Comparison of effortful and noneffortful swallows in healthy middle-aged and older adults
Comparison of effortful and noneffortful swallows in healthy middle-aged and older adults
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DOI：
10.1053/apmr.2001.28006
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发表时间：
2001-12-01
影响因子：
4.3
通讯作者：
Robbins, J
中科院分区：
文献类型：
--
作者：
Hind, JA;Nicosia, MA;Robbins, J
目的：评估用力吞咽（吞咽困难的一种常见代偿策略）对中老年男性和女性的食团和吞咽机制的影响。设计：病例对照设计，受试者完成干预技术和控制行为。设置：一所大学医院。参与者：64名来自社区的45至93岁的健康男性和女性。干预措施：受试者吞咽3毫升的稀液体团，包括正常吞咽和使用费力吞咽策略。主要结果测量：吞咽的生物力学和团流模式从视频荧光透视和同时的口腔压力数据进行分析。结果：所有年龄段的受试者在用力吞咽时，每个传感器位置的口腔压力都显著增加（p = .0001），中年受试者的压力增加大于老年受试者。用力吞咽的几个持续时间测量值显著更长，包括：舌骨最大前移（p <0.04），喉前庭关闭（p <0.0001）和上食管括约肌打开的持续时间（p = 0.0001）。舌骨随着用力吞咽进一步向上级方向移动（p = .002）。有一个趋势，减少口腔残留物的努力吞咽（p = 0.06）。结论：生物力学和丸流方面的吞咽改变时，健康人进行努力吞咽与3毫升丸。
Objective: To assess the effects of effortful swallowing, a common compensatory strategy for dysphagia, on the bolus and swallowing mechanism of middle-aged and older men and women.Design: Case-controlled design in which subjects completed both the intervention technique and the control behavior.Setting: A university hospital.Participants: Sixty-four healthy men and women between 45 and 93 years of age from the community.Interventions: Participants swallowed 3-mL thin liquid boluses both normally and using the effortful swallow strategy.Main Outcomes Measures: The biomechanics and bolus flow patterns of swallows were analyzed from videofluoroscopic and simultaneous oral pressure data.Results: Subjects at all ages generated significantly increased oral pressures at each sensor location using the effortful swallow (p = .0001), with the pressure increase greater for the middle-aged subjects compared with older subjects. Several durational measures were significantly longer with the effortful swallow including: hyoid maximum anterior excursion (p < .04), laryngeal vestibule closure (p < .0001), and duration of the upper esophageal sphincter opening (p =.0001). The hyoid bone moved further in the superior direction with the effortful swallow (p = .002). There was a trend of decreased oral residue with the effortful swallow (p = .06).Conclusion: Biomechanical and bolus flow aspects of swallowing changed when healthy individuals performed effortful swallows with 3-mL boluses.