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Potential for Volitional Control of Resting Pressure at the Upper Oesophageal Sphincter in Healthy Individuals

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Abstract

Resting pressure at the upper oesophageal sphincter (UOS) has been reported to be susceptible to factors such as emotional stress or respiration. This exploratory study investigated the potential for behavioural modulation of UOS resting pressure in healthy adults to increase our understanding of volitional control of UOS pressure, and the potential development of rehabilitation approaches. Six healthy adults were seen one hour daily for two weeks (10 days) and for one post-training session after a training break of two weeks. Manipulation of UOS resting pressure was practised during a protocol of alternating increased and decreased pressure. A high-resolution manometry contour plot was used as a biofeedback modality. Participants were asked to explore how to achieve warmer and cooler colours (pressure increase and decrease, respectively) at the UOS resting pressure band, without changing head position or manipulating activity of other muscles. Performance was analysed prior to training start and following daily training. Participants were able to increase resting pressure following one week of practice; however, there was no evidence for purposeful pressure decrease. The increased resting pressure achieved by participants indicates a capacity for purposeful pressure modulation given intensive biofeedback training. The lack of volitional reduction in pressure may be explained by sustained pressure generation due to the intrinsic muscular characteristics of the UOS and a flooring effect in healthy subjects, in whom physiology mandates a minimum degree of resting pressure to fulfil the barrier function. Distention caused by the presence of the intraluminal catheter cannot be ruled out.

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Acknowledgements

Reliability data were extracted by Susanne Ebert.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Psychology, Speech and Hearing, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand

    Katharina Winiker, Kristin Gozdzikowska, Esther Guiu Hernandez, Seh Ling Kwong, Phoebe Macrae & Maggie-Lee Huckabee

  2. The University of Canterbury Rose Centre for Stroke Recovery and Research, Leinster Chambers, Level one, 249 Papanui Rd, Private Bag 4737, Christchurch, 8140, New Zealand

    Katharina Winiker, Kristin Gozdzikowska, Esther Guiu Hernandez, Seh Ling Kwong, Phoebe Macrae & Maggie-Lee Huckabee

  3. The Laura Fergusson Trust, 279 Ilam Road, Christchurch, 8053, New Zealand

    Kristin Gozdzikowska

  4. Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Seh Ling Kwong

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  1. Katharina Winiker
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Correspondence to Katharina Winiker.

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Winiker, K., Gozdzikowska, K., Guiu Hernandez, E. et al. Potential for Volitional Control of Resting Pressure at the Upper Oesophageal Sphincter in Healthy Individuals. Dysphagia 36, 374–383 (2021). https://doi.org/10.1007/s00455-020-10146-7

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  • DOI: https://doi.org/10.1007/s00455-020-10146-7

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