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Tongue strength and swallowing dynamics in chronic obstructive pulmonary disease.
Epiu, Isabella; Gandevia, Simon C; Boswell-Ruys, Claire L; Wallace, Emma; Butler, Jane E; Hudson, Anna L.
Afiliación
  • Epiu I; Neuroscience Research Australia, Sydney, NSW, Australia.
  • Gandevia SC; University of New South Wales Sydney, NSW, Australia.
  • Boswell-Ruys CL; Prince of Wales Hospital, Sydney, NSW, Australia.
  • Wallace E; Neuroscience Research Australia, Sydney, NSW, Australia.
  • Butler JE; University of New South Wales Sydney, NSW, Australia.
  • Hudson AL; Prince of Wales Hospital, Sydney, NSW, Australia.
ERJ Open Res ; 7(3)2021 Jul.
Article en En | MEDLINE | ID: mdl-34262969
BACKGROUND: Swallowing disorders occur in COPD, but little is known about tongue strength and mastication. This is the first assessment in COPD of tongue strength and a test of mastication and swallowing solids (TOMASS). METHODS: Anterior tongue strength measures were obtained in 18 people with COPD, aged 73±11 years (mean±sd), and 19 healthy age-matched controls, aged 72±6 years. Swallowing dynamics were assessed using an eating assessment tool (EAT-10), timed water swallow test (TWST), and TOMASS. Swallowing measures were compared to an inhibitory reflex (IR) in the inspiratory muscles to airway occlusion (recorded previously in the same participants). RESULTS: Tongue strength was similar between COPD and controls (p=0.715). Self-assessed scores of dysphagia EAT-10 were higher (p=0.024) and swallowing times were prolonged for liquids (p=0.022) and solids (p=0.003) in the COPD group. During TWST, ∼30% of COPD group showed clinical signs of airway invasion (cough and wet voice), but none in the control group. For solids, the COPD group had ∼40% greater number of chews (p=0.004), and twofold-higher number of swallows (p=0.0496). Respiratory rate was 50% higher in COPD group than controls (p <0.001). The presence of an IR was not related to better swallowing outcomes, but signs of airway invasion were associated with a delayed IR. CONCLUSION: Dysphagia in stable COPD is not due to impaired anterior tongue strength, but rather swallowing-breathing discoordination. To address dysphagia, aspiration and acute exacerbations in COPD, therapeutic targets to improve swallowing dynamics could be investigated further.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: ERJ Open Res Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: ERJ Open Res Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido