Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic Parkinson's disease.

Hdl Handle:
http://hdl.handle.net/10147/207890
Title:
Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic Parkinson's disease.
Authors:
Regan, Julie; Walshe, Margaret; Tobin, W Oliver
Affiliation:
SLT Department, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland., julie.regan@amnch.ie
Citation:
Dysphagia. 2010 Sep;25(3):207-15. Epub 2009 Aug 26.
Journal:
Dysphagia
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207890
DOI:
10.1007/s00455-009-9244-x
PubMed ID:
19707818
Abstract:
Oropharyngeal dysphagia frequently presents in people with idiopathic Parkinson's disease (IPD). Clinical sequelae of dysphagia in this group include weight loss and aspiration pneumonia, the latter of which is the leading cause of hospital admissions and death in IPD. Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. The effects of TTS on swallowing have not yet been investigated in IPD. The aim of this study was to investigate the immediate effects of TTS on the timing of swallow in a cohort of people with IPD and known oropharyngeal dysphagia. Thirteen participants with IPD and known dysphagia attended for videofluoroscopy during which standardised volumes of liquid barium and barium paste were administered preceding and immediately subsequent to TTS. The immediate effects of TTS on swallowing were examined using oral, pharyngeal, and total transit times and pharyngeal delay times as outcome measures. TTS significantly reduced median pharyngeal transit time on fluids (0.20 s, 95% CI = 0.12-0.28, p = 0.004) and on paste (0.3 s, 95% CI = 0.08-0.66, p = 0.01). Median total transit time was also reduced on fluids (0.48 s, 95% CI = 0.00-1.17, p = 0.049) and on paste (0.52 s, 95% CI = 0.08-1.46, p = 0.033). Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). TTS did not significantly alter median oral transit time on either fluid or paste consistency. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. Significant results may be attributed to the role of sensory stimulation in improving motor function in IPD, with emphasis on the impaired glossopharyngeal and vagus nerves in this population. It is still unclear whether these findings will translate into a clinically beneficial effect.
Language:
eng
MeSH:
Aged; Confidence Intervals; Deglutition/*physiology; Deglutition Disorders/etiology/*physiopathology/therapy; Female; Fluoroscopy; Health Status Indicators; *Hot Temperature; Humans; Male; Middle Aged; Parkinson Disease/*complications/physiopathology; Prevalence; Reproducibility of Results; Statistics, Nonparametric; Time Factors; *Touch
ISSN:
1432-0460 (Electronic); 0179-051X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorRegan, Julieen_GB
dc.contributor.authorWalshe, Margareten_GB
dc.contributor.authorTobin, W Oliveren_GB
dc.date.accessioned2012-02-01T10:49:15Z-
dc.date.available2012-02-01T10:49:15Z-
dc.date.issued2012-02-01T10:49:15Z-
dc.identifier.citationDysphagia. 2010 Sep;25(3):207-15. Epub 2009 Aug 26.en_GB
dc.identifier.issn1432-0460 (Electronic)en_GB
dc.identifier.issn0179-051X (Linking)en_GB
dc.identifier.pmid19707818en_GB
dc.identifier.doi10.1007/s00455-009-9244-xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207890-
dc.description.abstractOropharyngeal dysphagia frequently presents in people with idiopathic Parkinson's disease (IPD). Clinical sequelae of dysphagia in this group include weight loss and aspiration pneumonia, the latter of which is the leading cause of hospital admissions and death in IPD. Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. The effects of TTS on swallowing have not yet been investigated in IPD. The aim of this study was to investigate the immediate effects of TTS on the timing of swallow in a cohort of people with IPD and known oropharyngeal dysphagia. Thirteen participants with IPD and known dysphagia attended for videofluoroscopy during which standardised volumes of liquid barium and barium paste were administered preceding and immediately subsequent to TTS. The immediate effects of TTS on swallowing were examined using oral, pharyngeal, and total transit times and pharyngeal delay times as outcome measures. TTS significantly reduced median pharyngeal transit time on fluids (0.20 s, 95% CI = 0.12-0.28, p = 0.004) and on paste (0.3 s, 95% CI = 0.08-0.66, p = 0.01). Median total transit time was also reduced on fluids (0.48 s, 95% CI = 0.00-1.17, p = 0.049) and on paste (0.52 s, 95% CI = 0.08-1.46, p = 0.033). Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). TTS did not significantly alter median oral transit time on either fluid or paste consistency. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. Significant results may be attributed to the role of sensory stimulation in improving motor function in IPD, with emphasis on the impaired glossopharyngeal and vagus nerves in this population. It is still unclear whether these findings will translate into a clinically beneficial effect.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshConfidence Intervalsen_GB
dc.subject.meshDeglutition/*physiologyen_GB
dc.subject.meshDeglutition Disorders/etiology/*physiopathology/therapyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFluoroscopyen_GB
dc.subject.meshHealth Status Indicatorsen_GB
dc.subject.mesh*Hot Temperatureen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshParkinson Disease/*complications/physiopathologyen_GB
dc.subject.meshPrevalenceen_GB
dc.subject.meshReproducibility of Resultsen_GB
dc.subject.meshStatistics, Nonparametricen_GB
dc.subject.meshTime Factorsen_GB
dc.subject.mesh*Touchen_GB
dc.titleImmediate effects of thermal-tactile stimulation on timing of swallow in idiopathic Parkinson's disease.en_GB
dc.contributor.departmentSLT Department, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland., julie.regan@amnch.ieen_GB
dc.identifier.journalDysphagiaen_GB
dc.description.provinceLeinster-

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