Effect of Task on Oral Pressure Dynamics During Swallowing


N/A
21 Years
N/A
Not Enrolling
Both
Deglutition Disorder, Healthy

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Trial Information

Effect of Task on Oral Pressure Dynamics During Swallowing


The tongue enacts complex mechanical events during swallowing, the most important of which
is the propulsion of a bolus from the oral cavity to the pharynx. Successful bolus
transport requires the tongue to interact with other oral structures, especially the hard
palate, to generate sufficient impulsive force or pressure gradients that drive the bolus
toward the oropharynx. Our knowledge of deglutitive lingual pressure dynamics is at best
incomplete. The available data on oral tongue pressure phenomena are based exclusively on
commanded single swallows. Oral pressure changes during other important everyday eating
activities (e.g., cup drinking) have not been studied to date. Past investigations revealed
that rapid sequential swallowing during continuous drinking, in contrast to commanded
discrete swallows, had unique tongue-palate contact patterns, surface electromyographic
response characteristics, and hyoid displacement profiles. Given the different
biomechanical properties and motor strategies, we hypothesize that oral lingual pressure
profiles for sequential swallowing are also different, that sequential swallows require less
impulsive force, and that selected dysphagic patients, especially those whose swallowing
deficits are associated with reduced tongue strength, will perform sequential swallows more
efficiently than they do discrete swallows. This protocol, therefore, proposes to test
these hypotheses in healthy individuals of different ages, and in patients with reduced
tongue strength and oral-oropharyngeal dysphagia associated with neurologic disorders,
musculoskeletal diseases, or head and neck cancer. Our goals are to: (a) acquire a better
and more complete understanding of normal tongue pressure phenomena as a function of
swallowing tasks, (b) characterize the interrelationship between task-induced lingual
pressure differences and result of clinical diagnostic tests of swallowing function in
patient populations, and (c) differentially identify the profiles of dysphagic patients who
can and those who cannot benefit from sequential swallowing as a compensatory/rehabilitative
strategy.

Inclusion Criteria


- INCLUSION CRITERIA:

Eligible healthy volunteers must:

1. be at least 21 years of age;

2. have no speech, swallowing, or respiratory problems;

3. be in good general health;

4. not be on medications that would adversely affect swallowing ability.

Eligible dysphagic patients must:

1. be at least 21 years of age;

2. have a neurologic disorder (e.g., CVA, PD, PSD, CBD, MS, Gaucher, leukodystrophy,
cerebral palsy), musculoskeletal disease (e.g., polymyositis), or head and neck
cancer that has caused impairments in tongue function and swallowing;

3. present with oral or oropharyngeal dysphagia without aspiration based on results of
the standard modified barium swallow study.

4. have sufficient auditory comprehension and cognitive skills to follow test
instructions and understand the nature of the study.

EXCLUSION CRITERIA:

For healthy volunteers:

1. History of swallowing problems or other conditions that adversely affect swallowing
function, tongue motility and control, hearing, language, and cognition.

2. On medication (e.g., anticholinergics, antidepressants) that adversely affects
swallowing function, tongue movement, comprehension, or cognition.

3. Oral dryness that interferes with swallowing.

4. Unsatisfactory performance status, as judged by the examining speech-language
pathologist, that indicates poor compliance for the planned tasks (e.g., undiagnosed
oral motor deficits).

For dysphagic patients:

1. Aspiration, as identified via the modified barium swallow study.

2. Pregnancy, as determined via a urine pregnancy test prior to the MBS test.

Type of Study:

Observational

Study Design:

N/A

Authority:

United States: Federal Government

Study ID:

010135

NCT ID:

NCT00013832

Start Date:

March 2001

Completion Date:

April 2007

Related Keywords:

  • Deglutition Disorder
  • Healthy
  • Pressure
  • Swallowing
  • Tongue
  • Healthy Volunteer
  • Dysphagia
  • Deglutition Disorders

Name

Location
National Institutes of Health Clinical Center, 9000 Rockville Pike Bethesda, Maryland  20892