Respiratory Patterns Associated with Swallowing in Athetoid Cerebral-Palsied Patients

OBJECTIVE: To evaluate the changes of the respiratory patterns associated with swallowing in athetoid cerebral palsied patients (CP), and to understand its relationship with their dysphagia and aspiration. METHOD: Seven adult athetoid CP and seven control subjects were selected for this study. Each subject performed swallowing tasks in upright sitting position, and submental electromyography and respirography by pneumobelt on mid-abdomen were recorded simultaneously. Swallowing tasks were composed of swallowing 5 cc, 75 cc of water, and chewing a cookie. And athetoid subjects performed videofluoroscopic swallowing study (VFSS) for each food texture. RESULTS: 1) In athetoid CP, respiratory patterns during swallowing were variable and more irregular than the resting tidal breathing. 2) In athetoid CP, completion time of the swallowing task and recovery time to the resting tidal breathing after swallow were significantly prolonged (p<0.01). 4) Athetoid subjects had significantly higher rate of postdeglutitive inspiration than that of the controls (p<0.01). 5) In correlation with the VFSS findings, aspirated group of the athetoid subjects had significantly higher rate of postdeglutitive inspiration than that of non-aspirated group (p<0.05). CONCLUSION: Respiratory-swallowing coordination was disrupted in the athtoid CP, and their higher rate of postdeglutitive inspiration suggested the higher risk for aspiration of the food materials, especially in drinking of large amounts of liquid.

Changes of Respiratory Patterns Associated with Swallowing in Brain-injured Patients

OBJECTIVE: The aim of the study is to evaluate the changes of the respiratory patterns associated with swallowing in the brain-injured patients. METHOD: Twenty brain-injured patients(6 bulbar lesions, 14 pseudobulbar lesions) and fifteen normal subjects were selected for this study. Each subject swallowed 5cc of water for ten times in a upright sitting position and a submental electromyography recording and respirography by pneumobelt on mid-abdomen were recorded simultaneously. RESULTS: 1) Most swallows occured during the late expiratory phase in both brain-injured patients and controls. 2) In brain-injured patients, the incidence of swallowing during inspiration was significantly higher than the controls(p<0.05). 3) In brain-injured patients, the postdeglutitive inspiration was significantly higher than the controls(p<0.05). 4) In patients with a bulbar lesion, the postdeglutitive inspiration was significantly higher than patients with a pseudobulbar lesion(p<0.01). 5) Postdeglutitive swallowing relatively correlates with the abnormalities in clinical findings and Video Fluoroscopic Swallowing Study(VFSS) findings. CONCLUSION: The respiratory patterns associated with the swallowing in brain-injured patients were different from that of the normal adults and the postdeglutitive inspiration could be the most valuable predictor of the aspiration.