Relationship Between Swallowing Function and Maximum Phonation Time in Patients With Parkinsonism
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Objective To identify the relationship between maximum phonation time (MPT) and swallowing function, as well as the elements of swallowing, in order to provide a rationale for speech therapy in patients with Parkinsonism manifesting dysphagia.Methods Thirty patients with Parkinsonism who underwent speech evaluation and videofluoroscopic swallowing study (VFSS) were recruited. The MPT, the longest periods of sustained pronunciation of /aa/, was evaluated. The VFSS was evaluated using Penetration Aspiration Scale (PAS), National Institutes of Health-Swallowing Safety Scale (NIH-SSS), and Videofluoroscopic Dysphagia Scale (VDS). The relationship between dysphagia scales and MPT was analyzed using Pearson correlation. The difference in VDS variables between subgroups (Parkinson disease or Parkinsonian syndrome, independent or dependent ambulation, and normal or abnormal MPT) and the difference in MPT between subgroups based on the VDS variables were analyzed using the independent t-test.Results Bolus formation and laryngeal elevation functions were significantly higher in the normal MPT group compared with the impaired group. In the VDS variables, patients with intact bolus formation, oral transit time, pharyngeal swallow triggering, and laryngeal elevation showed significantly longer MPTs compared with the impaired groups. In addition, MPT was significantly correlated with the VDS and modestly correlated with the NIH-SSS, but not the PAS, suggesting that phonatory function is related to the oropharyngeal swallowing function, but not directly to the aspiration itself.Conclusion The correlation between MPT and several swallowing-related elements was identified, indicating an interactive correlation between swallowing and phonation. This result justifies voice therapy as a treatment for dysphagia in patients with Parkinsonism.
Abstract
Objective To identify the relationship between maximum phonation time (MPT) and swallowing function, as well as the elements of swallowing, in order to provide a rationale for speech therapy in patients with Parkinsonism manifesting dysphagia.Methods Thirty patients with Parkinsonism who underwent speech evaluation and videofluoroscopic swallowing study (VFSS) were recruited. The MPT, the longest periods of sustained pronunciation of /aa/, was evaluated. The VFSS was evaluated using Penetration Aspiration Scale (PAS), National Institutes of Health-Swallowing Safety Scale (NIH-SSS), and Videofluoroscopic Dysphagia Scale (VDS). The relationship between dysphagia scales and MPT was analyzed using Pearson correlation. The difference in VDS variables between subgroups (Parkinson disease or Parkinsonian syndrome, independent or dependent ambulation, and normal or abnormal MPT) and the difference in MPT between subgroups based on the VDS variables were analyzed using the independent t-test.Results Bolus formation and laryngeal elevation functions were significantly higher in the normal MPT group compared with the impaired group. In the VDS variables, patients with intact bolus formation, oral transit time, pharyngeal swallow triggering, and laryngeal elevation showed significantly longer MPTs compared with the impaired groups. In addition, MPT was significantly correlated with the VDS and modestly correlated with the NIH-SSS, but not the PAS, suggesting that phonatory function is related to the oropharyngeal swallowing function, but not directly to the aspiration itself.Conclusion The correlation between MPT and several swallowing-related elements was identified, indicating an interactive correlation between swallowing and phonation. This result justifies voice therapy as a treatment for dysphagia in patients with Parkinsonism.
참고문헌 (21)
- Plowman-Prine EK, "The relationship between quality of life and swallowing in Parkinson's disease", Mov Disord, 24, pp.1352~1358 (2009)[DOI]
- Kalia LV, "Parkinson's disease", Lancet, 386, pp.896~912 (2015)[DOI]
- Potulska A, "Swallowing disorders in Parkinson's disease", Parkinsonism Relat Disord, 9, pp.349~353 (2003)[DOI]
- van Hooren MR, "Treatment effects for dysphagia in Parkinson's disease: a systematic review", Parkinsonism Relat Disord, 20, pp.800~807 (2014)[DOI]
- Suttrup I, "Dysphagia in Parkinson's disease", Dysphagia, 31, pp.24~32 (2016)[DOI]
- Regan J, "Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic Parkinson's disease", Dysphagia, 25, pp.207~215 (2010)[DOI]
- van Hooren MR, "Voice- and swallow-related quality of life in idiopathic Parkinson's disease", Laryngoscope, 126, pp.408~414 (2016)[DOI]
- Speyer R, "Effects of therapy in oropharyngeal dysphagia by speech and language therapists: a systematic review", Dysphagia, 25, pp.40~65 (2010)[DOI]
- Stegemoller EL, "Effects of singing on voice, respiratory control and quality of life in persons with Parkinson's disease", Disabil Rehabil, 39, pp.594~600 (2017)[DOI]
- Maslan J, "Maximum phonation time in healthy older adults", J Voice, 25, pp.709~713 (2011)[DOI]
- Speyer R, "Effects of voice therapy: a systematic review", J Voice, 22, pp.565~580 (2008)[DOI]
- Valim MA, "The relationship between the maximum time for phonation, fundamental frequency and protection of the lower airways in patients with neurological dysphagia", Int Arch Otorhinolaryngol, 11, pp.260~266 (2007)
- Kim H, "Neurologic speech-language disorders" (2012), Sigmapress
- Belafsky PC, "The clinician's guide to swallowing fluoroscopy", pp.59~68 (2014), Springer
- Rosenbek JC, "A penetration-aspiration scale", Dysphagia, 11, pp.93~98 (1996)[DOI]
- Han TR, "The prediction of persistent dysphagia beyond six months after stroke", Dysphagia, 23, pp.59~64 (2008)[DOI]
- El Sharkawi A, "Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study", J Neurol Neurosurg Psychiatry, 72, pp.31~36 (2002)[DOI]
- Troche MS, "Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial", Neurology, 75, pp.1912~1919 (2010)[DOI]
- Pitts T, "Impact of expiratory muscle strength training on voluntary cough and swallow function in Parkinson disease", Chest, 135, pp.1301~1308 (2009)[DOI]
- Stegemoller EL, "Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease", Complement Ther Med, 31, pp.127~133 (2017)[DOI]
- Russell JA, "Targeted exercise therapy for voice and swallow in persons with Parkinson's disease", Brain Res, 1341, pp.3~11 (2010)[DOI]