Physiological Compensation for Advanced Bolus Location at Swallow Onset: A Retrospective Analysis in Healthy Seniors.
Physiological Compensation for Advanced Bolus Location at Swallow Onset: A Retrospective Analysis in Healthy Seniors.
复制标题
吞咽开始时高级推注位置的生理代偿：健康老年人的回顾性分析。
DOI：
10.1044/2019_jslhr-19-00169
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Molfenter,SonjaM
中科院分区：
文献类型：
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作者：
Herzberg,EricaG;Brates,Danielle;Molfenter,SonjaM
目的：先前的研究已经证实，在健康老年人中，吞咽开始时的提前推注位置（BLSO）与吞咽安全风险增加无关。这项回顾性研究的主要目的是检查健康老年人是否系统地改变他们的喉前庭闭合反应时间（LVCrt），以保持安全吞咽的背景下先进的BLSO。第二个目标是确定是否更长的LVCrt区分渗透-抽吸量表（PAS; Rosenbek，Robbins，Roecker，Coyle，& Wood，1996）评分为1与2。方法对43名健康老年人（21名男性，22名女性;法师= 76.7岁，SD= 7.2）的视频透视研究进行了分析。计算每名受试者3 × 5 ml和3 × 20 ml稀液体钡团注的LVCrt。对所有吞咽进行PAS和BLSO（改良钡吞咽损伤特征成分6）评分。在所有测量中建立了可靠性（组内相关系数> .75）。线性混合效应回归分析检测PAS和BLSO对LVCrt的影响，同时控制推注量和重复吞咽试验。结果BLSO（F= 4.6，p = 0.004）和PAS（F= 29.3，p <0.001）对LVCrt有主效应。事后成对比较显示，BLSO评分为3（梨状骨）的LVCrt显著快于评分为0（升支后角）和1（谷）的LVCrt。PAS评分2与1相比，观察到LVCrt显著延长。没有显着的主要影响，丸量或试验，或相互作用，observed.ConclusionsOur研究结果表明，健康的老年人补偿先进的BLSO通过增加他们的LVCrt。此外，显示更快的LVCrt可区分PAS评分1与2。进一步的工作应该探讨吞咽困难人群，特别是那些已知的感觉障碍的LVCrt，BLSO和PAS评分之间的关系。
PurposePrevious work has established that advanced bolus location at swallow onset (BLSO) alone is not correlated with an increased swallowing safety risk in healthy seniors. The primary goal of this retrospective study was to examine whether healthy seniors systematically alter their laryngeal vestibule closure reaction time (LVCrt) to maintain a safe swallow in the context of advanced BLSO. The secondary goal was to determine if longer LVCrt distinguished Penetration–Aspiration Scale (PAS; Rosenbek, Robbins, Roecker, Coyle, & Wood, 1996) scores of 1 versus 2.MethodVideofluoroscopy studies from 43 healthy seniors (21 men, 22 women;Mage= 76.7 years,SD= 7.2) were analyzed. LVCrt was calculated for 3 × 5 ml and 3 × 20 ml thin liquid barium boluses per participant. PAS and BLSO (Modified Barium Swallow Impairment Profile Component 6) were scored for all swallows. Reliability (intraclass correlation coefficient > .75) was established on all measures. A linear mixed-effects regression was run to examine the effect of PAS and BLSO on LVCrt while controlling for bolus volume and repeated swallow trial.ResultsThere was a main effect of BLSO (F= 4.6,p= .004) and PAS (F= 29.3,p< .001) on LVCrt. Post hoc pairwise comparisons revealed that LVCrt was significantly faster in BLSO scores of 3 (pyriforms) compared to scores of both 0 (posterior angle of the ramus) and 1 (valleculae). Significantly prolonged LVCrt was observed in PAS scores of 2 in comparison to 1. No significant main effects of bolus volume or trial, or interactions, were observed.ConclusionsOur findings suggest that healthy seniors compensate for advanced BLSO by increasing their LVCrt. Furthermore, faster LVCrt was shown to distinguish PAS scores of 1 versus 2. Additional work should explore the relationship between LVCrt, BLSO, and PAS scores in dysphagic populations, specifically those with known sensory impairments.