19 April 2010
Angela R. South, MA, Stephanie M. Somers, MClSc and Mandar S. Jog, MD
Reduced swallowing frequency affects secretion management in Parkinson disease (PD). Gum chewing increases saliva flow and swallow frequency.
This study uses chewing gum to modify swallow frequency and latency between swallows in patients with PD.
Objectives: 1) Assess the frequency and latency of swallow at baseline (BL), during gum chewing (GC), and post gum chewing (PGC) for participants with PD (stage 2-4) nonsymptomatic for prandial dysphagia; and 2) assess carryover after gum is expectorated.
Methods: Twenty participants were studied across 3 tasks, each of 5 minutes in duration: BL, GC, and PGC. Respiratory and laryngeal signals were continuously recorded using PowerLab (version 5.5.5; ADI Instruments, Castle Hill, Australia). Frequency and latency of swallow events were calculated.
Results: Differences (analysis of variance) are reported for frequency (p < 0.000001) and latency (p < 0.000001). Swallow frequency (mean +/- SD) increased during GC (14.95 +/- 3.02) compared with BL (3.1 +/- 2.85) and PGC (7.0 +/- 2.57). Latency in seconds (mean +/- SD) decreased during GC (24.1 +/- 4.174) and increased with BL (131.8 +/- 59.52) and PGC (mean = 60.74 +/- 25.25).
Intertask comparisons (t test) found differences in swallow frequency and latency between tasks: BL vs GC (p < 0.0001, p < 0.0001), BL vs PGC (p < 0.0011, p < 0.0009), and GC vs PGC (p < 0.0001, p < 0.0002), respectively. Post hoc analysis showed carryover to 5.317 minutes.
Conclusions: Modifying sensorimotor input by chewing gum alters frequency and latency of swallowing and may be an effective strategy for secretion management in Parkinson disease.
Classification of evidence: This study provides Class III evidence that chewing gum increases swallow frequency and decreases latency of swallowing in an experiment in patients with stage 2 to 4 Parkinson disease who are nonsymptomatic for significant prandial dysphagia.
