The purpose of this experimental study was to investigate the influence of airflow via high-flow nasal cannula (HFNC) on the duration of laryngeal vestibule closure (dLVC) and Penetration-Aspiration Scale (PAS) scores. Twenty-nine healthy adults participated in a repeated-measures design. Each participant completed a videofluoroscopic swallow study while receiving airflow via HFNC across a control condition of zero flow and conditions of 10, 20, 30, 40, 50, and 60 L/min. Five raters rated dLVC and PAS scores. Laryngeal vestibule closure was complete on all swallows. Linear regression revealed that the amount of airflow via HFNC significantly influenced dLVC, F(1, 810) = 19.056, p < .001. The mode of airway invasion for each airflow condition was PAS 2, with > 80% frequency compared to other PAS scores. Aspiration (PAS 7 or 8) did not occur. A Fisher's Exact test determined there was no association between normal/abnormal PAS score and no airflow/HFNC (p = .610). Findings indicate that for healthy adults, airflow via HFNC influenced dLVC in a dose-dependent manner with no change in airway invasion. The influence of HFNC on dLVC was a positive relationship, meaning when airflow increased, dLVC increased, and when airflow decreased, dLVC decreased. Modulation of dLVC in response to the amount of airflow highlights the ability of healthy adults to adapt to swallow conditions as needed to protect the airway.
Pleural effusions are rare in adult non-transplanted CF patients. These fluid collections appear to be quite inflammatory with a higher rate of empyema than in the general population.
Introduction: Motor learning is the process involved in acquiring and refining motor skills, which relies on accurate practice and feedback. The purpose of the current investigation was to examine the influence of three types of feedback on successfully performing a swallow motor pattern of a common swallowing intervention known as the Mendelsohn Maneuver (MM). Method: One hundred twenty healthy participants were randomized to one of three feedback conditions: (1) visual and verbal feedback (VVF), (2) verbal feedback only (VF), and (3) intrinsic feedback (IF). Participants were asked to perform a swallow motor pattern associated with the MM. Data was collected using surface electromyography (sEMG). Results: Percentages of participants who performed the pattern successfully and the time required to complete three successful swallowing patterns were significantly different by the feedback condition. The feedback conditions influenced the performance of the MM swallow motor pattern. One hundred percent of the participants randomized to the VVF condition performed the motor pattern successfully and performed three consecutive successful trails in a shorter time period (211 seconds; X2(2) = 95.95, p < 0.001) when compared to the VF condition (74% performed in 505 seconds) and the IF condition (18% performed in 826 seconds; X2(2) = 95.96, p < 0.001). However, considering the participants who met the performance criteria, the number of repetition attempts required to correctly produce the MM pattern did not differ significantly between the three feedback conditions (X2(2) = 14.86, p = 0.81). Conclusion: Visual and verbal feedback improves the performance of the MM and decreases the time to perform three successful MM swallowing patterns in healthy adults.
Introduction Spastic dysarthria is a motor speech disorder produced by bilateral damage to the activation pathways of the central nervous system. Its speech characteristics reflect the effects of hypertonicity and weakness of the bulbar musculature in a way that slows movement and reduces range of motion and force. Perceptually, speech has a high-pitched, strained, hypernasal vocal quality with decreased intelligibility. Purpose The purpose is to present a case illustration describing the use of a novel treatment protocol to improve speech intelligibility in the presence of spastic dysarthria. Method An underlying framework, including principles of exercise, neuroplasticity, and motor learning with adjunctive biofeedback, is described. The protocol consisted of four sessions per week for 4 weeks with daily homework. Results The participant exhibited improvements in intelligibility, patient satisfaction, lingual, and jaw range of motion, nasality, and tongue strength. Conclusion The use of a novel protocol using biofeedback and incorporating principles of exercise science, neuroplasticity, and motor learning for the treatment of spastic dysarthria demonstrated positive outcomes.
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