Videofluoroscopic measures of swallowing in people with stable COPD compared to healthy aging.
Renata Mancopes, Catriona Margaret Steele
PMID 37878956WHAT IT FOUND
In stable COPD, swallowing showed shorter airway closure, earlier and shorter upper esophageal sphincter opening, and weaker pharyngeal squeeze compared with matched healthy adults.
Penetration-aspiration was absent, so these differences may raise aspiration risk.
Key findings
01Stable COPD showed shorter laryngeal vestibule closure duration, shorter timing from hyoid burst onset to upper esophageal sphincter opening, shorter upper esophageal sphincter opening duration, and reduced pharyngeal constriction compared with matched healthy controls.
02Incomplete laryngeal vestibule closure was more common in the COPD group than in matched controls, but the difference did not reach statistical significance.
03No participant with COPD aspirated material below the vocal folds, and penetration was not increased.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only 28 adults with stable COPD and 28 matched controls, which the authors state is insufficient for generalization. Only discrete, comfortably sized natural sips were tested, so the results may not capture swallowing problems during larger-volume or sequential drinking. Respiration and respiratory-swallow coordination were not monitored, although abnormal timing within the respiratory cycle may be relevant in COPD. Participants were in stable COPD, not exacerbation, so findings may not apply during acute worsening. Most COPD participants had severe airflow limitation, so mild or very advanced groups may differ. The analysis used only the first bolus of each consistency to match datasets, which may not represent repeated swallowing. The controls were extracted from a separate healthy reference dataset rather than being recruited concurrently for this analysis.
Declared interests
Financial support was partially provided by an R01 grant from the National Institutes of Health to the final author. No other conflicts of interest are stated in the supplied text.
The easy way to misread this
Do not conclude that stable COPD causes aspiration from these data. No penetration-aspiration was observed on the tested discrete sips, and the study only describes swallowing differences, not a demonstrated aspiration outcome.