Physiological Flow of Liquids in Healthy Swallowing

NCT ID: NCT04114617

Last Updated: 2022-12-21

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-01-01

Study Completion Date

2020-12-31

Brief Summary

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Thickened liquids are commonly used as an intervention for people with dysphagia (swallowing impairment). However, the field currently lacks a proper understanding of how this intervention works. The overall goal of the project is to collect measurements of bolus flow through the oropharynx (i.e., mouth and throat) during swallowing. The factors that are expected to influence bolus flow include the liquid/food consistency (i.e., thin, slightly-thick, mildly-thick, moderately-thick, extremely thick, solid) and the forces applied during swallowing (i.e., tongue pressures and swallowing muscle contraction). The objective is to determine how these factors interact to influence the flow of a bolus through the oropharynx in healthy swallowing.

Detailed Description

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The aims of this study are as follows:

Aim 1: To determine the relationship between bolus flow and healthy swallowing physiology. The investigators will collect concurrent videofluoroscopic and physiological measures of swallowing (tongue pressure, electromyography \[sEMG\]) in healthy adults using barium stimuli across the continuum of liquid consistency (thin, slightly thick, mildly thick, moderately thick and extremely thick liquids, as defined by the International Dysphagia Diet Standardisation Initiative, www.iddsi.org). Significance: This will show the impact of consistency on bolus flow through the oropharynx, controlling for the forces used to initiate flow and propel the bolus.

Aim 2: To compare healthy swallowing physiology for barium versus non-barium stimuli. The investigators will collect physiological measures of swallowing using barium and non-barium stimuli matched for consistency. Significance: This will determine how swallowing behaviors (tongue pressures, sEMG) differ between barium and non-barium stimuli with matched consistency, enabling us to develop models of flow accounting for these differences.

Aim 3: To compare healthy swallowing physiology across different commercial barium products. Significance: This will determine whether differences in barium concentration or brand influence swallowing behaviors, enabling us to make recommendations regarding ideal contrast agents for use in radiographic swallowing assessment.

Conditions

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Deglutition Healthy Swallowing Aging

Keywords

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Swallowing Deglutition

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Healthy Adults

Participants will be asked to swallow a series of up to 54 liquid stimuli: a) liquid barium (different brands and concentrations); b) a 20% w/v concentration liquid barium thickened to different consistencies using either a starch-based or xanthan-gum based food thickener; and c) lemon-flavored water thickened to different consistencies using either a starch-based or xanthan-gum based food thickener.

Starch-thickened liquids

Intervention Type OTHER

Thickener added in amounts required to reach slightly thick, mildly thick, moderately thick and extremely thick consistencies, as defined by the International Dysphagia Diet Standardisation Initiative flow test.

Xanthan-gum thickened liquids

Intervention Type OTHER

Thickener added in amounts required to reach slightly thick, mildly thick, moderately thick and extremely thick consistencies, as defined by the International Dysphagia Diet Standardisation Initiative flow test.

Barium concentration

Intervention Type COMBINATION_PRODUCT

Commercially available barium products diluted to different concentrations (i.e., 20% w/v, 40% w/v) through the addition of water

Interventions

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Starch-thickened liquids

Thickener added in amounts required to reach slightly thick, mildly thick, moderately thick and extremely thick consistencies, as defined by the International Dysphagia Diet Standardisation Initiative flow test.

Intervention Type OTHER

Xanthan-gum thickened liquids

Thickener added in amounts required to reach slightly thick, mildly thick, moderately thick and extremely thick consistencies, as defined by the International Dysphagia Diet Standardisation Initiative flow test.

Intervention Type OTHER

Barium concentration

Commercially available barium products diluted to different concentrations (i.e., 20% w/v, 40% w/v) through the addition of water

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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Nestle Resource ThickenUp Nestle Resource ThickenUp Clear Bracco E-Z-Paque barium powder; Bracco E-Z-HD barium suspension; Bracco Polibar Plus liquid barium suspension

Eligibility Criteria

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Inclusion Criteria

\- healthy adults

Exclusion Criteria

* prior history of swallowing, motor speech, gastro-esophageal or neurological difficulties, chronic sinusitis or taste disturbance
* history of surgery to the speech or swallowing apparatus (other than routine tonsillectomy or adenoidectomy)
* Type 1 Diabetes
* cognitive communication difficulties that may hinder comprehension of the study documents
* known allergies to latex, food coloring or dental glue
* current pregnancy
* recent x-ray to the neck (in the past 6 months)
* occupationally exposure to radiation exceeding 10 milliSieverts in the year
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Deafness and Other Communication Disorders (NIDCD)

NIH

Sponsor Role collaborator

University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Catriona Steele, PhD

Role: PRINCIPAL_INVESTIGATOR

KITE - Toronto Rehabilitation Institute, University Health Network

Locations

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Toronto Rehabilitation Institute

Toronto, Ontario, Canada

Site Status

Countries

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Canada

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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5R01DC011020

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CAPCR 15-9431 (NIH_HV)

Identifier Type: OTHER

Identifier Source: secondary_id

15-9431

Identifier Type: -

Identifier Source: org_study_id