title: Normalization of temporal aspects of swallowing physiology after the McNeill dysphagia therapy program.
abstract: OBJECTIVE
  We examined the timing of physiological swallowing events in patients before and after completion of an exercise-based dysphagia intervention (McNeill Dysphagia Therapy Program; MDTP) and compared their performance to that of healthy volunteers.
  
  
  METHODS
  Eight adults (mean age, 57.5 years) with chronic dysphagia (mean, 45 months) completed 3 weeks of the MDTP. Before and after the MDTP we measured lingual-palatal and pharyngeal manometric pressures during swallows of thin liquid, thick liquid, and pudding material in 5-mL volumes. Using the pressure peak of the pharyngoesophageal segment clearing wave as the anchor point, we measured the relative timing of pressure peaks from the anterior, middle, and posterior parts of the tongue and the manometric peaks from the base of the tongue, the hypopharynx, and the nadir of the pharyngoesophageal segment. We compared these results to identical measures obtained from 34 healthy adults (mean age, 44.0 years).
  
  
  RESULTS
  The timing of physiological events before the MDTP was significantly slower than that of the group of healthy volunteers. The timing data from after the MDTP were not significantly different from those of the healthy group. The magnitude change was greatest for thin liquid.
  
  
  CONCLUSIONS
  Dysphagia therapy with the MDTP improves the timing of physiological events during swallowing. Temporal coordination of swallowing components after therapy approximates that of healthy adults, suggesting a normalization of swallow timing after the MDTP.
authors.affiliation: Department of Speech, Language, and Hearing Sciences College of Public Health and Health Professions, University of Florida, Gainesville, Florida 32610-0174, USA.
authors.forename: Yue
authors.initials: Y
authors.lastname: Lan
authors.forename: Mai
authors.initials: M
authors.lastname: Ohkubo
authors.forename: Giédre
authors.initials: G
authors.lastname: Berretin-Felix
authors.forename: Isaac
authors.initials: I
authors.lastname: Sia
authors.forename: Giselle D
authors.initials: GD
authors.lastname: Carnaby-Mann
authors.forename: Michael A
authors.initials: MA
authors.lastname: Crary
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000534:rehabilitation*; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010159:Palate / Q000502:physiology; D010614:Pharynx / Q000502:physiology; D013997:Time Factors; D014059:Tongue / Q000502:physiology; D014160:Transducers, Pressure; D014783:Viscosity