Factors Influencing Initiation of Pharyngeal Swallow in Healthy Adults.
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ABSTRACT:
SUBMITTER: Bhutada AM
PROVIDER: S-EPMC8740560 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveThe pharyngeal phase of swallowing involves a coordinated sequence of events. Event durations may be prolonged in people with Parkinson disease (PwPD), and amyotrophic lateral sclerosis (PwALS); however, the cumulative effect of these changes is unexplored. We compared event latencies relative to hyoid burst (HYB) (time zero) to understand differences in deglutatory event timing. We hypothesized PwPD and PwALS would display similarly prolonged cumulative pharyngeal phase durations compared to healthy controls, with greater prolongations with increasing bolus viscosity.MethodWe retrospectively evaluated videofluoroscopic data of healthy adults (n = 78), PwPD (n = 17), and PwALS (n = 20). Participants swallowed 15 boluses of 20% (w/v) barium across five liquid consistencies. Paired raters evaluated nine deglutitive events using the ASPEKT method. Latencies were plotted by consistency relative to HYB and compared across cohorts using Mann-Whitney U tests (p ≤ .05). Cohen's d was calculated for all statistically significant results to determine effect size.ResultsIn PwPD, significantly prolonged latencies were observed on thin liquid boluses compared to healthy controls. Latencies to all post-HYB events were significantly prolonged except for maximum upper esophageal sphincter distension. In PwALS, significantly prolonged latencies for events preceding and following HYB were noted on all consistencies compared to healthy controls and PwPD.ConclusionIn PwPD, event latencies for multiple components of the swallowing sequence were prolonged culminating in overall prolongation of the pharyngeal phase on thin liquid. A similar pattern, but with significantly greater prolongation, was seen in the PwALS, and extended to swallows of all liquid consistencies.
| S-EPMC10116960 | biostudies-literature
Project description:PurposeOur study aims were (a) to examine laryngeal vestibular closure (LVC) temporal measures in healthy adults across tasks used in the Modified Barium Swallow Impairment Profile (MBSImP) protocol to establish normative reference values and (b) to examine influences of age, gender, and swallow task on LVC temporal measures.MethodA retrospective analysis of 195 healthy adults (85 men, 110 women; age range: 21-89 years) who participated in a videofluoroscopic swallowing study was completed. Seven swallow tasks of standardized viscosities and volumes, as per the MBSImP protocol, were analyzed to measure time-to-LVC and LVC duration (LVCd). Descriptive statistics were employed for all measures of interest. Regression modeling was used to explore relationships between LVC temporal measures (time-to-LVC, LVCd) with age, gender, and swallow task. The relationship between time-to-LVC and LVCd was also explored.ResultsSignificant findings included an increasing trend in LVCd across age (older individuals had a longer LVCd), with women demonstrating a greater increase. Related to viscosity, LVCd was significantly shorter for pudding compared to thin liquid. Furthermore, when compared to 5-ml tasks, LVCd was significantly longer in cup tasks, while time-to-LVC was significantly shorter. An association was also observed between time-to-LVC and LVCd: As time-to-LVC decreased, LVCd increased.ConclusionsLVCd was influenced by age, gender, and swallow task. Longer time-to-LVC was observed in older individuals, particularly older women, and with thin liquids. Study findings contribute to adult normative reference values for LVC temporal measures (time-to-LVC and LVCd) across MBSImP swallowing tasks.Supplemental materialhttps://doi.org/10.23641/asha.24126432.
| S-EPMC10713015 | biostudies-literature
Project description:Swallow is a complex behavior that consists of three coordinated phases: oral, pharyngeal, and esophageal. Esophageal distension (EDist) has been shown to elicit pharyngeal swallow, but the physiologic characteristics of EDist-induced pharyngeal swallow have not been specifically described. We examined the effect of rapid EDist on oropharyngeal swallow, with and without an oral water stimulus, in spontaneously breathing, sodium pentobarbital anesthetized cats (n = 5). Electromyograms (EMGs) of activity of 8 muscles were used to evaluate swallow: mylohyoid (MyHy), geniohyoid (GeHy), thyrohyoid (ThHy), thyropharyngeus (ThPh), thyroarytenoid (ThAr), cricopharyngeus (upper esophageal sphincter: UES), parasternal (PS), and costal diaphragm (Dia). Swallow was defined as quiescence of the UES with overlapping upper airway activity, and it was analyzed across three stimulus conditions: 1) oropharyngeal water infusion only, 2) rapid esophageal distension (EDist) only, and 3) combined stimuli. Results show a significant effect of stimulus condition on swallow EMG amplitude of the mylohyoid, geniohyoid, thyroarytenoid, diaphragm, and UES muscles. Collectively, we found that, compared to rapid cervical esophageal distension alone, the stimulus condition of rapid distension combined with water infusion is correlated with increased laryngeal adductor and diaphragm swallow-related EMG activity (schluckatmung), and post-swallow UES recruitment. We hypothesize that these effects of upper esophageal distension activate the brainstem swallow network, and function to protect the airway through initiation and/or modulation of a pharyngeal swallow response.
| S-EPMC8018667 | biostudies-literature
Project description:BACKGROUND:Monitoring and interfacing technologies may increase physical activity (PA) program adherence in older adults, but they should account for aspects influencing older adults' PA behavior. This study aimed at gathering preliminary wrist-based PA adherence data in free-living and relate these to the influencing factors. METHODS:Ten healthy older adults (4 females, aged 70-78 years) provided health, fatigue, activity levels, attitude towards pacing, and self-efficacy information and performed a 6 min-walk test to assess their fitness. After a baseline week they followed a two-week walking and exercise intervention. Participants saw their progress via a purposely designed mobile application. RESULTS:Walking and exercise adherence did not increase during the intervention (p = 0.38, p = 0.65). Self-efficacy decreased (p = 0.024). The baseline physical component of the Short Form Health Survey was the most predictive variable of walking adherence. Baseline perceived risk of over-activity and resting heart rate (HRrest) were the most predictive variables of exercise adherence. When the latter two were used to cluster participants according to their exercise adherence, the fitness gap between exercise-adherent and non-adherent increased after the intervention (p = 0.004). CONCLUSIONS:Risk of over-activity and HRrest profiled short-term exercise adherence in older adults. If confirmed in a larger and longer study, these could personalize interventions aimed at increasing adherence.
| S-EPMC7503601 | biostudies-literature
Project description:We assessed the long-term persistence of humoral immunity against diphtheria in adults with childhood vaccination and the immunogenicity of a booster dose considering demographic, behavioural and vaccinating factors. We conducted a trial in 200 healthy Slovak adults aged 24-65 years, immunised against diphtheria in childhood and against tetanus at regular 10-15 year intervals, and receiving a dose of a tetanus-diphtheria toxoid vaccine. The response was determined by ELISA antibody concentrations of paired sera before and at 4 weeks post-vaccination. A seroprotection rate of 21% (95% confidence interval, CI 15.6-27.3%) was found in adults up to 59 years since the last vaccination with seroprotective levels of antibodies against diphtheria ≥0.1 IU/mL and a geometric mean concentration of 0.05 IU/mL. Conversely, seropositive levels ≥0.01 IU/mL were observed in 98% of adults (95% CI 95-99.5%). Booster-induced seroprotection was achieved in 78% of adults (95% CI 71.6-83.5%) clearly depending on pre-booster antibody levels correlating with age and time since the last vaccination. Moreover, only 54.2% of smokers and 53.3% of patients on statins exhibited seroprotection. Booster vaccination against diphtheria was unable to confer seroprotection in all recipients of only childhood vaccination.
| S-EPMC6963617 | biostudies-literature
Project description:PurposeWe quantified pharyngeal residue using pixel-based methods in a normative data set, while examining influences of age, gender, and swallow task.MethodOne hundred ninety-five healthy participants underwent a videofluoroscopic swallow study following the Modified Barium Swallow Impairment Profile (MBSImP) protocol. ImageJ was used to compute Normalized Residue Ratio Scale and the Analysis of Swallowing Physiology: Events, Kinematics and Timing (ASPEKT) pharyngeal residue measures. Reliability was established. Descriptive statistics were performed for all residue measures. Inferential statistics were performed using ASPEKT total scores (i.e., %C2-42). Logistic regression models explored predictors of residue versus no residue. Generalized linear mixed models explored predictors of nonzero residue. Spearman rho explored relationships between ASPEKT total residue scores and MBSImP Component 16 (Pharyngeal Residue) scores.ResultsMajority of swallows (1,165/1,528; 76.2%) had residue scores of zero. Residue presence (%C2-42 > 0) was influenced by age (more in older [F = 9.908, p = .002]), gender (more in males [F = 18.70, p < .001]), viscosity (more in pudding, nectar, and honey [F = 25.30, p < .001]), and volume (more for cup sip [F = 37.430, p < .001]). When residue was present (363/1,528 = 23.8%), amounts were low (M = 1% of C2-42, SD = 2.4), and only increasing age was associated with increased residue (F = 9.008, p = .007) when controlling for gender and swallow task. Increasing residue was incremental (0.01% of C2-42 per year). As ASPEKT total residue values increased, MBSImP Component 16 scores also increased.ConclusionsPharyngeal residue amounts were very low in healthy adults. Residue presence can be influenced by age, gender, and swallow task. However, when present, the amount of pharyngeal residue was only associated with increasing age.Supplemental materialhttps://doi.org/10.23641/asha.21957221.
| S-EPMC10205106 | biostudies-literature
Project description:BackgroundMany factors influence the menopausal transition and the complexity of this transition increases with the addition of immigration transition. This review aims to identify the factors that influence the menopausal transition for immigrant women based on ecosocial theory.MethodsA scoping review of English publications was conducted according to PRISMA guidelines using CINAHL, AgeLine, MEDLINE, PsycINFO, ERIC, Nursing and Allied Health Database, PsycARTICLES, Sociology Database, and Education Research Complete. Thirty-seven papers were included for this review.ResultsThe factors which influence the menopausal transition for immigrant women were grouped into three categories: (a) personal factors, (b) familial factors, and (c) community and societal factors. Personal factors include income and employment, physical and psychological health, perceptions of menopause, and acculturation. Familial factors include partner support, relationships with children, and balancing family, work, and personal duties. Community and societal factors encompassed social network, social support, healthcare services, traditional cultural expectations, and discrimination in host countries.ConclusionsInterventions addressing the menopausal transition for immigrant women should be designed considering different psychosocial factors and actively work to address systemic barriers that negatively impact their transition.
| S-EPMC8101137 | biostudies-literature
Project description:BackgroundPhysical activity (PA) is a well-documented and accepted adjunct therapy for the maintenance and improvement of long-term health in cystic fibrosis (CF). Although the benefits of PA for CF populations are well-established, adherence to PA programmes within this population remains low. This study aimed to investigate the factors that influence engagement in physical activity, and to explore exercise preferences, among adults with cystic fibrosis (CF).MethodsSemi-structured telephone interviews were conducted. Participants were twenty-one adults (mean age 35 years, SD ± 8) with an established diagnosis of CF, living in Ireland. Interview scripts were digitally recorded and transcribed verbatim. Thematic analysis was used to analyse the data.ResultsFour main themes emerged: barriers, motives, value of exercise-related outcomes, and exercise preferences. The main barriers included: low energy levels, time, the weather, and exercise-related confidence. Enjoyment and perceived competence underpinned autonomous motivation. Participants who self-identified as being regularly active valued personally identified exercise-related outcomes such as, accomplishment and affect regulation. Participants indicated a preference for home-based physical activity programs compared to gym- or facility-based programs.ConclusionInterventions aimed at promoting physical activity among adults with CF should involve programs that foster autonomous motivation, enjoyable activities, personally identified outcomes, competence and that can be conducted from the home environment.Clinical implicationsTo increase physical activity participation among adults with CF, interventions that can be conducted from the home environment, that pay attention to the patients' personally-valued exercise outcomes may be required.
| S-EPMC8017094 | biostudies-literature
Project description:Seaweed has been traditionally consumed in Asian and Pacific cultures, yet aside from sushi, is still not commonly eaten in Western societies. Edible seaweeds offer distinct nutritional benefits to terrestrial crops, particularly with respect to mineral and fibre content. Understanding the motivations that drive young Australians to eat seaweed is necessary for food product development and consumer marketing strategies, as well as informing future sustainable production through seaweed aquaculture and wild-harvest practices. An observational cross-sectional online survey with n = 1403 young (19-30 years) Australian seaweed consumers was conducted. The 19-item survey included closed-ended, open-ended, and Likert scale responses. Most respondents were female (89.0%), with tertiary level education or above (57.7%). Seaweed was eaten mostly as a snack (87.7%) and in home-prepared meals (30.7%). The key advantages to consumption were flavour (89.1%), nutrient content (49.1%), and health benefits (44.6%), whilst the key barriers were poor accessibility (59.5%), unaffordable pricing (46.5%), and undesirable packaging (19.0%). The consumers reported wanting more promotion to improve their knowledge about seaweed, in addition to environmentally sustainable packaging and sourcing. Pathways to overcome barriers and encourage greater seaweed consumption are discussed. Most critically, improving the promotion and environmental sustainability of seaweed products will improve intake amongst current and future consumers.
| S-EPMC9563983 | biostudies-literature
Project description:Swallowing impairment (dysphagia) post-stroke results in poorer outcomes. Pharyngeal electrical stimulation (PES) is a potential treatment for post-stroke dysphagia. In a post hoc analysis, we investigated PES using videofluoroscopy swallow studies (VFSS) from the STEPS trial incorporating multiple measures of safety (penetration aspiration scale-PAS), speed and duration (timing), and efficiency (clearance), as opposed to the original trial which only measured PAS scores. 81 randomised participants (PES (N = 43) versus sham (N = 38)) were analysed at baseline and 2 weeks. Participants swallowed up to 6 × 5 ml and 1 × 50 ml of thin liquid barium at 40% w/v, images at ≥25 fps. Based on PAS, the 5 ml mode bolus (most frequently occurring PAS from 6 × 5 ml) and the worst 50 ml bolus were chosen for further analysis. Eight timing measures were performed, including stage transition duration (STD) and pharyngeal transit time (PTT). Clearance measures comprised oral and pharyngeal residue and swallows to clear. Comparisons of change of scoring outcomes between PES and sham were done at 2 weeks. Wilcoxon Signed Ranks Test was also used to evaluate longitudinal changes from both groups' combined results at two weeks. Between-group analysis showed no statistically significant differences. Issues with suboptimal image quality and frame rate acquisition affected final numbers. At two weeks, both groups demonstrated a significant improvement in most safety scores (PAS) and STD, possibly due to spontaneous recovery or a combination of spontaneous recovery and swallowing treatment and usual care. A nonsignificant trend for improvement was seen in other timing measures, including PTT. This study, which conducted additional measurements of kinematic and residue analysis on the STEPS data did not detect "missed" improvements in swallowing function that the PAS is not designed to measure. However, more studies with greater numbers are required.
| S-EPMC8205591 | biostudies-literature