{
    "abstract": "To determine if fatigue systematically effects the timing of swallowing events and to discuss underlying causes of fatigue other than peripheral neuromuscular fatigue.\nPre-post within-subject repeated-measures design.\nGeneral acute care hospital and designated stroke center.\nThirteen patients (10 males and 3 females) aged 52-80 years (mean 64.84\u00b19.58 y) with acute stroke and clinically suspected dysphagia.\nUnder videofluoroscopy, each participant swallowed a pre- and post-study 1-mL liquid barium bolus and, in an attempt to fatigue the system, 30-45 additional bolus trials of varying amounts (ie, 5 mL, 10 mL, and bite-sized) and consistencies (ie, International Dysphagia Diet Standardisation Initiative Level 0-7).\nSix temporal sequences (ie, oral, pharyngeal, and pharyngeal delay transit times and durations of laryngeal vestibule closure, cricopharyngeal opening, and laryngeal elevation) for 1-mL liquid boluses were measured pre- and postvideofluoroscopic swallowing study and compared.\nFindings indicated that only 2 of the 6 temporal factors yielded significant differences pre- to post fatigue. The postvideofluoroscopic 1-mL liquid swallow took longer than the pre-videofluoroscopic 1-mL liquid swallow in terms of pharyngeal transit (\nThese findings indicate that peripheral neuromuscular fatigue is unlikely to be the primary cause of the observed changes, as only 2 of the 6 temporal measures-pharyngeal transit time and pharyngeal delay time-were affected. In cases of peripheral neuromuscular fatigue, one would expect increases across all 6 timing measures due to the integrated nature of the swallowing process. Instead, the results suggest that the inconsistencies may stem from a delayed excitatory response of neurons or a delay in synaptic transmission within the nucleus tractus solitarius, potentially associated with stroke. This delay likely contributes to the prolongation of both pharyngeal transit and pharyngeal delay times. Thus, a model focused solely on peripheral neuromuscular fatigue does not fully account for the findings, highlighting the importance of considering central neural mechanisms in the clinical evaluation of swallowing disorders.",
    "authors": [
        {
            "affiliation": "Peninsula Hospital Center, Department of Speech-Language Pathology and Audiology, Far Rockaway, NY.\nThe University of Scranton, Department of Health and Human Performance, Scranton, PA.",
            "firstname": "Hope E",
            "initials": "HE",
            "lastname": "Baylow"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 The Authors.",
    "doi": "10.1016/j.arrct.2024.100381\n10.1007/PL00009583",
    "journal": "Archives of rehabilitation research and clinical translation",
    "keywords": [
        "Deglutition",
        "Deglutition disorders",
        "Neuromuscular fatigue",
        "Swallowing disorders",
        "dysphagia",
        "rehabilitation",
        "stroke",
        "videofluoroscopy"
    ],
    "methods": null,
    "publication_date": "2025-01-17",
    "pubmed_id": "39822197\n17702815\n11581501\n35324642\n18195089\n14658992\n23339207\n21674405\n12617692\n10367724\n11274347\n25194202\n2484181\n11820386\n9828274\n17216388\n36793109\n21822745\n15382793\n11063246\n1499933\n3251688\n8460698\n7900799\n19399555\n8359038\n32654058\n32650664\n30711683\n27398981\n8023945\n7823550",
    "results": "Findings indicated that only 2 of the 6 temporal factors yielded significant differences pre- to post fatigue. The postvideofluoroscopic 1-mL liquid swallow took longer than the pre-videofluoroscopic 1-mL liquid swallow in terms of pharyngeal transit (",
    "title": "Assessing the Effect of Fatigue on Swallowing Function in Adults with Acute Stroke. A Pilot Study.",
    "xml": "<Element 'PubmedArticle' at 0x7885055007c0>"
}