Outcomes of manual therapy on the biomechanics of swallowing in individuals with COPD.

Purpose: Several swallowing disorders have been reported in chronic obstructive pulmonary disease (COPD) patients due to the mechanical disadvantage of the respiratory muscles caused by hyperinflation. To date, no reports have been found in the literature among the therapeutic strategies on the use of manual therapy (MT) to manage swallowing disorders in COPD. The aim of the study was to verify the outcomes of a TM program on the biomechanics of swallowing of individuals with COPD.

Methods: 18 individuals with a mean age of 66.06 ± 8.86 years, 61.1% (11) men, and a FEV1% mean of 40.28 ± 16.73 were evaluated before and after TM. The measures analyzed were: oral transit time, pharyngeal transit time (PTT), number of swallows, vallecular (VL) residue and pyriform sinuses, penetration/aspiration and hyolaryngeal excursion in liquid and pasty consistencies.

Results: A significant difference was found in PTT (p=0.04), VL residue (p=0.03), maximal hyoid elevation (p=0.003), and displacement of hyoid (p=0.02) in the pasty consistency. In the liquid consistency, we found a decrease in VL residue (p=0.001).

Conclusion: The MT program influenced the swallowing biomechanics of COPD patients demonstrated by a reduction in PTT and VL residue and increased hyoid elevation and displacement in the pasty consistency. In the liquid consistency, a decrease in VL residue was found.