Alterations to Swallowing Physiology as the Result of Effortful Swallowing in Healthy Seniors.

The study was done in healthy seniors without dysphagia, so it cannot show what effortful swallowing does for patients with swallowing problems. The regular and effortful swallows were not randomized; all regular swallows came before all effortful swallows, although the analysis found no trial-order effect. The data were a secondary analysis from a larger aging study, and only 5 ml nectar-thick barium boluses were used. Two-dimensional lateral videofluoroscopy may miss improvements in pharyngeal constriction, especially because 36 of 132 regular swallows already showed full constriction. The pyriform residue finding had an extremely small change, and penetration-aspiration scores were mostly normal, limiting safety conclusions. The effortful swallow cue emphasized throat effort, which may not match instructions used in other clinical settings.

The supplied publication types indicate NIH extramural research support, and the article states no other conflicts of interest to disclose.

Do not conclude that effortful swallowing is an effective exercise for older adults with dysphagia. The study was in healthy seniors and tested only immediate swallows; it did not improve pharyngeal constriction and showed worse pharyngeal shortening and more pyriform residue.