Biomechanical and Cortical Control of Tongue Movements During Chewing and Swallowing
AbstractTongue function is vital for chewing and swallowing and lingual dysfunction is often associated with dysphagia. Better treatment of dysphagia depends on a better understanding of hyolingual morphology, biomechanics, and neural control in humans and animal models. Recent research has revealed significant variation among animal models in morphology of the hyoid chain and suprahyoid muscles which may be associated with variation in swallowing mechanisms. The recent deployment of XROMM (X-ray Reconstruction of Moving Morphology) to quantify 3D hyolingual kinematics has revealed new details on flexion and roll of the to...
Source: Dysphagia - June 16, 2023 Category: Speech-Language Pathology Source Type: research
Assessing Prevalence and Characteristics of Oro-bulbar Involvement in Children and Adults with SMA Type 2 and 3 Using a Multimodal Approach
AbstractBulbar and jaw muscles are impaired in patients with Spinal Muscular Atrophy (SMA) but the assessment of their severity and progression are limited by the lack of age-appropriate and disease-specific measures. We investigated mastication and swallowing in children and adults with SMA, sitters and walkers. In a 2-year multicentre cross-sectional prospective study, lip and tongue strength (Iowa Oral Performance Instrument), chewing and swallowing (Test of Masticating and Swallowing Solids), active mouth opening (aMMO) were compared to age-appropriate normative data. The perceived burden of oro-bulbar involvement (SMA...
Source: Dysphagia - June 8, 2023 Category: Speech-Language Pathology Source Type: research
Eating Assessment Tool (EAT —10) Scores to Detect Self-Reported Dysphagia in Brazilians
The objective of this investigation was to evaluate the scores, sensitivity, and specificity of the method to define self-reported dysphagia in Brazilians. EAT-10 scores were evaluated in 443 healthy individuals (273 women and 170 men), aged 20 to 84 years, with no swallowing difficulties or diseases, and 72 patients with diseases that cause dysphagia (35 women and 37 men), aged 29 to 88 years. Each of the 10 instrument items has a 0–4 rating scale, in which 0 indicates no problem and 4, a severe problem; total results range from 0 to 40. T he median EAT-10 score of healthy subjects was 0 (range: 0–20), and that of ...
Source: Dysphagia - June 5, 2023 Category: Speech-Language Pathology Source Type: research
Development and Validation of a Risk Prediction Model to Predict Postextubation Dysphagia in Elderly Patients After Endotracheal Intubation Under General Anesthesia: A Single-Center Cross-Sectional Study
AbstractAt present, the incidence and risk factors for dysphagia after extubation in elderly inpatients are still unclear, and we aimed to develop and validate a risk prediction model that prospectively identifies high-risk patients to reduce the occurrence rate of dysphagia. The 469 patients recruited were randomly divided into modeling and validation groups in a 7:3 ratio. In the modeling group, the postextubation dysphagia (PED) risk factors were analyzed, and a risk prediction model was established. In the validation group, the model was validated and evaluated. The model was constructed based on the risk factors deter...
Source: Dysphagia - June 5, 2023 Category: Speech-Language Pathology Source Type: research
Neural Correlates of Oral Stereognosis —An fMRI Study
AbstractOral stereognosis is the ability to recognize, discriminate and localize a bolus in the oral cavity. Clinical observation indicates deficits in oral stereognosis in patients with vascular or neurodegenerative diseases particularly affecting the parietal lobes. However, the precise neural representation of oral stereognosis remains unclear whereas the neural network of manual stereognosis has already been identified. We hypothesize that oral and manual stereognosis share common neuronal substrates whilst also showing somatotopic distribution. Functional magnetic resonance images (fMRI; Siemens Prisma 3 T) from 20 ...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
Proactive Swallowing Rehabilitation in Patients with Recurrent Oral Cancer Receiving Salvage Treatment: Long-Term Swallowing-Related Outcomes
AbstractThe present study aimed to evaluate the impact of proactive swallowing rehabilitation on swallowing function and quality of life in patients with recurrent oral cancer in the first 2 years after salvage treatment. Consecutive adult patients with recurrent oral cancer who received salvage surgery and free flap reconstruction were recruited prospectively, to whom proactive swallowing rehabilitation was provided. Body weight (BW); fiberoptic endoscopic evaluation of swallowing (FEES), functional oral intake scale (FOIS), and diet level; 10-item eating assessment tool (EAT-10), and MD Anderson Dysphagia Inventory (MDAD...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
Development of a Remote Examination of Deglutition Based on Consensus Surveys of Clinicians (Part II): Reliability and Validity in Healthy Elderly Individuals and Oral Cancer Patients
This study aimed at verifying the reliability and validity of RED. The participants were 21 healthy elderly individuals and 72 postoperative oral cancer (OC) patients. OC patients underwent videofluoroscopic dysphagia examination, and severity was judged on the dysphagia severity scale (DSS). Reliability and validity of RED were examined in all participants under face-to-face conditions, in comparison with the Mann Assessment of Swallowing Ability (MASA). Reliability and validity of remote administration of RED were examined in 40 participants. ROC curves were used to find cut-off RED scores to predict aspiration and deglu...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
Behavioral Interventions Targeting Base of Tongue to Posterior Pharyngeal Wall Approximation: A Scoping Review
AbstractPharyngeal pressure generated by approximation of the base of tongue to the posterior pharyngeal wall (BOT-PPW approximation) is critical for efficient pharyngeal bolus passage and is a frequent goal of dysphagia management. This scoping review evaluated behavioral interventions available to improve BOT-PPW approximation. We searched MEDLINE, CINAHL, Ovid Emcare, Web of Science, SCOPUS, and ProQuest for studies that met the following criteria: (i) behavioral interventions targeting BOT-PPW approximation, which (ii) were assessed using BOT-PPW-specific outcome measures, and (iiia) performed over a period of time (Re...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
Quantification of the Swallowing Mechanism Through Muscle Synergy Analysis
AbstractDecreased swallowing function increases the risk of choking and aspiration pneumonia. Videofluoroscopy and computed tomography allow for detailed observation of the swallowing movements but have radiation risks. Therefore, we developed a method using surface electromyography (sEMG) to noninvasively assess swallowing function without radiation exposure. A 44-channel flexible sEMG sensor was used to measure the sEMG signals of the hyoid muscles during swallowing in 14 healthy young adult and 14 elderly subjects. Muscle synergy analysis was performed to extract the muscle synergies from the sEMG signals, and the three...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
Expanding Rehabilitation Options for Dysphagia: Skill-Based Swallowing Training
AbstractOver the past four decades, our understanding of swallowing neural control has expanded dramatically. However, until recently, advances in rehabilitation approaches for dysphagia have not kept pace, with a persistent focussing on strengthening peripheral muscle. This approach is no doubt very appropriate for some if not many of our patients. But what if the dysphagia is not due to muscles weakness? The purpose of this clinical manusc ript is to reflect on where we have been, where we are now and perhaps where we need to go in terms of our understanding of swallowing motor control and rehabilitation of motor contr...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
The Effect of Sensory Level Versus Motor Level Electrical Stimulation of Pharyngeal Muscles in Acute Stroke Patients with Dysphagia: A Randomized Trial
This study compared the effectiveness of sensory and motor level stimulation on post-stroke dysphagia. This is a randomized trial conducted in an inpatient rehabilitation facility. Thirty-one participants who had dysphagia caused by stroke within 6 months prior to enrolment were included. Participants were excluded if they had a contraindication for electrical stimulation, previous stroke, psychiatric disorder, contraindications for modified barium swallow study (MBSS), or pre-morbid dysphagia. Each patient received ten sessions that include d 45 min of anterior neck sensory or motor level electrical stimulation in addi...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
Increasing Adherence to Prophylactic Swallowing Exercises During Head and Neck Radiotherapy: The Multicenter, Randomized Controlled PRESTO-Trial
ConclusionsPSE adherence decreased during the first 4 radiotherapy weeks regardless of group, but with a significant difference between groups. The therapist group achieved the highest adherence rates with a rather limited decline, therefore, increasing the face-to-face contact with a speech-language therapist can overcome the well-known problem of low adherence to PSE in this population.Trial RegistrationTrial registration: ISRCTN, ISRCTN98243550. Registered December 21, 2018 – retrospectively registered,https://www.isrctn.com/ISRCTN98243550?q=gwen%20van%20nuffelen&filters=&sort=&offset=1&totalResults=2&...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
Risk Factors for Dysphagia in Patients Hospitalized with COVID-19
AbstractPatients hospitalized with COVID-19 may be at risk for dysphagia and vulnerable to associated consequences. We investigated predictors for dysphagia and its severity in a cohort of patients hospitalized with COVID-19 at a single hospital center. A large level I trauma center database was queried for all patients hospitalized with COVID-19. Demographics, medical information associated with COVID-19, specific to dysphagia, and interventions were collected. 947 patients with confirmed COVID-19 met the criteria. 118 (12%) were seen for a swallow evaluation. Individuals referred for evaluation were significantly older, ...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
The Impact of Obesity on the Fibrostenosis Progression of Eosinophilic Esophagitis in a U.S. Veterans Cohort
AbstractWhether obesity is protective against progression of EoE is unknown. The aim of this study was to assess factors that alter the progression of EoE and determine if BMI is correlated with reduced disease severity. In this retrospective analysis of the Department of Veterans Affairs electronic health records, patients with EoE who received at least one dilation were identif ied using ICD and CPT codes. Kaplan–Meier curves determined the relationship between BMI and time to second esophageal dilation as a measurement of severity of disease. Cox proportional hazards models assessed the risk of second dilation adju...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
Inhibition of Water-Evoked Swallowing During Noxious Mechanical Stimulation of Tongue in Anesthetized Rats
AbstractDysphagia is sometimes accompanied by pain. Because orofacial structures subserve mastication and swallowing, orofacial pain might impair both functions. Tongue biting can occur not only accidentally while eating but also in some pathological conditions. However, it remains unclear whether noxious mechanical stimulation of the tongue affects swallowing. To explore this question, we evaluated the effects of lingual pinch stimulation on the initiation of swallowing evoked by distilled water (DW) infusion with a flow rate of 5.0 µL/s for 20 s into the pharyngolaryngeal region in anesthetized rats. The swallowing r...
Source: Dysphagia - May 13, 2023 Category: Speech-Language Pathology Source Type: research
