Preferred Name

Teresa Drulia

Date of Award

Fall 2016

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Department of Communication Sciences and Disorders

Advisor(s)

Cynthia O'Donoghue

Christy Ludlow

Abstract

Chronic Obstructive Pulmonary Disease (COPD), a respiratory disease that leads to reduced airflow, may result in difficulty swallowing with disease progression. The coordination between the respiratory and swallowing systems decouple and they may experience increased risk of aspiration. This study aimed to determine the effects of lung volume on swallowing in individuals with COPD compared with older healthy. Specifically, the study examined if altering lung volume at the time of the swallow changed swallowing timing, specifically pharyngeal swallow duration, and impacted the respiratory-swallow pattern in individuals with COPD. Measurement of estimated lung volume (ELV), pharyngeal swallow duration, and respiratory-swallow patterning in individuals with COPD was compared with older healthy at varying lung volume conditions. Participants completed seven 20 ml water bolus swallows by medicinal cup across 4 lung volumes: non-cued volume (NC), and in order of increasing volume, resting expiratory level (REL), tidal volume (TV), and total lung capacity (TLC) . ELV was determined using respiratory inductive plethysmography (RIP) and spirometry. Swallow timing was measured by events during the swallow with pharyngeal manometry. Individuals with COPD had lower lung volumes at the time of the swallow than older healthy individuals. A moderate to strong negative relationship between estimated lung volume at the time of the swallow and pharyngeal swallow duration was found in individuals with COPD that was not present in the healthy participants. They had a longer pharyngeal duration when swallowing at lower lung volumes. The percentage of swallows resuming on inspiration post-swallow were significantly greater in individuals with COPD than the healthy. In the COPD group, resumption of respiration in inspiration occurred significantly less often at the higher lung volumes (TLC and TV) than the lower volume condition, REL. In conclusion lower lung volumes at the time of the swallow in individuals with COPD were associated with longer pharyngeal swallow duration and increased resumption of respiration in inspiration post-swallow.

Available for download on Sunday, November 18, 2018

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