Faculty Collaboration Database

Effects of laryngeal restriction on pharyngeal peristalsis and biomechanics: Clinical implications. Am J Physiol Gastrointest Liver Physiol 2016 Jun 01;310(11):G1036-43

Date

04/16/2016

Pubmed ID

27079611

Pubmed Central ID

PMC4935483

DOI

10.1152/ajpgi.00010.2016

Scopus ID

2-s2.0-84984656894 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

To date, rehabilitative exercises aimed at strengthening the pharyngeal muscles have not been developed due to the inability to successfully overload and fatigue these muscles during their contraction, a necessary requirement for strength training. The purpose of this study was to test the hypothesis that applying resistance against anterosuperior movement of the hyolaryngeal complex will overload the pharyngeal muscles and by repetitive swallowing will result in their fatigue manifested by a reduction in pharyngeal peristaltic amplitude. Studies were done in two groups. In group 1 studies 15 healthy subjects (age: 42 ± 14 yr, 11 females) were studied to determine whether imposing resistance to swallowing using a handmade device can affect the swallow-induced hyolaryngeal excursion and related upper esophageal sphincter (UES) opening. In group 2, an additional 15 healthy subjects (age 56 ± 25 yr, 7 females) were studied to determine whether imposing resistance to the anterosuperior excursion of the hyolaryngeal complex induces fatigue manifested as reduction in pharyngeal contractile pressure during repeated swallowing. Analysis of the video recordings showed significant decrease in maximum deglutitive superior laryngeal excursion and UES opening diameter (P < 0.01) due to resistive load. Consecutive swallows against the resistive load showed significant decrease in pharyngeal contractile integral (PhCI) values (P < 0.01). Correlation analysis showed a significant negative correlation between PhCI and successive swallows, suggesting "fatigue" (P < 0.001). In conclusion, repeated swallows against a resistive load induced by restricting the anterosuperior excursion of the larynx safely induces fatigue in pharyngeal peristalsis and thus has the potential to strengthen the pharyngeal contractile function.

Author List

Shaker R, Sanvanson P, Balasubramanian G, Kern M, Wuerl A, Hyngstrom A

Authors

Gokulakrishnan Balasubramanian MD Associate Professor in the Medicine department at Medical College of Wisconsin
Allison Hyngstrom PhD Associate Professor in the Physical Therapy department at Marquette University
Patrick P. Sanvanson MD Associate Professor in the Medicine department at Medical College of Wisconsin
Reza Shaker MD Assoc Provost, Sr Assoc Dean, Ctr Dir, Chief, Prof in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Biomechanical Phenomena
Deglutition
Female
Humans
Male
Middle Aged
Muscle Contraction
Muscle Fatigue
Peristalsis
Pharyngeal Muscles
Pharynx