Coordination between respiration and swallowing (Xu et al., 2024)

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 S1. Bedside Swallowing Evaluation (BSE).

Supplemental Material S2. Patients’ demographic and clinical characteristics and data of parameters related to the coordination between respiration and swallowing.

Xu, X., Zhang, Q., Xie, Y., Yang, D., Gao, F., Yuan, Y., Zhang, Y., & Li, J. (2024). Coordination between respiration and swallowing in patients with dysphagia after cervical spinal cord injury: An observational case–control study. American Journal of Speech-Language Pathology, 33(5), 2572–2581. https://doi.org/10.1044/2024_AJSLP-24-00135