The effect of bolus viscosity on swallowing function in neurogenic dysphagia.
Pere Clavé,M. De Kraa,Viridiana Arreola,Meritxell Girvent,Ricard Farre,Elisabet Palomera,Mateu Serra-Prat +6 more
TLDR
To assess the pathophysiology and treatment of neurogenic dysphagia, a large number of animals have been fitted with EMTs for the first time and the results show clear signs of EMT-like activity in humans.Abstract:
ummary
Aim
To assess the pathophysiology and treatment of neurogenic dysphagia.
Methods
46 patients with brain damage, 46 with neurodegenerative diseases and eight healthy volunteers were studied by videofluoroscopy while swallowing 3–20 mL liquid (20.4 mPa s), nectar (274.4 mPa s) and pudding (3931.2 mPa s) boluses.
Results
Volunteers presented a safe and efficacious swallow, short swallow response (≤740 ms), fast laryngeal closure (≤160 ms) and strong bolus propulsion (≥0.33 mJ). Brain damage patients presented: (i) 21.6% aspiration of liquids, reduced by nectar (10.5%) and pudding (5.3%) viscosity (P < 0.05) and (ii) 39.5% oropharyngeal residue. Neurodegenerative patients presented: (i) 16.2% aspiration of liquids, reduced by nectar (8.3%) and pudding (2.9%) viscosity (P < 0.05) and (ii) 44.4% oropharyngeal residue. Both group of patients presented prolonged swallow response (≥806 ms) with a delay in laryngeal closure (≥245 ms), and weak bolus propulsion forces (≤0.20 mJ). Increasing viscosity did not affect timing of swallow response or bolus kinetic energy.
Conclusions
Patients with neurogenic dysphagia presented high prevalence of videofluoroscopic signs of impaired safety and efficacy of swallow, and were at high risk of respiratory and nutritional complications. Impaired safety is associated with slow oropharyngeal reconfiguration and impaired efficacy with low bolus propulsion. Increasing bolus viscosity greatly improves swallowing function in neurological patients.read more
Citations
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European Society for Swallowing Disorders - European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome.
Laura W. J. Baijens,Pere Clavé,Patrick Cras,Olle Ekberg,Alexandre Forster,Gerald F. Kolb,Jean Claude Leners,Stefano Masiero,Jesús Mateos-Nozal,Omar Ortega,David G. Smithard,Renée Speyer,Margaret Walshe +12 more
TL;DR: Oropharyngeal dysphagia should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications.
Journal ArticleDOI
The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review
Catriona M. Steele,Woroud Abdulrahman Alsanei,Sona Ayanikalath,Carly E. A. Barbon,Carly E. A. Barbon,Jianshe Chen,Julie A. Y. Cichero,Kim Coutts,Roberto Oliveira Dantas,Janice Duivestein,Lidia Giosa,Ben Hanson,Peter Lam,Caroline Lecko,Chelsea Leigh,Ahmed Nagy,Ahmed Nagy,Ashwini M. Namasivayam,Ashwini M. Namasivayam,Weslania Viviane Nascimento,Inge Odendaal,Christina H. Smith,Helen Wang +22 more
TL;DR: The literature suggests a need to classify food and fluid behavior in the context of the physiological processes involved in oral transport and flow initiation, and pointed to properties of hardness, cohesiveness, and slipperiness as being relevant both for physiological behaviors and bolus flow patterns.
Journal ArticleDOI
Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration *
Pere Clavé,Pere Clavé,Viridiana Arreola,Maise Romea,Lucía Medina,Elisabet Palomera,Mateu Serra-Prat,Mateu Serra-Prat +7 more
TL;DR: The V-VST is a sensitive clinical method to identify patients with dysphagia at risk for respiratory and nutritional complications, and patients whose deglutition could be improved by enhancing bolus viscosity.
Journal ArticleDOI
Dysphagia: current reality and scope of the problem
Pere Clavé,Reza Shaker +1 more
TL;DR: A unified field of deglutology is developing, with new professional profiles to cover the needs of all patients with dysphagia in a nonfragmented way, as well as marked advances in understanding the pathophysiology of these conditions.
Journal ArticleDOI
Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly
Laia Rofes,Viridiana Arreola,Jordi Almirall,Mateu Cabré,Lluís Campins,Pilar García-Peris,Renée Speyer,Pere Clavé +7 more
TL;DR: Clinical screening methods should be used to identify older people with oropharyngeal dysphagia and to identify those patients who are at risk of aspiration and a multidisciplinary approach is needed for diagnosis and management.
References
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