title: Variations in tongue-palate swallowing pressures when swallowing xanthan gum-thickened liquids.
abstract: Thickened liquids are frequently recommended to reduce the risk of aspiration in patients with oropharyngeal dysphagia. Although it has previously been reported that tongue-palate pressures increase when swallowing spoon-thick and semi-solid consistencies compared to thin liquids, relatively little is known about how swallowing behaviors differ when swallowing liquids of nectar- or honey-thick consistency. Furthermore, previous studies have primarily used starch-based thickeners, and little is known about swallowing behaviors with xanthan gum-thickened liquids, which have recently been introduced for dysphagia management. In this study, we measured variations in tongue-palate pressures during the swallowing of liquids thickened to apparent viscosities of 190, 250, and 380 mPa s at 50/s using increasing concentrations of xanthan gum (0.5, 0.63 and 0.87 w/w%). The viscosity differences between these nectar- and honey-thick stimuli were confirmed to exceed sensory perceptual discrimination thresholds. Data were collected from 78 healthy adults in two sex-balanced age-groups (young; mature) and compared to reference values obtained during water swallowing. The results confirm that increased amplitudes of tongue-palate pressure were used when swallowing the thickened liquid stimuli, compared to swallows of water, and for the honey-thick liquid compared to the two nectar-thick liquids. Age-related reductions were seen in tongue strength but not in swallowing pressures, which fell below 40 % of maximum isometric pressure values. Thus, the use of xanthan gum-thickened liquids is unlikely to tax the swallowing system in terms of tongue pressure generation requirements, even in seniors with reduced maximum isometric tongue pressure measures.
authors.affiliation: Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, #12-101, Toronto, ON, M5G 2A2, Canada, catriona.steele@uhn.ca.
authors.forename: Catriona M
authors.initials: CM
authors.lastname: Steele
authors.forename: Sonja M
authors.initials: SM
authors.lastname: Molfenter
authors.forename: Melanie
authors.initials: M
authors.lastname: Péladeau-Pigeon
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Polacco
authors.forename: Clemence
authors.initials: C
authors.lastname: Yee
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000628:therapy; D005260:Female; D005503:Food Additives; D006801:Humans; D008297:Male; D010159:Palate / Q000502:physiology*; D011135:Polysaccharides, Bacterial; D011312:Pressure; D012737:Sex Factors; D012996:Solutions; D014059:Tongue / Q000502:physiology*; D014783:Viscosity
chemical_list: D005503:Food Additives; D011135:Polysaccharides, Bacterial; D012996:Solutions; C002563:xanthan gum
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