Skip to main content
Erschienen in:

22.01.2021 | Original Article

The Influence of Age, Eating a Meal, and Systematic Fatigue on Swallowing and Mealtime Parameters

verfasst von: Danielle Brates, Sonja Molfenter

Erschienen in: Dysphagia | Ausgabe 6/2021

Einloggen, um Zugang zu erhalten

Abstract

Fatigue is widely accepted as a clinically relevant factor in the diagnosis, treatment, and management of dysphagia. Despite the relative importance that is placed on swallowing-related fatigue, the occurrence and effects of fatigue during swallowing is unclear. The goal of this study was to explore effects of eating a meal on measures of tongue strength, endurance, and other parameters of swallowing function under normal conditions compared to when the tongue is intentionally fatigued. Thirty healthy females, 15 “Young” (18–35 years old), and 15 “Old” (70 + years old) were seen for two data collection sessions one week apart. On both days, pre-meal measures were collected, then participants consumed a standardized meal based on a previously published protocol (half a bagel with peanut butter and 8 baby carrots) followed by post-meal measures. An additional pre-meal fatigue task was included on one of the test days (counterbalanced), involving maximal tongue presses until participants could not achieve 40% of baseline maximum pressure. Pre- and post-meal measures included anterior and posterior maximum tongue pressures, saliva swallow pressure, tongue endurance, surface electromyography (sEMG), the modified Borg scale, and the Test of Mastication and Swallowing of Solids (TOMASS). Linear mixed effects regressions compared pre- and post-meal outcome measures (1) on the non-fatigue day and (2) between fatigue and non-fatigue days while controlling for participant and age. The fatigue task caused significant reductions in maximum anterior and posterior tongue pressure. After a normal meal (i.e., without fatigue), we found decreased anterior pressures in the older group only. Older participants also had decreased saliva swallow pressures after the meal compared to pre-meal, while this measure increased post-mean in the young participants. When compared to the non-fatigue meal, eating a meal after tongue fatigue resulted in significantly lower post-meal posterior pressures, regardless of age group. The same pattern was observed with posterior functional reserve. Our results demonstrate that a systematic, participant-specific tongue fatigue task induced measurable changes in maximum tongue pressure. A meal by itself was observed to reduce anterior tongue strength and saliva swallow pressures only in older participants. Overall, it appears that older adults may be more vulnerable to fatigue-induced changes in tongue strength, though the relationship between these measures and changes to functional swallowing remains unknown.
Literatur
3.
Zurück zum Zitat Solomon NP. Assessment of tongue weakness and fatigue. Int J Orofacial Myology. 2004;30:8–19.CrossRef Solomon NP. Assessment of tongue weakness and fatigue. Int J Orofacial Myology. 2004;30:8–19.CrossRef
4.
Zurück zum Zitat Ferdjallah M, Wertsch JJ, Shaker R. Spectral analysis of surface electromyography (EMG) of upper esophageal sphincter-opening muscles during head lift exercise. J Rehabil Res Dev. 2000;37(3):335–40.PubMed Ferdjallah M, Wertsch JJ, Shaker R. Spectral analysis of surface electromyography (EMG) of upper esophageal sphincter-opening muscles during head lift exercise. J Rehabil Res Dev. 2000;37(3):335–40.PubMed
5.
Zurück zum Zitat Jurell KC, Shaker R, Mazur A, Haig AJ, Wertsch JJ. Spectral analysis to evaluate hyoid muscles involvement in neck exercise. Muscle Nerve. 1996;19:1224. Jurell KC, Shaker R, Mazur A, Haig AJ, Wertsch JJ. Spectral analysis to evaluate hyoid muscles involvement in neck exercise. Muscle Nerve. 1996;19:1224.
8.
Zurück zum Zitat Van Ravenhorst-Bell HA, Goldberg L Changes in tongue strength and endurance after a typical meal in healthy older adults in a continuing care community. In: 8th Annual GRASP Symposium, Wichita State University, 2012. Van Ravenhorst-Bell HA, Goldberg L Changes in tongue strength and endurance after a typical meal in healthy older adults in a continuing care community. In: 8th Annual GRASP Symposium, Wichita State University, 2012.
10.
Zurück zum Zitat Solomon NP. Changes in normal speech after fatiguing the tongue. J Speech Lang Hear Res. 2000;43(6):1416–28.CrossRef Solomon NP. Changes in normal speech after fatiguing the tongue. J Speech Lang Hear Res. 2000;43(6):1416–28.CrossRef
11.
Zurück zum Zitat Vanderwegen J, Van Nuffelen G. Evaluation of different fatigue-inducing paradigms (FP) on maximum isometric pressures (MIP) of the anterior tongue in healthy adults and elderly. Dublin, Ireland: Paper presented at the European Society for Swallowing Disorders; 2018. Vanderwegen J, Van Nuffelen G. Evaluation of different fatigue-inducing paradigms (FP) on maximum isometric pressures (MIP) of the anterior tongue in healthy adults and elderly. Dublin, Ireland: Paper presented at the European Society for Swallowing Disorders; 2018.
14.
Zurück zum Zitat Kryger MH, Roth T, Dement WC. Sleep Deprivation. In: Banks S, Dorrian J, Basner M, editors. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia: Elsevier; 2017. Kryger MH, Roth T, Dement WC. Sleep Deprivation. In: Banks S, Dorrian J, Basner M, editors. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia: Elsevier; 2017.
19.
Zurück zum Zitat Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377–81.CrossRef Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377–81.CrossRef
21.
Zurück zum Zitat Huckabee ML, McIntosh T, Fuller L, Curry M, Thomas P, Walshe M, McCague E, Battel I, Nogueira D, Frank U, van den Engel-Hoek L, Sella-Weiss O. The Test of Masticating and Swallowing Solids (TOMASS): reliability, validity and international normative data. Int J Lang Commun Disord. 2018;53(1):144–56. https://doi.org/10.1111/1460-6984.12332.CrossRefPubMed Huckabee ML, McIntosh T, Fuller L, Curry M, Thomas P, Walshe M, McCague E, Battel I, Nogueira D, Frank U, van den Engel-Hoek L, Sella-Weiss O. The Test of Masticating and Swallowing Solids (TOMASS): reliability, validity and international normative data. Int J Lang Commun Disord. 2018;53(1):144–56. https://​doi.​org/​10.​1111/​1460-6984.​12332.CrossRefPubMed
24.
30.
Zurück zum Zitat Ditor DS, Hicks AL. The effect of age and gender on the relative fatigability of the human adductor pollicis muscle. Can J Physiol Pharmacol. 2000;78(10):781–90.CrossRef Ditor DS, Hicks AL. The effect of age and gender on the relative fatigability of the human adductor pollicis muscle. Can J Physiol Pharmacol. 2000;78(10):781–90.CrossRef
32.
Zurück zum Zitat Aniansson A, Grimby G, Hedberg M, Rungren A, Sperling L. Muscle function in old age. Scand J Rehabil Med Suppl. 1978;6:43–9.PubMed Aniansson A, Grimby G, Hedberg M, Rungren A, Sperling L. Muscle function in old age. Scand J Rehabil Med Suppl. 1978;6:43–9.PubMed
43.
Zurück zum Zitat Powers S, Howley E. Skeletal Muscle: Structure and Function. In: Powers S, editor. Exercise Physiology: Theory and Application to Fitness and Performance. 10th ed. New York: McGraw-Hill; 2018. Powers S, Howley E. Skeletal Muscle: Structure and Function. In: Powers S, editor. Exercise Physiology: Theory and Application to Fitness and Performance. 10th ed. New York: McGraw-Hill; 2018.
50.
Zurück zum Zitat Robbins J, Levine R, Wood J, Roecker EB, Luschei E. Age effects on lingual pressure generation as a risk factor for dysphagia. J Gerontol A Biol Sci Med Sci. 1995;50(5):M257-262.CrossRef Robbins J, Levine R, Wood J, Roecker EB, Luschei E. Age effects on lingual pressure generation as a risk factor for dysphagia. J Gerontol A Biol Sci Med Sci. 1995;50(5):M257-262.CrossRef
51.
Zurück zum Zitat Steele CM. Electromyography as a biofeedback tool for rehabilitating swallow muscle function. In: Steele C, editor. Applications of EMG in clinical and sports medicine. Croatia: InTech, Rijeka; 2011. Steele CM. Electromyography as a biofeedback tool for rehabilitating swallow muscle function. In: Steele C, editor. Applications of EMG in clinical and sports medicine. Croatia: InTech, Rijeka; 2011.
Metadaten
Titel
The Influence of Age, Eating a Meal, and Systematic Fatigue on Swallowing and Mealtime Parameters
verfasst von
Danielle Brates
Sonja Molfenter
Publikationsdatum
22.01.2021
Verlag
Springer US
Erschienen in
Dysphagia / Ausgabe 6/2021
Print ISSN: 0179-051X
Elektronische ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-020-10242-8

Weitere Artikel der Ausgabe 6/2021

Dysphagia 6/2021 Zur Ausgabe

Neu im Fachgebiet HNO

Mit bimodaler Neuromodulation gegen Tinnitus

Eine Kombination von Klangtherapie und elektrischer Stimulation der Zunge soll Patientinnen und Patienten mit Tinnitus Linderung verschaffen. Die positiven Ergebnisse der TENT-A3-Studie haben die FDA veranlasst, das Gerät in den USA zur Tinnitustherapie zuzulassen.

Hörverlust begünstigt Morbus Parkinson

Nicht nur das Alzheimerrisiko ist bei Schwerhörigen erhöht, sondern auch das für Morbus Parkinson. Die gute Nachricht: Wer Hörhilfen nutzt, erkrankt seltener an solchen neurodegenerativen Leiden.

Häufigere Komplikationen nach Entfernung der Zungenmandeln

Eine neue US-amerikanische Studie zeigt, dass nach einer Tonsillektomie der Zungenmandeln sowohl bei Kindern als auch bei Erwachsenen häufiger Dysphagie und Aufnahmen auf die Intensivstation auftreten als nach einer chirurgischen Entfernung der Gaumenmandeln.

„Ein Patient mit einem metastasierten Speicheldrüsenkarzinom gehört sequenziert!“

Bei Speicheldrüsenkarzinomen handelt es sich um seltene Tumoren, entsprechend sind Daten zur molekularen Therapiesteuerung rar. Gute Ergebnisse liegen zu einer gegen HER2-gerichteten Behandlung vor, ebenso wie für die Inhibition von NTRK-Fusionen.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.