Proof-of-principle pilot study of oropharyngeal air-pulse application in individuals with dysphagia after hemispheric stroke.

OBJECTIVE: To test the hypothesis that oropharyngeal air-pulse application is associated with increased swallowing rates in individuals with dysphagia secondary to stroke. DESIGN: Case control. SETTING: Stroke rehabilitation hospital or home setting. PARTICIPANTS: Convenience sample of individuals (N=8) with new-onset dysphagia after stroke. INTERVENTIONS: Air-pulse trains were applied to the oropharynx of 8 subjects who presented with dysphagia after hemispheric stroke. Resting swallowing rates were determined for 5 experimental conditions: baseline without air-pulse mouthpiece, baseline with mouthpiece in situ, unilateral right oropharyngeal air-pulse, unilateral left oropharyngeal air-pulse, and bilateral oropharyngeal air-pulse application. Individual swallowing responses were analyzed using a 2-SD band method. MAIN OUTCOME MEASURE: Swallowing rate (swallows/min). RESULTS: Swallowing rates associated with bilateral air-pulse application were greater than baseline in 4 of the 8 subjects. The 4 subjects who demonstrated this response to air-pulse application had greater baseline swallowing rates than did subjects whose swallowing rates were not altered in association with air-pulse application. CONCLUSIONS: Oropharyngeal air-pulse trains can be applied in individuals with swallowing impairment. Air-pulse application is associated with increased resting swallowing rates in some individuals with dysphagia secondary to hemispheric stroke. Further research should extend this proof-of-principle study by examining the efficacy of oropharyngeal air-pulse application in terms of improved swallowing and related outcomes in dysphagic stroke through a large randomized trial.

Psychological and Psychophysiological Effects of Recuperative Music Postexercise.

PURPOSE: Few studies have examined the psychological and psychophysiological effects of recuperative music after exhaustive exercise. The main purpose of the present study was to examine the effects of two music conditions compared with a no-music control on psychological and psychophysiological recovery processes after exercise. METHODS: A randomized, fully counterbalanced, crossover design was used. Core affect, salivary cortisol, heart rate, and blood pressure were measured before exhaustive exercise, immediately after, and in 10-, 20-, and 30-min intervals during passive recovery (21 women and 21 men; 20.9 ± 1.7 yr) over three separate trials (slow, sedative music; fast, stimulative music; no-music control). The exercise task entailed incremental cycle ergometry performed at 75 rpm with an increase in intensity of 22.5 W·min at the end of each minute until exhaustion. Data were analyzed using mixed-model 3 (condition) × 4 (time) × 2 (gender) MANOVA/ANCOVA. RESULTS: The largest decline in affective arousal between active and passive recovery phases was evident in the slow, sedative condition (ηp = 0.50). Women had a more pronounced reduction in arousal than did men in the slow, sedative music condition. Heart rate measures showed that fast, stimulative music inhibited the return of heart rate toward resting levels (ηp = 0.06). Similarly, salivary cortisol levels tended to be lower in response to slow, sedative music (ηp = 0.11). There was a main effect of condition for affective valence indicating that the slow, sedative condition elicited more positive affective responses compared with the control and fast, stimulative conditions (ηp = 0.12). CONCLUSIONS: The present findings support the notion that slow, sedative music can expedite the recovery process immediately after strenuous exercise.