Swallowing Disorders

Swallowing Disorders
Swallowing disorders have attracted considerable attention in the healthcare sector in recent years. Numerous studies have been carried out in the past few years to examine various aspects of swallowing disorders. Nagami et al. (2017) conducted a study in which they examined discoordination between breathing and swallowing among patients with chronic obstructive pulmonary disease (COPD). The research was conducted on the premise that COPD is a major life-threatening ling disease across the globe. One of the major objectives in prevention and/or management of chronic obstructive pulmonary disease is preventing exacerbation, which has severe impacts on mortality, morbidity, and healthcare costs. In their previous research, Nagami et al. (2017) found that frequent COPD exacerbation is associated with symptoms of gastro-oesophageal reflux (GER). GER symptoms are mostly treated using a proton pump inhibitor, which was found to be ineffective in lessening COPD exacerbation. Existing literature has established a link between GER symptoms and impaired swallowing abnormalities in patients suffering from chronic obstructive pulmonary disease.
Therefore, it’s increasingly important to examine these swallowing abnormalities to help enhance the clinical outcomes of patients with GER symptoms and COPD. In this regard, the researchers developed a non-invasive quantitative technique for examining the coordination between breathing and swallowing. To achieve the purpose of the study, the researchers developed a hypothesis that was tested using this this technique for measuring breathing-swallowing coordination. The research hypothesis is, “Breathing-swallowing coordination may be impaired in patients with COPD and that breathing-swallowing ‘discoordination’ may be a significant risk factor for frequent and/or further exacerbation” (Nagami et al., 2017, p.1).
A group of 65 stable outpatients with chronic obstructive pulmonary disease was selected to participate in the research, which was part of prospective observational cohort group at Kyoto University. Recruitment of the study participants and measurements of breathing-swallowing coordination were conducted between May 2015 and October 2016. The study participants were COPD patients aged 40 years or older and in stable conditions during the recruitment day. During recruitment, the participants were subjected to a swallowing function analysis as well as pulmonary function test and questionnaires. The participants’ respiratory symptoms were evaluated using the COPD Assessment Test (CAT) and modified Medical Research Council Dysponea Scale. On the other hand, GER symptoms were evaluated using a self-reported frequency scale for symptoms of GERD (FSSG) questionnaire. For data analysis, the researchers utilized Fisher’s exact test, t-tests, and univariate and multivariate analyses.
The study found that breathing-swallowing discoordination resulted in frequent COPD exacerbation and discoordination is linked to risk of aspiration. Therefore, clinical interventions focusing on breathing-swallowing coordination is essential for treatment of COPD patients. While the findings of the study are consistent with those in existing literature, its still unclear whether its possible to enhance breathing-swallowing discoordination in COPD patients.
Quality of the Research
Through their study, Nagami et al. (2017) provide significant insights regarding breathing-swallowing disccordination among patients with chronic obstructive pulmonary disease. Since this research was conducted as part of a prospective observational cohort study, its quality is Level II A. The research is of high quality since it was carried out using a comprehensive research approach and provides results that are consistent with existing literature on the phenomenon under investigation. The results of this study are not only consistent, but also provides a fair level of confidence for making recommendations for clinical practice.
Reference
Nagami et al. (2017, May 2). Breathing-swallowing Discoordination is Associated with Frequent Exacerbations of COPD. BMJ Open Respiratory Research, 4, 1-9.