Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY.
Purdue University, West Lafayette, IN.
Am J Speech Lang Pathol. 2022 Mar 10;31(2):705-721. doi: 10.1044/2021_AJSLP-21-00044. Epub 2021 Nov 9.
The aim of this study was to examine the effects of bolus holding on respiratory-swallow coordination (RSC) in people with Parkinson's disease (PD).
People with PD were prospectively recruited to undergo RSC assessment using simultaneous respiratory inductive plethysmography and flexible laryngoscopy. During RSC assessment, participants swallowed 5-ml thin liquid boluses during held and nonheld swallowing tasks. Measures of RSC were analyzed for each swallow, which included respiratory pause duration, lung volume at swallow initiation, respiratory phase patterning, and the presence of paradoxical respiratory movements. Multilevel statistical modeling was used to determine if differences in RSC were present between the held and nonheld tasks.
Thirty-three participants were enrolled. When compared to the nonheld swallows, the held swallows exhibited shorter respiratory pauses ( = .001, = .019), lower lung volumes at swallow initiation ( < .001, = .116), more frequent exhale-swallow-exhale patterns ( < .001, = 4.30), and less frequent paradoxical respiratory movements ( = .001, = 0.43).
Findings from this study revealed that bolus holding significantly influences RSC in people with PD. This demonstrates that bolus holding may be an efficacious strategy to immediately improve RSC in PD. However, clinicians and researchers should consider avoiding bolus holding during swallowing evaluations if attempting to assess RSC behaviors that are most typical for the examinee.
本研究旨在探讨吞咽时屏气对帕金森病（PD）患者呼吸-吞咽协调性（RSC）的影响。
前瞻性招募 PD 患者进行 RSC 评估，使用呼吸感应容积描记法和软式喉镜同时进行。在 RSC 评估期间，参与者在屏气和非屏气吞咽任务中吞咽 5 毫升稀薄液体。对每个吞咽动作的 RSC 进行分析，包括呼吸暂停持续时间、吞咽起始时的肺容量、呼吸相位模式和反常呼吸运动的存在。采用多水平统计模型确定屏气和非屏气任务之间 RSC 是否存在差异。
共纳入 33 名参与者。与非屏气吞咽相比，屏气吞咽的呼吸暂停时间更短（ <.001， =.019），吞咽起始时的肺容量更低（ <.001， =.116），呼气-吞咽-呼气的呼吸模式更频繁（ <.001， = 4.30），反常呼吸运动的发生频率更低（ <.001， = 0.43）。
本研究结果表明，吞咽时屏气显著影响 PD 患者的 RSC。这表明，屏气可能是一种立即改善 PD 患者 RSC 的有效策略。然而，如果试图评估最符合受检者的 RSC 行为，临床医生和研究人员在吞咽评估时应避免屏气。
