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J Appl Physiol (August 8, 2003). doi:10.1152/japplphysiol.00316.2003
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Submitted on March 27, 2003
Accepted on August 7, 2003

Lung volume effects on pharyngeal swallowing physiology

Roxann D Gross1*, Charles W Atwood, Jr.2, Judith P Grayhack1, and Susan Shaiman3

1 Department of Audiology & Speech Pathology, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; School of Health & Rehabilitation Sciences, Department of Communication Sciences & Disorders, University of Pittsburgh, Pittsburgh, PA, USA
2 Pulmonary Section, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
3 School of Health & Rehabilitation Sciences, Department of Communication Sciences & Disorders, University of Pittsburgh, Pittsburgh, PA, USA

* To whom correspondence should be addressed. E-mail: Roxann.Gross{at}med.va.gov.

The experiment was a prospective, repeated measures design intended to determine how the variation of lung volume affects specific measures of swallowing physiology. Swallows were recorded in 28 healthy subjects that ranged in age from 21 to 40 years (mean age of 29) using simultaneous videofluoroscopy, bipolar intramuscular electromyography (EMG) and respiratory inductance plethysmography. Each subject swallowed three standardized pudding-like consistency boluses at three randomized lung volumes: total lung capacity, functional residual capacity and residual volume. The results showed that pharyngeal activity duration of deglutition for swallows produced at residual volume was significantly longer than those occurring at total lung capacity or at functional residual capacity. No significant differences were found for bolus transit time or intramuscular EMG of the superior constrictor. The results of this experiment lend support for the hypothesis that the respiratory system may have a regulatory function related to swallowing and that positive subglottic air pressure may be important swallowing integrity. Eventually, new treatment paradigms for oropharyngeal dysphagia that are based upon respiratory physiology may be developed.




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