Swallow training for the elderly on the basis of coordination with respiration in swallowing

2002 Fiscal Year Final Research Report Summary

• Project/Area Number: 13672524
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Clinical nursing
• Research Institution: Aichi Prefectural College of Nursing & Health
• Principal Investigator: KMAKURA Yayoi Aichi Prefectural College of Nursing & Health Nursing Professor, 看護学部, 教授 (00177560)
• Project Period (FY): 2001 – 2002
• Keywords: Community-residing elderly / Dysphagia / Respiration pattern / Deglutition apnea / Biofeedback / Supraglottic swallow / Nursing

Research Abstract

This study is an attempt to develop a technique to care for the community-residing elderly with swallowing disorders, We investigated the effect of aging on the duration of deglutition apnea and of using the swallow training on the basis of coordination with respiration in swallowing. As the elderly person swallowed 5 ml water, the respiograms and surface electromyograms of the suprahyoid muscles were recorded. Subjects were classified into the following four age groups : 60-69 years old (n= 24, males 11, females 13) ; 70-74 years old (n=23, males 12, females 11) ; 75-79 years old (n=19, males 8, females 11) ; and over 80 years old (n=24, males 15, females 9). The four groups were compared using a test to clarify the difference in the frequency of respiration patterns. Two-way analysis of variance (ANOVA) was used for the duration of deglutition apnea.
As a result, in comparison with the group 60-69 years old, the frequency of single swallowing (the respiratory pattern in which swallowi ng finishes with one laryngeal movement) decreased in other groups in males and in the 70-74 and 75-79 year groups in females. In males, the duration of deglutition apnea in the group 60-69 years old was 0.870 ± 0.14 sec (mean ± SD). In the groups 70-74, 75-79, and over 80 years old, the duration was 0.957 ± 0.13 sec, 0.841 ± 0.08 sec, and 0.952 ± 0.25 sec, respectively. In females, the duration of deglutition apnea in the group 60-69 years old was 0.996 ± 0.19 sec (mean ± SD), while in the groups 70-74, 75-79 and over 80 years old, it was 1.061 ± 0.13 sec, 0.973 ± 0.15 sec, and 0.905 ± 0.15 sec, respectively. The duration of deglutition apnea was extended in females (p < 0.05), and most extended in the group 70-74 years old in both males and females.
Next, a subject found to have dysphagia by videofluorography who had agreed to participate in this research was examined for the effect of the swallow training program, and for the coordination of deglutition and respiration. The program involved a supraglottic maneuver using respirographic biofeedback. The ABAB method was used as the experimental design. The subject underwent 22 sessions in which10 trials of the 5 ml water swallowing was 1 session. The numbers of supraglottic and piecemeal swallows were recorded for each session. As a result, the number of supraglottic swallows increased and the number of piecemeal swallows decreased from the training.
These results showed that intervention at 70-74 years of age is necessary in order to prevent swallowing disorders in the community-residing elderly and that the training program was effective for the elderly with dysphagia.