Coordination Between Respiration and Swallowing in Patients With Dysphagia After Cervical Spinal Cord Injury: An Observational Case-Control Study.

IF 2.3 3区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY American Journal of Speech-Language Pathology Pub Date : 2024-09-18 Epub Date: 2024-09-06 DOI:10.1044/2024_AJSLP-24-00135

Xuluan Xu, Qingsu Zhang, Yongqi Xie, Degang Yang, Feng Gao, Yongxue Yuan, Yu Zhang, Jianjun Li

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Abstract

Purpose: The purpose of the present study was to characterize the differences between respiration and swallowing in patients with dysphagia after cervical spinal cord injury (CSCI) and to explore the underlying physiological changes.

Method: A total of 95 participants were recruited for bedside swallowing evaluation followed by a flexible endoscopic evaluation of swallowing and surface electromyography with a thermocouple nasal airflow sensor examination: 32 with dysphagia, 33 without dysphagia, and 30 healthy controls. The differences in respiratory patterns, swallowing apnea duration (SAD), inspiratory-expiratory ratio, and swallowing efficiency were observed among healthy adults, CSCI patients with and without dysphagia after CSCI.

Results: Compared with those of healthy controls and patients without dysphagia after CSCI, the postswallow respiratory pattern of patients with dysphagia after CSCI was an inspiratory pattern, and the SAD was significantly shorter in patients with dysphagia after CSCI (p < .001). Additionally, the expiratory time in patients with dysphagia was significantly shorter than the inspiratory time, and the swallowing efficiency was reduced, requiring multiple swallows. Moreover, the index of SAD was statistically significant for predicting the development of dysphagia in patients with CSCI (p < .001).

Conclusion: Patients with CSCI have an inspiratory pattern after swallowing, and the SAD is significantly reduced; SAD can be used as the predictor of dysphagia in patients after CSCI; the pattern of coordination between respiration and swallowing in patients with dysphagia after CSCI is different from that of healthy controls and patients without dysphagia after CSCI.

Supplemental material: https://doi.org/10.23641/asha.26524717.

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颈脊髓损伤后吞咽困难患者呼吸与吞咽之间的协调：一项观察性病例对照研究。

目的：本研究旨在描述颈脊髓损伤（CSCI）后吞咽困难患者呼吸和吞咽之间的差异，并探讨其潜在的生理变化：方法：共招募 95 名参与者进行床旁吞咽评估，然后进行灵活的内窥镜吞咽评估和表面肌电图与热电偶鼻气流传感器检查：其中 32 人有吞咽困难，33 人无吞咽困难，30 人为健康对照组。观察了健康成人、CSCI 患者和 CSCI 后无吞咽困难者在呼吸模式、吞咽呼吸暂停持续时间（SAD）、吸气呼气比和吞咽效率方面的差异：与健康对照组和 CSCI 后无吞咽困难的患者相比，CSCI 后吞咽困难患者吞咽后的呼吸模式为吸气模式，CSCI 后吞咽困难患者的 SAD 明显较短（P < .001）。此外，吞咽困难患者的呼气时间明显短于吸气时间，吞咽效率降低，需要多次吞咽。此外，SAD指数对预测CSCI患者吞咽困难的发生具有统计学意义（p < .001）：结论：CSCI 患者吞咽后有吸气模式，且 SAD 明显降低；SAD 可作为 CSCI 患者吞咽困难的预测指标；CSCI 后吞咽困难患者呼吸与吞咽之间的协调模式不同于健康对照组和 CSCI 后无吞咽困难的患者。补充材料：https://doi.org/10.23641/asha.26524717。

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来源期刊

American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

4.30

自引率

11.50%

发文量

353

审稿时长

>12 weeks

期刊介绍： Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.