The effect of effortful swallow on pharyngeal manometric measurements during saliva and water swallowing in healthy participants.

OBJECTIVE To evaluate the effect of effortful swallow on pharyngeal manometric pressure measurements during saliva and water swallowing. DESIGN Comparative analysis of pharyngeal pressure generation under 2 bolus and 2 task conditions. SETTING Swallowing rehabilitation research laboratory. PARTICIPANTS Healthy participants (N=40), sex equally represented, with a mean age of 25.8 years. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Manometric peak and nadir amplitude and duration measures at 3 locations in the pharynx. RESULTS Significantly higher peak pressures were measured for saliva swallows compared with water swallows under both swallowing conditions at the proximal pharyngeal sensor only (P=.011). No significant differences were observed between the effortful versus noneffortful conditions at the proximal and midpharyngeal sensors; however, upper esophageal sphincter (UES) nadir pressures were significantly lower for effortful than noneffortful swallows (P=.034) with significantly lower pressure measurements in saliva effortful swallows (P=.008) compared with water effortful swallows. Saliva swallows resulted in significantly longer pressure durations than water swallows at the proximal (P=.003) and middle (P=.048) sensors. Pressure-generation duration was significantly longer in effortful versus noneffortful swallows for the middle sensor (P=.036) only. CONCLUSIONS The results indicate that the effect of effortful swallow on pharyngeal peak pressure measurement is not altered by bolus type (saliva vs water). However, this is not the case for nadir pressure measurements in the UES, which were significantly lower in effortful saliva swallows than in effortful water swallows.