Modulation of Tongue Pressure According to Liquid Flow Properties in Healthy Swallowing.
Catriona M Steele, Melanie Peladeau-Pigeon, Carly A E Barbon and 8 others
PMID 30950761WHAT IT FOUND
Healthy adults pressed harder and faster on the palate as liquids became thicker, and they took smaller sips.
At the low barium concentration used, barium-containing liquids did not change tongue pressure compared with nonbarium liquids.
Key findings
01Healthy adults produced higher peak tongue-palate pressures and steeper pressure rise and decay slopes per millilitre as liquids became thicker.
02Tongue pressures did not differ significantly between thin barium and thin nonbarium liquids, and the same was seen for thicker liquids.
03Across gravity-flow-matched liquids, there was no consistent tongue-pressure pattern for barium versus nonbarium or starch versus xanthan gum.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The participants were healthy adults with no reported swallowing, motor speech, gastro-oesophageal or neurological problems, so the findings do not show what happens in people with dysphagia. The study measured tongue pressure only; it did not view bolus flow under videofluoroscopy, so it cannot show how these pressures changed actual swallowing safety or efficiency. Some participants may have taken more than one swallow per bolus, especially with larger sips, although separate data from the same participants suggested single swallows were common. Taste and flavour differences from thickeners were not controlled and may have affected sip size. The barium concentration was low, so results may not apply to higher barium concentrations used elsewhere. Extremely thick liquids were not included because their viscosity varied too much despite similar IDDSI flow results.
Declared interests
The study was funded by the National Institute on Deafness and Other Communication Disorders through RO1 Grant DC011020 to the first author. The supplied text does not report other conflicts of interest.
The easy way to misread this
Do not assume that barium-containing liquids always behave like nonbarium liquids in clinical swallowing. The study used healthy adults and a low barium concentration, and it did not view bolus flow under videofluoroscopy.