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Strategies for the Integration of Cough and Swallow to Maintain Airway Protection in Humans

Authors
  • Huff, Alyssa1, 2, 3
  • Reed, Mitchell D.2, 3
  • Smith, Barbara K.4
  • Brown, Edward H. Jr.2, 3
  • Ovechkin, Alexander V.1, 2, 3
  • Pitts, Teresa2, 3, 5
  • 1 University of Louisville, Department of Physiology, Louisville, KY, USA , Louisville (United States)
  • 2 University of Louisville, Department of Neurological Surgery, Louisville, KY, USA , Louisville (United States)
  • 3 University of Louisville, Kentucky Spinal Cord Injury Research Center, Louisville, KY, USA , Louisville (United States)
  • 4 University of Florida, Department of Physical Therapy, Gainesville, FL, USA , Gainesville (United States)
  • 5 University of Louisville, Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, School of Medicine, 511 S Floyd Street, Louisville, KY, 40202, USA , Louisville (United States)
Type
Published Article
Journal
Lung
Publisher
Springer US
Publication Date
Jun 20, 2018
Volume
196
Issue
5
Pages
601–608
Identifiers
DOI: 10.1007/s00408-018-0133-7
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeAirway protective behaviors, like cough and swallow, deteriorate in many populations suffering from neurologic disorders. While coordination of these behaviors has been investigated in an animal model, it has not been tested in humans.MethodsWe used a novel protocol, adapted from previous work in the cat, to assess cough and swallow independently and their coordination strategies in seven healthy males (26 ± 6 years). Surface electromyograms of the submental complex and external oblique complex, spirometry, and thoracic and abdominal wall kinematics, were used to evaluate the timing of swallow, cough, and breathing as well as lung volume (LV) during these behaviors.ResultsUnlike the cat, there was significant variability in the cough-swallow phase preference; however, there was a targeted LV range in which swallow occurred.ConclusionThese results give insight into the differences between the cat and human models in airway protective strategies related to the coordination of cough and swallow behaviors, allowing for better understanding of dystussia and dysphagia.

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