Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults.
Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults.
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DOI：
10.1016/j.physbeh.2017.03.018
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发表时间：
2017-05-15
影响因子：
2.9
通讯作者：
Humbert IA
中科院分区：
文献类型：
--
作者：
Guedes R;Azola A;Macrae P;Sunday K;Mejia V;Vose A;Humbert IA
吞咽动作在吞咽困难的康复训练中被常规训练，假设练习的行为转移到功能性吞咽，然而在吞咽文献中很少研究这种转移。这项研究的目的是训练意志性喉前庭关闭(VLVC)动作，这是一种吞咽动作，目标是延长喉前庭关闭(LVC)。在两个不同的训练实验中，69名健康成人接受了长保持(尽可能长保持vLVC)或短保持vLVC(保持vLVC 2秒)的训练。在vLVC训练前后，完成自然燕子(无治疗技术吞咽)。结果变量包括喉前庭关闭反应时间和喉前庭关闭时间。结果表明，无论是长持还是短持vLVC训练，vLVC燕子的喉前庭关闭反应时间和关闭喉前庭的持续时间都比训练前的5ml液体燕子快。然而，只有更快的喉前庭关闭反应时间转移到训练后的5ml液体燕子(快20%-24%)，但没有延长喉前庭关闭的持续时间。我们的发现表明，吞咽动作训练有可能诱导将练习的东西转移到功能性吞咽行为上，尽管并不是所有练习的行为都可以推广。这些发现对于支持吞咽困难管理医疗环境的有效性具有重要意义，应该在有吞咽困难的个体中进行测试。
Swallowing maneuvers are routinely trained in dysphagia rehabilitation with the assumption that practiced behaviors transfer to functional swallowing, however transfer is rarely examined in the deglutition literature. The goal of this study was to train the volitional laryngeal vestibule closure (vLVC) maneuver, which is a swallowing maneuver that targets prolonged laryngeal vestibule closure (LVC). In two different training experiments, 69 healthy adults underwent Long-hold (hold vLVC as long as possible) or Short-hold vLVC training (hold vLVC for 2 seconds). Before and after vLVC training, natural swallows (swallowing without a therapeutic technique) were completed. The outcome variables included laryngeal vestibule closure reaction time and the duration of laryngeal vestibule closure. Results indicate that during both Long-hold and Short-hold vLVC trainings, vLVC swallows had faster laryngeal vestibule closure reaction times and longer durations of laryngeal vestibule closure than in pre-training 5ml liquid swallows. However, only faster laryngeal vestibule closure reaction times transferred to post-training 5ml liquid swallows (20–24% faster), but not prolonged durations of laryngeal vestibule closure. Our findings suggest that swallowing maneuver training has the potential to induce transfer of what was practiced to functional swallowing behavior, although not all practiced behaviors may generalize. These findings are significant for bolstering the effectiveness of dysphagia management medical settings and should be tested in individuals with dysphagia.