TY - JOUR
T1 - Swallowing in myotonic muscular dystrophy
T2 - A videofluoroscopic study
AU - Leonard, Rebecca J
AU - Kendall, Katherine A.
AU - Johnson, Ralph
AU - McKenzie, Susan
PY - 2001
Y1 - 2001
N2 - Objectives: (1) To determine how swallow function in patients with myotonic muscular dystrophy (MD) differs from that of healthy controls, (2) to identify the contributors to and predictors of improvement, and (3) to evaluate strategies that facilitate swallowing. Design: Observational. Setting: University medical center. Participants: Eighteen adults with myotonic MD (age range, 24-58yr) and 60 healthy adult control subjects (age range, 18-73yr). Interventions: Swallow facilitation strategies. Main Outcome Measures: Between-group comparisons of mean bolus transit times, onsets of swallow gestures, and displacement measures obtained by dynamic lateral view videofluoroscopy. Results: The MD patients' bolus transit times were significantly longer, and onsets of some swallow gestures were significantly delayed. Upper esophageal sphincter opening was prolonged (myotonic MD, .61 ± .13s; control, .5 ± .11s). Hyoid displacement was significantly less in men with myotonic MD (1.9 ± .05cm) than in male controls (2.4 ± .68cm); this difference was not observed between control and myotonic women. Of particular importance was the markedly reduced pharyngeal constriction found in the MD group. Conclusions: Weakness associated with the disease, as opposed to myotonia, was the most significant contributor to impairment. Persons at risk for aspiration may be identified by a measure of pharyngeal area. Selected strategies to facilitate pharyngeal clearing are worthwhile.
AB - Objectives: (1) To determine how swallow function in patients with myotonic muscular dystrophy (MD) differs from that of healthy controls, (2) to identify the contributors to and predictors of improvement, and (3) to evaluate strategies that facilitate swallowing. Design: Observational. Setting: University medical center. Participants: Eighteen adults with myotonic MD (age range, 24-58yr) and 60 healthy adult control subjects (age range, 18-73yr). Interventions: Swallow facilitation strategies. Main Outcome Measures: Between-group comparisons of mean bolus transit times, onsets of swallow gestures, and displacement measures obtained by dynamic lateral view videofluoroscopy. Results: The MD patients' bolus transit times were significantly longer, and onsets of some swallow gestures were significantly delayed. Upper esophageal sphincter opening was prolonged (myotonic MD, .61 ± .13s; control, .5 ± .11s). Hyoid displacement was significantly less in men with myotonic MD (1.9 ± .05cm) than in male controls (2.4 ± .68cm); this difference was not observed between control and myotonic women. Of particular importance was the markedly reduced pharyngeal constriction found in the MD group. Conclusions: Weakness associated with the disease, as opposed to myotonia, was the most significant contributor to impairment. Persons at risk for aspiration may be identified by a measure of pharyngeal area. Selected strategies to facilitate pharyngeal clearing are worthwhile.
KW - Fluoroscopy
KW - Myotonic dystrophy
KW - Rehabilitation
KW - Swallowing
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U2 - 10.1053/apmr.2001.23962
DO - 10.1053/apmr.2001.23962
M3 - Article
C2 - 11441389
AN - SCOPUS:0034935721
VL - 82
SP - 979
EP - 985
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 7
ER -