Skip to main content

Advertisement

SpringerLink
Log in

Effects of Bolus Consistency on Timing and Safety of Swallow in Patients with Parkinson’s Disease

  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Aspiration pneumonia is the leading cause of death in Parkinson’s disease (PD) patients. In clinical practice, the videofluoroscopic examination (VFE) is the most common method for evaluation of swallowing disorders. One of the variables manipulated during the VFE is consistency of the bolus. The results of this examination greatly influence the recommendations made by speech-language pathologists regarding swallow therapy and/or intervention. The primary aim of this study was to investigate the effects of bolus consistency on penetration-aspiration (P-A) score and timing of swallow of persons with PD. The videoradiographic images of ten participants with PD swallowing six thin and six pudding-thick boluses were analyzed. Swallow timing and P-A were measured. (i.e., oral transit time, pharyngeal transit time, number of tongue pumps, and P-A score). The results demonstrated various significant differences and relationships among the dependent variables. Implications for further research and clinical practice are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Parkinson J: An essay on the shaky palsy. London: Whittingham and Bowland, 1817

    Google Scholar 

  2. Ardran GM, Kemp FH: The mechanism of swallowing. Proc R Soc Med 44:1038-1040, 1951

    PubMed  CAS  Google Scholar 

  3. Ardran GM, Kemp FH: Radiologic investigation of pharyngeal and laryngeal palsy. Acta Radiol 46:446-455, 1956

    PubMed  CAS  Google Scholar 

  4. Ardran GM, Kemp FH: The mechanism of the larynx. II. The epiglottis and closure of the larynx. Br J Radiol 40:72-89, 1967

    Article  Google Scholar 

  5. Blonsky ER, Logemann JA, Boshes B, Fisher HB: Comparison of speech and swallowing function in patients with tremor disorders and in normal geriatric patients: a cinefluorographic study. J Gerontol 30:299-303, 1975

    PubMed  CAS  Google Scholar 

  6. Bosma JF: Deglutition: pharyngeal phase. Physiol Rev 37:275-300, 1957

    PubMed  CAS  Google Scholar 

  7. Logemann JA: Evaluation and Treatment of Swallowing Disorders. Austin, TX: Pro-Ed, 1983

  8. Hind JA, Nicosia MA, Gangnon R, Robbins J: The effects of intraoral pressure sensors on normal young and old swallowing patterns. Dysphagia 20:249-253, 2005

    Article  PubMed  Google Scholar 

  9. Lof GL, Robbins J: Test-retest variability in normal swallowing. Dysphagia 4:236-242, 1990

    Article  PubMed  CAS  Google Scholar 

  10. Ali GN, Wallace KL, Schwartz R, DeCarle DJ, Zagami AS, Cook IJ: Mechanisms of oral-pharyngeal dysphagia in patients with Parkinson’s disease. Gastroenterology 110:383-392, 1996

    Article  PubMed  CAS  Google Scholar 

  11. Bushmann M, Dobmeyer SM, Leeker L, Perlmutter S: Swallowing abnormalities and their response to treatment in Parkinson’s disease. Neurology 39:1309-1314, 1989

    PubMed  CAS  Google Scholar 

  12. Nagaya M, Kachi T, Yamada T, Igata A: Videofluorographic study of swallowing in Parkinson’s disease. Dysphagia 13:95-100, 1998

    Article  PubMed  CAS  Google Scholar 

  13. Stroudley J, Walsh M: Radiological assessment of dysphagia in Parkinson’s disease. Br J Radiol 64:890-893, 1991

    PubMed  CAS  Google Scholar 

  14. Born LJ, Harned RH, Rikkers LF, Pfeiffer RF, Quigley EM: Cricopharyngeal dysfunction in Parkinson’s disease: role in dysphagia and response to myotomy. Mov Disord 11:53-58, 1996

    Article  PubMed  CAS  Google Scholar 

  15. Coates C, Bakheit AMO: Dysphagia in Parkinson’s disease. Eur Neurol 38:49-52, 1997

    Article  PubMed  CAS  Google Scholar 

  16. Ertekin C, Tarlaci S, Ayodogdu I, Kiylioglu N, Yuceyar N, Turman AB, et al.: Electrophysiological evaluation of pharyngeal phase of swallowing in patients with Parkinson’s disease. Mov Disord 17:942-949, 2002

    Article  PubMed  Google Scholar 

  17. Leopold NA, Kagel MC: Prepharyngeal dysphagia in Parkinson’s disease. Dysphagia 11:14-22, 1996

    Article  PubMed  CAS  Google Scholar 

  18. Leopold NA, Kagel MC: Pharyngo-esophageal dysphagia in Parkinson’s disease. Dysphagia 12:11–18, 1997

    Article  PubMed  CAS  Google Scholar 

  19. Eadie MJ, Tyrer JH: Radiological abnormalities of the upper part of the alimentary tract in Parkinsonism. Australas Ann Med 14:23-27, 1964

    Google Scholar 

  20. Hunter PC, Crameri J, Austin S, Woodward MC, Hughes AJ: Response of parkinsonian swallowing dysfunction to dopaminergic stimulation. J Neurol Neurosurg Psychiatry 63:579-583, 1997

    Article  PubMed  CAS  Google Scholar 

  21. El Sharkawi A, Ramig L, Ogemann JA, Pauloski BR, Rademaker AW, Smith CH, Pawlas A, Baum S, Werner C: Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study. J Neurol Neurosurg Psychiatry 72:31-36, 2002

    Article  PubMed  CAS  Google Scholar 

  22. Silverman EP, Sapienza CM, Saleem A, Carmichael C, Davenport PW, Hoffman-Ruddy B, Okun M: Tutorial on maximum inspiratory and expiratory pressures in individuals with idiopathic Parkinson disease (IPD) and the preliminary results of an expiratory muscle strength training program. NeuroRehabilitation 21:71-79, 2006

    PubMed  Google Scholar 

  23. Hoehn M, Yahr M: Parkinsonism: onset, progression, and mortality. Neurology 17:427-442, 1967

    Article  PubMed  CAS  Google Scholar 

  24. Folstein MF, Folstein SE, McHugh PR: “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res 12:189-198, 1975

    Article  CAS  Google Scholar 

  25. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL: A penetration-aspiration scale. Dysphagia 11:93-98, 1996

    Article  PubMed  CAS  Google Scholar 

  26. Kendall KA, Leonard RJ, McKenzie SW: Accommodation to changes in bolus viscosity in normal deglutition: a videofluoroscopic study. Ann Otol Rhinol Laryngol 110:1059-1065, 2001

    PubMed  CAS  Google Scholar 

  27. Han TR, Paik NJ, Park JW: Quantifying swallowing function after stroke: A functional dysphagia scale based on videofluoroscopic studies. Arch Phys Med Rehabil 82:677-682, 2001

    Article  PubMed  CAS  Google Scholar 

  28. Monte FS, da Silva-Junior FP, Braga-Neto P, Nobre e Souza MA, Sales de Bruin VM: Swallowing abnormalities and dyskinesia in Parkinson’s disease. Mov Disorders 20:457-62, 2005

    Article  Google Scholar 

  29. Robbins J, Levine RL, Maser A, Rosenbek JC, Kempster GB: Swallowing after unilateral stroke of the cerebral cortex. Arch Phys Med Rehabil 74:1295-300, 1993

    Article  PubMed  CAS  Google Scholar 

  30. Dantas RO, Dodds WJ: Effects of bolus volume and consistency on swallow-induced submental and infrahyoid electromyographic activity. Braz J Med Biol Res 23:37-44, 1990

    PubMed  CAS  Google Scholar 

  31. Robbins JA, Logemann JA, Kirschner HS: Swallowing and speech production in Parkinson’s disease. Ann Neurol 19:283-287, 1986

    Article  PubMed  CAS  Google Scholar 

  32. Edwards LL, Quigley EMM, Pfeiffer RF: Gastrointestinal dysfunction in Parkinson’s disease: frequency and pathophysiology. Neurology 42:726-732, 1992

    PubMed  CAS  Google Scholar 

  33. Yamaguchi S, Kobayashi S: Contributions of the dopaminergic system to voluntary and automatic orienting of visuospatial attention. J Neurosci 18:1869-1878, 1998

    PubMed  CAS  Google Scholar 

  34. Bulow M, Olsson R, Ekberg O: Videoradiographic analysis of how carbonated thin liquids and thickened liquids affect the physiology of swallowing in subjects with aspiration on thin liquids. Acta Radiol 44:366-372, 2003

    Article  PubMed  CAS  Google Scholar 

  35. Kuhlemeier KV, Palmer JB, Rosenberg D: Effect of liquid bolus consistency and delivery method on aspiration and pharyngeal retention in dysphagia patients. Dysphagia 16:119-122, 2001

    Article  PubMed  CAS  Google Scholar 

  36. Fernandez HH, LaPane KL: Predictors of mortality among nursing home residents with a diagnosis of Parkinson’s disease. Med Sci Monit 8:241-246, 2002

    Google Scholar 

  37. Gorell JM, Johnson CC, Rybicki BA: Parkinson’s disease and its comorbid disorders: an analysis of Michigan mortality data, 1970 to 1990. Neurology 44:1856-1858, 1994

    Google Scholar 

  38. Schiermier S, Schafer D, Schafer T, Greulich W, Schlafke ME: Breathing and locomotion in patients with Parkinson’s disease. Pflugers Arch Eur J Physiol 443:67-71, 2001

    Article  CAS  Google Scholar 

  39. Shill H, Stacy M: Respiratory function in Parkinson’s disease. Clin Neurosci N Y 5:131-135, 1998

    CAS  Google Scholar 

  40. Singer RB: Mortality in patients with Parkinson’s disease treated with dopa. J Insur Med 24:126-127, 1992

    PubMed  CAS  Google Scholar 

  41. Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, Loesche WJ: Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia 13:69-81, 1998

    Article  PubMed  CAS  Google Scholar 

  42. Saleem A, Sapienza CM, Okun M: Respiratory muscle strength training: treatment and response duration in a patient with early idiopathic Parkinson’s disease. NeuroRehabilitation 20:323-333, 2005

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Communication Sciences and Disorders, University of Florida, Gainesville, PO Box 117420, Florida, 32611, USA

    Michelle S. Troche MA, Christine M. Sapienza PhD, CCC-SLP & John C. Rosenbek PhD, CCC-SLP

  2. Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida, USA

    Michelle S. Troche MA, Christine M. Sapienza PhD, CCC-SLP & John C. Rosenbek PhD, CCC-SLP

Authors
  1. Michelle S. Troche MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christine M. Sapienza PhD, CCC-SLP
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John C. Rosenbek PhD, CCC-SLP
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michelle S. Troche MA.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Troche, M.S., Sapienza, C.M. & Rosenbek, J.C. Effects of Bolus Consistency on Timing and Safety of Swallow in Patients with Parkinson’s Disease. Dysphagia 23, 26–32 (2008). https://doi.org/10.1007/s00455-007-9090-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-007-9090-7

Keywords

Search

Navigation