiratory inductive plethysmography and nasal airflow and included measurements of respiratory pause duration, respiratory phase patterning, and lung volume during swallowing. Swallowing safety and efficiency were assessed using flexible endoscopic evaluation of swallowing, analyzed using the Visual Analysis of Swallowing Efficiency and Safety, and included measurements of pharyngeal residue, penetration, and aspiration. All data were blindly analyzed, with 20% of the data repeated for interrater reliability assessment. Multilevel statistical models were used to examine the relationships between RSC and swallowing. Results: A total of 812 swallows were analyzed from 24 participants. Only 33.4% of swallows exhibited the typical exhale-swallow-exhale pattern. Additionally, 95% of participants exhibited abnormal swallow function. More severe hypophar-yngeal residue ratings were associated with inhaling before the swallow compared to exhaling before the swallow. Additionally, more severe events of penetration and aspiration were associated with (a) inhaling before the swallow compared to exhaling before the swallow, (b) inhaling after the swallow compared to exhaling after the swallow, and (c) longer swallow-related respiratory pause durations. Inhaling after the swallow exhibited the strongest relationship with impairments in swallowing safety when compared to all other RSC variables. Conclusions: RSC exhibited significant relationships with pharyngeal residue, penetration, and aspiration in these PwPD. Clinicians should attend to RSC when assessing swallowing in PwPD. Future research is needed to examine if training an exhale-swallow-exhale pattern can be used to improve disordered swallowing in PwPD. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=180765741
RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1044/2024_JSLHR-24-00056
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        Text: English
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      – SubjectFull: Inter-observer reliability
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      – SubjectFull: Plethysmography
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      – SubjectFull: Nasal cavity
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      – SubjectFull: Statistical models
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      – SubjectFull: Cross-sectional method
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      – SubjectFull: Respiration
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      – SubjectFull: Pharynx
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      – SubjectFull: Odds ratio
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      – SubjectFull: Lung volume measurements
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