Enhancing Swallowing-Respiration Coordination

David H. McFarland*, Bonnie Martin Harris, Annie Joëlle Fortin

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Purpose of Review: This review was designed to summarize our current understanding of optimal respiratory-swallowing coordination and to highlight a novel intervention to improve coordination in patients with dysphagia consequent to head and neck cancer and treatment. Additional consideration was given to the challenges of recording respiratory movements for clinical and research purposes surrounding respiratory-swallowing coordination. Recent Findings: Our recent findings in normal humans reveal that the respiratory pause to accommodate swallowing interrupts quiet breathing in a restricted range of lung volumes from mid to low tidal volume. We have hypothesized that this “optimal” range imparts significant airway protective and physiological swallowing benefits. Systematic respiratory-swallow training in patients treated for head and neck cancer with refractory dysphagia and less than optimal patterning not only improved respiratory-swallowing coordination but also diminished aspiration and improved key components of swallowing physiology. Summary: These data suggest that respiratory-swallow training may be an important treatment tool to re-establish respiratory-swallowing coordination and could be used in conjunction with other swallowing treatments to improve swallowing outcomes in susceptible patients. Future research is needed to explore mechanisms of change and to refine the treatment methodology to further improve swallowing outcomes.

Original languageEnglish (US)
Pages (from-to)239-244
Number of pages6
JournalCurrent Physical Medicine and Rehabilitation Reports
Volume6
Issue number4
DOIs
StatePublished - Dec 1 2018

Keywords

  • Respiratory movements
  • Respiratory-swallowing coordination
  • Swallowing outcomes

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Orthopedics and Sports Medicine
  • Medicine (miscellaneous)

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