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Excerpt
This study was undertaken to evaluate the changes of respiratory patterns associated with swallowing in athetoid cerebral palsied patients (CP) and to understand their influences in dysphagia and aspiration of the athetoid CP. Seven adult athetoid CPs and seven controls were subjected to perform the respirography in use of pneumobelt and the submental electromyography simultaneously during swallowing tasks in the upright sitting position. Tasks involved swallowing 5 ml and 75 ml of water and chewing a cookie. Athetoid subjects performed Video-fluoroscopic swallowing study (VFSS) for each food texture. The following results were observed in the athetoid CP. Respiratory patterns during swallowing were variable and more irregular than those during resting tidal breathing. The completion time of swallowing tasks and recovery time to the resting tidal breathing after one swallow were significantly prolonged (P < 0.01). Postdeglutitive inspiration rate was significantly higher than that of controls (P < 0.01). The aspirated group of athetoid subjects had a significantly higher rate of postdeglutitive inspiration than the nonaspirated group in correlation with their VFSS findings (P < 0.05). Respiratory-swallowing coordination was disrupted in the athetoid CPs, and their higher rate of postdeglutitive inspiration suggested a higher risk of aspiration, especially when drinking large amounts of liquid.
