TY - JOUR T1 - Tongue strength and swallowing dynamics in chronic obstructive pulmonary disease JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00192-2021 SP - 00192-2021 AU - Isabella Epiu AU - Simon C. Gandevia AU - Claire L. Boswell-Ruys AU - Emma Wallace AU - Jane E. Butler AU - Anna L. Hudson Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/04/29/23120541.00192-2021.abstract N2 - Background Swallowing disorders occur in chronic obstructive pulmonary disease (COPD), but little is known about tongue strength and mastication. This is the first assessment in COPD of tongue strength and a test of mastication and swallowing solids (TOMASS).Methods Anterior tongue strength measures were obtained in 18 people with COPD, aged 73±11 years (mean±sd), and 19 healthy age-matched controls, aged 72±6 years. Swallowing dynamics were assessed using an eating assessment tool (EAT-10), timed water swallow test (TWST), and TOMASS. Swallowing measures were compared to an inhibitory reflex in the inspiratory muscles to airway occlusion (IR; recorded previously in the same participants).Results Tongue strength was similar between COPD and controls (p=0.715). Self-assessed scores of dysphagia EAT-10 were higher (p=0.024) and swallowing times were prolonged for liquids (p=0.022) and solids (p=0.003) in the COPD group. During TWST, ∼30% of COPD group showed clinical signs of airway invasion (cough and wet voice), but none in the control group. For solids, the COPD group had ∼40% greater number of chews (p=0.004), and two-fold-higher number of swallows (p=0.0496). Respiratory rate was 50% higher in COPD group than controls (p <0.001). The presence of an IR was not related to better swallowing outcomes, but signs of airway invasion were associated with a delayed IR.Conclusion Dysphagia in stable COPD is not due to impaired anterior tongue strength, but rather swallowing-breathing discoordination. To address dysphagia, aspiration, and acute exacerbations in COPD, therapeutic targets to improve swallowing dynamics could be investigated further.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Isabella Epiu has nothing to disclose.Conflict of interest: Dr. Gandevia reports receiving a fellowship from the National Health and Medical Research Council.Conflict of interest: Dr. Boswell-Ruys has nothing to disclose.Conflict of interest: Dr. Wallace has nothing to disclose.Conflict of interest: Dr. Butler has nothing to disclose.Conflict of interest: Dr. Hudson reports grants from National Health and Medical Research Council, grants from Rebecca L Cooper Foundation, during the conduct of the study. ER -