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This study of healthy young and elderly individuals is intended to assess the effects of pharyngeal exerciser on pharyngeal pressure phenomenon during swallowing. Our specific aim is to test if the pharyngeal exerciser increases the workload of muscles involved in pharyngeal phase of swallowing.
5 ml and 10 ml- of water swallows at room temperature x 5 times each.
5 ml and 10 ml- mashed potato swallowed at room temperature x 5 times each.
8. The sequence of the swallow types will be randomized. The swallow will be performed under device pressure of zero, 20, 30, 40 and 60 mm Hg in a randomized fashion. Each swallow type will be repeated 5 times with 30-second intervals in between.
9. The externally applied pressure will be measured by means of the pressure gauge included in the device
10. All the subjects will be given the option to participate in the concurrent videofluoroscopic examination along with pharyngeal manometry
11. The fluoroscopy machine will be turned "on" for 5 seconds only during the swallowing. The rest of the time fluoroscopy machine will be turned off.
12. These subjects undergoing concurrent fluoroscopy and manometry will perform the following swallows at zero, 20, and 40 mm Hg of device pressure:
Dry swallows x 3 times.
5 ml and 10 ml of water mixed barium swallow at room temperature x 3 times each.
5 ml- mashed potatoes mixed with barium at room temperature x 3 times.
The participant will also be instructed to resume their regular diet and activity.
All the tracings and video recordings will be analyzed by two individuals in a blinded fashion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pharyngeal exerciser group | Experimental | Test that application of the pharyngeal exerciser increases the workload of muscles involved in pharyngeal phase of swallowing as evidenced manometrically by changes in Pharyngeal peak pressures Pharyngeal (velopharynx, oropharynx and hypopharynx) contractile duration Pharyngeal (velopharynx, oropharynx and hypopharynx) contractile integral Hypopharyngeal intrabolus pressure and duration UES nadir pressure UES relaxation time Baseline UES pressure |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pharyngeal exerciser | Device | Pharyngo-esophageal manometry during lateral fluoroscopy |
|
| Measure | Description | Time Frame |
|---|---|---|
| laryngeal excursion during swallowing | maximum laryngeal excursion from resting position measured from fluoroscopic images during swallowing | During mano-fluorography procedure |
| hyoid excursion during swallowing | maximum hyoid bone excursion from resting position measured from fluoroscopic images during swallowing | During mano-fluorography procedure |
| upper esophageal sphincter (UES) opening during swallowing | maximum UES anterior-posterior diameter measured from fluoroscopic images during swallowing | During mano-fluorography procedure |
| pharyngeal peak peristaltic pressure | maximum deglutitive pressure within the pharynx | During mano-fluorography procedure |
| pharyngeal (velopharynx, oropharynx and hypopharynx) contractile duration | manometric duration of peristaltic pressure wave in velopharynx, oropharynx and hypopharynx | During mano-fluorography procedure |
| pharyngeal (velopharynx, oropharynx and hypopharynx) contractile integral | space-time and length integral of pharyngeal pressures in the velopharynx, oropharynx and hypopharynx | During mano-fluorography procedure |
| hypopharyngeal intrabolus pressure | maximum pressure within the hypopharynx as the swallowed bolus covers the pressure sites within the hypopharynx |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Reza Shaker, MD | Contact | 4149556840 | rshaker@mcw.edu | |
| Mark Kern | Contact | 4148053826 | mkern@mcw.edu |
| Name | Affiliation | Role |
|---|---|---|
| Reza Shaker, MD | Medical College of Wisconsin | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical College of Wisconsin | Recruiting | Milwaukee | Wisconsin | 53086 | United States |
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| ID | Term |
|---|---|
| D003680 | Deglutition Disorders |
| ID | Term |
|---|---|
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D010608 | Pharyngeal Diseases |
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Study of healthy subjects
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| During mano-fluorography procedure |
| hypopharyngeal intrabolus duration | duration of maximum pressure within the hypopharynx as the swallowed bolus covers the pressure sites within the hypopharynx | During mano-fluorography procedure |
| UES nadir pressure | minimum pressure within the upper esophageal sphincter (UES) during UES deglutitive relaxation | During mano-fluorography procedure |
| UES relaxation time | duration pressure drops within the upper esophageal sphincter during UES deglutitive relaxation | During mano-fluorography procedure |
| baseline UES pressure | average UES pressure when no swallow activity is present | During mano-fluorography procedure |
| D010038 | Otorhinolaryngologic Diseases |