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Dr Phoebe Macrae

Contact

Department: School of Psychology, Speech and Hearing

Email: phoebe.macrae@canterbury.ac.nz

Phone Number: +64 3 369 3999 ext. null

Office: Psychology 310

Language: English

About
Research / Creative works
Supervision
Networks
Methods & Equipment

Fields of Research

  • swallowing
  • cough
  • Neurophysiology
  • rehabilitation
  • dysphagia
  • dystussia
  • upper aerodigestive function
  • sensation
  • sensorimotor rehabilitation
  • deglutition

Researcher Summary

Coughing and swallowing are crucial to our survival due to their role in protecting our airways. Dysfunction of these two functions frequently co-occurs, critically compromising our respiratory system. Approximately 9,000 New Zealanders will be diagnosed with swallowing impairment each year due to a vast array of medical diagnoses (i.e., stroke, head and neck cancer). Almost one third of these patients will die from secondary complications, such as pneumonia. There is an urgent clinical need to better understand the coordination of these functions, so that diagnosis is improved, and an understanding of the mechanisms by which remediation of impairment is gained. Of the medical diagnoses associated with a swallowing and coughing impairment, Māori are disproportionately represented in burden statistics, indicating increased risk of living with the effects of dysfunction. I have three distinct but related areas of research in the area of upper aerodigestive function:
- Defining the role of sensation in upper aerodigestive function
- Increasing scientific rigor of outcome measures of upper aerodigestive function
- Addressing hauora inequities for Māori
My research programme utilizes expertise from a range of disciplines to explore the relationship between respiration, swallowing and coughing. This will improve our ability to diagnose and manage dysfunction in any one of these systems. My thorough approach to scientific rigor and sustained productivity in transforming outcome measurement will ensure robust estimates of these functions, significantly impacting our capacity to characterize mechanisms of dysfunction. I am developing Kaupapa Māori research to indigenize management of these disorders, and enhance clinical competence in service delivery.

Subject Area: Disciplines

  • Health and Health Sciences: Speech & Language Therapy

Resources

  • Rose Centre for Stroke Recovery and Research

Prizes and Awards

  • Health Research Council of New Zealand Explorer's Grant ( 2016 - 2018)

Research/Scholarly/Creative Works

Journal Articles
  • Erfmann KLC., Macrae PR., Jones RD., Guiu Hernandez E. and Huckabee ML. (2022) Effects of cerebellar transcranial direct current stimulation (tDCS) on motor skill learning in swallowing. Disability and Rehabilitation 44(11): 2276-2284. http://dx.doi.org/10.1080/09638288.2020.1827303.
  • Kwong SL., Hernandez EG., Winiker K., Gozdzikowska K., Macrae P. and Huckabee ML. (2022) Effect of Topical Nasal Anesthetic on Comfort and Swallowing in High-Resolution Impedance Manometry. Laryngoscope 132(11): 2124-2131. http://dx.doi.org/10.1002/lary.30010.
  • Miller KJW., Macrae P., Paskaranandavadivel N., Huckabee ML. and Cheng LK. (2022) Non-invasive assessment of swallowing using flexible high-density electromyography arrays. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2022-July: 5120-5123. http://dx.doi.org/10.1109/EMBC48229.2022.9871168.
  • Ng KB., Guiu Hernandez E., Erfmann KLC., Jones RD., Macrae P. and Huckabee ML. (2022) Effect of Volitional Effort on Submental Surface Electromyographic Activity During Healthy Swallowing. Dysphagia 37(2): 297-306. http://dx.doi.org/10.1007/s00455-021-10278-4.
  • Winiker K., Gozdzikowska K., Guiu Hernandez E., Kwong SL., Macrae P. and Huckabee ML. (2022) Potential for Behavioural Pressure Modulation at the Upper Oesophageal Sphincter in Healthy Swallowing. Dysphagia 37(4): 763-771. http://dx.doi.org/10.1007/s00455-021-10324-1.
  • Ng KB., Jones RD., Hernandez EG., Macrae P. and Huckabee ML. (2021) Classification of Stroke Patients With Dysphagia Into Subgroups Based on Patterns of Submental Muscle Strength and Skill Impairment. Archives of Physical Medicine and Rehabilitation 102(5): 895-904. http://dx.doi.org/10.1016/j.apmr.2020.11.014.
  • Winiker K., Burnip E., Gozdzikowska K., Guiu Hernandez E., Hammond R., Macrae P. and Huckabee ML. (2021) Ultrasound: Validity of a Pocket-Sized System in the Assessment of Swallowing. Dysphagia 36(6): 1010-1018. http://dx.doi.org/10.1007/s00455-020-10232-w.
  • Winiker K., Burnip E., Gozdzikowska K., Hernandez EG., Hammond R., Macrae P., Thomas P. and Huckabee ML. (2021) Ultrasound: Reliability of a pocket-sized system in the assessment of swallowing. Journal of Speech, Language, and Hearing Research 64(8): 2928-2940. http://dx.doi.org/10.1044/2021_JSLHR-21-00026.
  • Winiker K., Gozdzikowska K., Guiu Hernandez E., Kwong SL., Macrae P. and Huckabee ML. (2021) Potential for Volitional Control of Resting Pressure at the Upper Oesophageal Sphincter in Healthy Individuals. Dysphagia 36(3): 374-383. http://dx.doi.org/10.1007/s00455-020-10146-7.
  • Wallace E., Hernandez EG., Epton M., Ploen L., Huckabee ML. and Macrae P. (2020) A sensory stimulation protocol to modulate cough sensitivity: A randomized controlled trial safety study. American Journal of Speech-Language Pathology 29(3): 1423-1433. http://dx.doi.org/10.1044/2020_AJSLP-19-00180.
  • Wallace E., Macrae P. and Huckabee ML. (2020) Objective measurement of acoustic intensity of coughing for clearance of penetration and aspiration on video-fluoroscopy. International Journal of Speech-Language Pathology : 1-8. http://dx.doi.org/10.1080/17549507.2020.1784280.
  • Wallace E., Guiu Hernandez E., Ang A. and Macrae P. (2019) Quantifying test-retest variability of natural and suppressed citric acid cough thresholds and urge to cough ratings. Pulmonary Pharmacology and Therapeutics 58 http://dx.doi.org/10.1016/j.pupt.2019.101838.
  • Wallace E., Guiu Hernandez E., Ang A., Hiew S. and Macrae P. (2019) A systematic review of methods of citric acid cough reflex testing. Pulmonary Pharmacology and Therapeutics 58 http://dx.doi.org/10.1016/j.pupt.2019.101827.
  • Calvo I., Sunday KL., Macrae P. and Humbert IA. (2017) Effects of chin-up posture on the sequence of swallowing events. Head and Neck 39(5): 947-959. http://dx.doi.org/10.1002/hed.24713.
  • Guedes R., Azola A., Macrae P., Sunday K., Mejia V., Vose A. and Humbert IA. (2017) Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults. Physiology and Behavior 174: 155-161. http://dx.doi.org/10.1016/j.physbeh.2017.03.018.
  • Huckabee ML., Macrae P. and Lamvik K. (2016) Expanding instrumental Options for Dysphagia Diagnosis and Research: Ultrasound and Manometry. Folia Phoniatrica et Logopaedica 67(6): 269-284. http://dx.doi.org/10.1159/000444636.
  • Macrae P. (2016) Swallowing impairment after stroke. INTERNATIONAL JOURNAL OF STROKE 11: 3-3.
  • Anderson C., Macrae P., Taylor-Kamara I., Serel S., Vose A. and Humbert IA. (2015) The perturbation paradigm modulates error-based learning in a highly automated task: Outcomes in swallowing kinematics. Journal of Applied Physiology 119(4): 334-341. http://dx.doi.org/10.1152/japplphysiol.00155.2015.
  • Azola AM., Greene LR., Taylor-Kamara I., Macrae P., Anderson C. and Humbert I. (2015) The Relationship Between Submental Surface Electromyography and Hyo-Laryngeal Kinematic Measures of Mendelsohn Maneuver Duration. Journal of Speech, Language, and Hearing Research 58(6): 1627-1636. http://dx.doi.org/10.1044/2015_JSLHR-S-14-0203.
  • Young JL., Macrae P., Anderson C., Taylor-Kamara I. and Humbert IA. (2015) The sequence of swallowing events during the chin-down posture. American Journal of Speech-Language Pathology 24(4): 659-670. http://dx.doi.org/10.1044/2015_AJSLP-15-0004.
  • Huckabee ML. and Macrae P. (2014) Rethinking Rehab: Skill Based Training for Swallowing Impairment. SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia) 23: 46-53. http://dx.doi.org/10.1044/sasd23.1.46.
  • Lamvik K., Macrae P., Doeltgen SH., Collings A. and Huckabee ML. (2014) Normative data for pharyngeal pressure generation during saliva, bolus and effortful saliva swallowing across age and gender. Speech Language and Hearing 17(4): 210-215. http://dx.doi.org/10.1179/2050572814Y.0000000042.
  • Macrae P., Anderson C. and Humbert I. (2014) Mechanisms of airway protection during chin-down swallowing. Journal of Speech, Language, and Hearing Research 57(4): 1251-1258. http://dx.doi.org/10.1044/2014_JSLHR-S-13-0188.
  • Macrae P., Anderson C., Taylor-Kamara I. and Humbert I. (2014) The effects of feedback on volitional manipulation of airway protection during swallowing. Journal of Motor Behavior 46(2): 133-139. http://dx.doi.org/10.1080/00222895.2013.878303.
  • Macrae PR., Jones RD. and Huckabee ML. (2014) The effect of swallowing treatments on corticobulbar excitability: A review of transcranial magnetic stimulation induced motor evoked potentials. Journal of Neuroscience Methods 233: 89-98. http://dx.doi.org/10.1016/j.jneumeth.2014.06.010.
  • Macrae P. and Humbert I. (2013) Exploiting Experience-Dependent Plasticity in Dysphagia Rehabilitation: Current Evidence and Future Directions. Current Physical Medicine and Rehabilitation Reports 1(4): 231-241. http://dx.doi.org/10.1007/s40141-013-0025-y.
  • Macrae PR., Jones RD., Myall DJ., Melzer TR. and Huckabee ML. (2013) Cross-Sectional Area of the Anterior Belly of the Digastric Muscle: Comparison of MRI and Ultrasound Measures. Dysphagia 28(3): 375-380. http://dx.doi.org/10.1007/s00455-012-9443-8.
  • Macrae PR., Jones RD., Myall DJ., Melzer TR. and Huckabee ML. (2013) Erratum to: Cross-Sectional Area of the Anterior Belly of the Digastric Muscle: Comparison of MRI and Ultrasound Measures. Dysphagia : 1. http://dx.doi.org/10.1007/s00455-013-9477-6.
  • Humbert IA., Michou E., Macrae P. and Crujido L. (2012) Electrical stimulation and swallowing: How much do we know? Seminars in speech and language 33(3): 203-216. http://dx.doi.org/10.1055/s-0032-1320040.
  • Macrae PR., Doeltgen SH., Jones RD. and Huckabee ML. (2012) Intra- and inter-rater reliability for analysis of hyoid displacement measured with sonography. Journal of Clinical Ultrasound 40(2): 74-78. http://dx.doi.org/10.1002/jcu.20874.
  • Al-Toubi AK., Abu-Hijleh A., Huckabee ML., Macrae P. and Doeltgen SH. (2011) Effects of repeated volitional swallowing on the excitability of submental corticobulbar motor pathways. Dysphagia 26(3): 311-317. http://dx.doi.org/10.1007/s00455-010-9313-1.
  • Doeltgen SH., Macrae P. and Huckabee ML. (2011) Pharyngeal pressure generation during tongue-hold swallows across age groups. American Journal of Speech-Language Pathology 20(2): 124-130. http://dx.doi.org/10.1044/1058-0360(2011/10-0067.
  • Doeltgen SH., Macrae P. and Huckabee ML. (2011) Pharyngeal pressure generation during tongue-hold swallows across age groups. American Journal of Speech-Language Pathology 20(2): 124-130. http://dx.doi.org/10.1044/1058-0360(2011/10-0067).
  • Doeltgen SH., MacRae P. and Huckabee ML. (2011) Pharyngeal pressure generation during tongue-hold swallows across age groups. Dysphagia 26(4): 426. http://dx.doi.org/10.1007/s00455-011-9353-1.
  • Macrae PR., Myall DJ., Jones RD. and Huckabee ML. (2011) Pharyngeal pressures during swallowing within and across three sessions: within-subject variance and order effects. Dysphagia 26(4): 385-391. http://dx.doi.org/10.1007/s00455-010-9324-y.
Chapters
  • Huckabee M-L., Macrae P. and Wallace E. (2019) Impaired laryngeal response to cough reflex testing.. In Sandhu GS; Allen J; Nouraei SA (Ed.), Laryngology A Case-Based Approach: 511-520. San Diego: Plural Publishing.
  • Huckabee ML. and Macrae P. (2012) Effortful Swallow. In Shaker R; Easterling C; Belafsky PC; Postma GN (Ed.), Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition: 281-298. San Diego: Springer. http://dx.doi.org/10.1007/978-1-4614-3779-6_15.
Conference Contributions - Published
  • Calvo I., Sunday K., Macrae P. and Humbert I. (2016) How does the chin-up posture influence the physiology of swallowing? In.
  • Erfmann K., Macrae P., Jones R. and Huckabee M-L. (2016) The influence of cerebellar transcranial direct current stimulation on motor learning in swallowing.. In.
  • Kwong S., Macrae P., Gozdzikowska K., Humbert I. and Huckabee M-L. (2016) Measures of upper esophageal sphincter function in videofluoroscopy and high-resolution manometry: subject variance within and across sessions.. In.
  • Macrae P., Taylor-Kamara I., Anderson C. and Humbert I. (2016) The role of augmented feedback in volitional manipulation of airway closure during swallowing.. In.
  • Ng K., Jones R., Erfmann K., Macrae P. and Huckabee M-L. (2016) Effect of maximum and minimum effort swallowing on sEMG activity in healthy adults.. In.
  • Sunday K., Vose A., Taylor-Kamara I., Macrae P. and Humbert I. (2016) The effect of neck-extension on swallowing and bolus flow kinematics in healthy adults.. In.
  • Serel S., Macrae P., Humbert I. and Vose A. (2015) Context of Surface Electrical Stimulation Gradually Improves Hyo-laryngeal Kinematics Over Several Trials. In.
  • Humbert I., Macrae P., Anderson C. and Taylor-Kamara I. (2014) Kinematic feedback improves swallowing maneuver outcome. In.
  • Macrae P., Finley J. and Humbert I. (2014) Correcting for head movement during measurement of hyoid displacement. In.
  • Anderson C., Macrae P., Taylor-Kamara I. and Humbert I. (2013) Goal-oriented practice improves accuracy and carryover of Mendelsohn maneuver. In.
  • Macrae P., Anderson C. and Humbert I. (2013) Mechanisms behind airway protection in chin-tuck maneuver. Oral presentation. In 28(4): 611.
  • Taylor-Kamara I., Macrae P., Anderson C. and Humbert I. (2013) Submental surface EMG and hyolaryngeal kinematics: unmatched during the Mendelsohn maneuver. In.
  • Macrae P., Huckabee M-L. and Jones RD. (2010) Manometric pressures within and across 3 sessions: Within-subject variance and order effects. In Dysphagia 25: 377-378.
  • Macrae P., Huckabee M-H., Doeltgen S. and Jones RD. (2009) Intra- and inter-rater reliability of hyoid displacement as measured by ultrasound. In Dysphagia 24: 482-483.
Conference Contributions - Other
  • Erfmann K., Guiu Hernandez E., Macrae P., Jones R. and Huckabee M-L. (2018) The influence of cerebellar stimulation on motor learning in swallowing. Christchurch NEW ZEALAND: Stroke Rehab: From no-tech to go-tech Conference, 29-31 Jan 2018.
  • NG K., Jones R., Macrae P. and Huckabee M-L. (2018) Clinical classification of skill versus strength deficits in dysphagia after stroke. Christchurch, New Zealand: Stroke Rehab: From No-Tech to Go-Tech conference, 29-31 Jan 2018.
  • Lim S., Macrae P., Guiu Hernandez E. and Huckabee M-L. (2017) Variability of citric acid cough reflext test: A tidal breath dose-response method. Barcelona Spain: 7th Congress of the European Society for Swallowing Disorders - World Dysphagia Summit, 21-23 Sep 2017.
  • Macrae P., Barkmeier-Kraemer J., Paydarfar D., Malandraki G. and Rosenbek J. (2017) Addressing the Gaps in Dysphagia Rehabilitation. Portland, Oregon, USA: Annual meeting of Dysphagia Research Society, 2-4 Mar 2017.
  • Wallace E., Macrae P. and Huckabee M-L. (2017) How strong is strong enough to clear aspiration? Barcelona Spain: 7th Congress of the European Society for Swallowing Disorders - World Dysphagia Summit, 21-23 Sep 2017.
  • Winiker K., Gozdzikowska K., Guiu Hernandez E., Kwong S., Macrae P. and Huckabee M-L. (2017) Volitional control of resting pressure at the upper oesophageal sphincter in healthy adults: an exploratory study. Barcelona Spain: 7th Congress of the European Society for Swallowing Disorders - World Dysphagia Summit, 21-23 Sep 2017.
  • Young J., Humbert IA., Macrae P., Anderson C. and Taylor-Kamara I. (2014) The effect of surface electrical stimulation on the sequence of swallowing events. Orlando, FL, USA: ASHA Convention, 20-22 Nov 2014.
  • Al-Toubi A., Abu-Hijleh A., Huckabee M., Macrae P. and Doeltgen S. (2010) Effects of Repeated Volitional Swallowing on the Excitability of Submental Corticobulbar Motor Pathways Dysphagia. San Diego, CA, USA: 18th Annual Dysphagia Research Society Meeting, 3-6 Mar 2010.
  • Macrae P., Huckabee M. and Jones R. (2010) Manometric Pressures Within and Across 3 Sessions: Within-Subject Variance and Order Effects. San Diego, CA, USA: 18th Annual Dysphagia Research Society Meeting, 3-6 Mar 2010.
  • Macrae P., Huckabee M., Doeltgen S. and Jones R. (2009) Intra- and inter-rated reliability of hyoid displacement measured by ultrasound. New Orleans, LA, USA: 17th Annual Dysphagia Research Society Meeting, 4-7 Mar 2009.
Oral Presentations
  • Humbert I., Macrae P. and Steele C. (2014) Evidence-Based Practice In Adult Dysphagia Management: What The Evidence Says About Commonly Selected Rehabilitation Interventions. Online webinar: Accredited CEU webinar for clinicians.
Theses / Dissertations
  • Macrae P. (2012) Biomechanical and neurophysiological changes associated with modified head-lift and effortful-swallowing rehabilitation techniques. Christchurch, New Zealand. University of Canterbury.
Other
  • Huckabee ML. and Macrae P. (2009) Temporal resolution in swallowing neural control: The way forward. Clinical Neurophysiology 120(10): 1764-1765. http://dx.doi.org/10.1016/j.clinph.2009.08.012. [Editorial].

Student Supervision

Displaying all items.
    Current
  • PhD - Cross E: Voice and swallowing characteristics of Chronic cough (2023)
  • PhD - Darrock K: The effect of cough reflex testing on clinical decision making in dysphagia management (2022)
  • PhD - Ng K: Swallowing Skill Training in Patients with Dysphagia
  • Masters - Winiker K: -pending- (2016)
  • Completed
  • PhD - Erfmann K: The influence of cerebellar tDCS on swallowing motor learning (2018)
  • PhD - Kwong S: Behavioural Balloon Dilatation in treatment of Upper Esophageal Sphincter (UES) dysfunction (2019)
  • PhD - Ng K: Swallowing Skill Training in Patients with Dysphagia (2018)
  • PhD - Wallace E: Rehabilitation of cough reflex (2019)
  • Masters - Darrock K: Assessment and Modulation of the Sensorimotor Cough Response (2019)
  • Masters - Lim S: Cough Reflex Sensitivity Shifting in Healthy Individuals (2018)
  • Honours - Ang AT-T: Examining the Reliability of Citric Acid Cough Reflex Threshold Testing (2017)
  • Honours - Cross E: The effect of saliva pH and saliva flow rate on citric acid cough thresholds in healthy individuals (2019)
  • Honours - Hiew S: Reliability of nebulizer output (2018)

Review and Refereeing

Displaying all items.
  • Archives of Physical Medicine and Rehabilitation ( 2014 - 2023)
  • Clinical Neurophysiology ( 2012 - 2023)
  • Dysphagia ( 2013 - 2023)
  • Experimental Brain Research ( 2015 - 2023)
  • Journal of Speech, Language, and Hearing Research ( 2013 - 2023)
  • Neuromodulation: Technology at the Neural Interface ( 2014 - 2023)
  • Physiological Measurement ( 2013 - 2023)
  • Physiology and Behavior ( 2013 - 2023)

Research Groups

  • The University of Canterbury Rose Centre for Stroke Recovery and Research at St George’s Medical Centre

Key Methodologies

  • cough reflex testing
  • swallowing-respiratory coordination
  • sensory probing
  • videofluoroscopy
  • pharyngeal manometry
  • Laryngeal endoscopy
  • electromyography
  • ultrasound
  • Kaupapa Māori Research
  • Precision estimates
  • validity estimates
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