The Assessment of Swallowing using Tongue and Laryngeal Movements - Influence of the Factor in Food -

本研究的目的是建立吞咽障碍的评估方法，并阐明吞咽障碍的康复治疗效果。本研究设计了一种以舌对腭部的压力、喉部运动和吞咽音为指标的吞咽功能评价装置。无论是用现成的薄膜压力传感器还是用定制的腭板加两个压力传感器测量舌压。喉运动定义为喉的相对向前运动，并自制带应变片的颈带用于测量喉运动。将麦克风或加速度传感器贴在下甲状软骨中央皮肤上记录吞咽声，研究年龄和健康状况对吞咽的影响。接受护理的老年人最大舌压低于其他组。老年人的舌运动和喉运动的时间模式比其他组长。我们使用设备对吞咽障碍的康复方法进行了研究。采用的康复方法有三种：腭板调整、体位调整、食物口味调整。腭板越厚，舌压最大值的持续时间越长。仰卧位的喉运动小于直立位。30个仰卧位的舌和喉运动的时间模式与直立位相似，尽管仰卧位的时间较短。食物的味道几乎不影响吞咽，新的评估方法可以有效地评估吞咽。结果表明，老年人的年龄、健康状况、腭部形态的改变、体位的改变对吞咽有影响。

The purpose of this study was to establish the assessment of swallowing and to clarify efficacy of rehabilitation for the disorder of swallowing. I derived a new apparatus for evaluation of swallowing aiming at tongue pressure to the palate, laryngeal movements and swallowing sound. Either using ready-made film pressure transducer or custom-made palatal plate with two pressure transducers measured tongue pressure. Laryngeal movements were defined as the relative forward movement of larynx and a self-made neckband with strain gauges was fabricated for measuring the movements. A microphone or an acceleration sensor that was attached on the skin of center of inferior thyroid cartilage recorded swallowing sound.We investigated the influence of the aging and health condition on swallowing using the apparatus. The maximum tongue pressure of the elderly who was cared was lower than that of another groups. The temporal patterns of tongue and laryngeal movements of the elderly who was cared were longer than those of another groups. We investigated efficacy of rehabilitation methods for the disorder of swallowing using equipment. Rehabilitation methods used are three adjustments: palatal plate, body position, taste of food. The thicker the palatal plate was, the longer the maximum tongue pressure was. Laryngeal movements of the supine position were smaller than that of the upright position. The temporal patterns of tongue and laryngeal movements at 30 reclined positions were similar to the upright position, although those at the supine position were shorter. The food taste scarcely affects swallowing.The new assessments are effective to evaluate swallowing. We showed that the aging and health condition, the change of the palatar form, and body position influences swallowing.