The impact of sensory intervention on motor output and feeding performance in term and preterm infants

婴儿喂养是一种复杂的行为，既需要获得母乳的能力，也需要运输和 吞下它吧。早产儿通常表现出产生吸力以获得乳汁的能力降低，并且 体验运输和吞咽牛奶的挑战。了解这些背后的机制 由于婴儿喂养的复杂性以及早产儿的脆弱性质，挑战是困难的。 摄食是由多个脑神经和超过25块肌肉控制的，但我们对这些肌肉是如何控制的知之甚少 由于获取人类婴儿数据的伦理和实际限制，这一功能受到了限制。临床医生不能 控制患者的早产程度，不能准确或准确地测量肌肉功能， 由于视频透视吞咽的辐射，他们的数据在时间分辨率上受到限制 学习。这项提议的目标是使用有效的动物模型来获得受控的、高分辨率的 研究足月儿和早产儿对改善喂养性能的干预措施的反应的数据 喂食。这项研究将结合双平面(3D)高速(100fps)视频透视和慢性 留置细丝肌电图仪以测量肌肉如何驱动运动学、吞咽安全性和液体 足月儿和早产儿喂养的动态。中心假设是足月儿会表现出更高的 压力产生的水平和输送粘性流体的能力，但塑料神经系统 早产儿将能够对压力产生需求的增加表现出更大的反应 并增加了粘度。首先，我将测量肌肉骨骼系统如何应对 获得足月和早产仔猪食物的压力产生要求(SA1-K99)，然后 测量足月和早产仔猪(SA2-K99)对粘度变化的神经运动反应。 随后，我将测量足月儿和早产儿在喂食 仿生乳头，与目前商业上可用的(SA3-R00)进行比较。这项研究将提供 深入了解婴幼儿喂养行为的驱动机制，为婴幼儿的发展奠定基础 基于生理学而不是定性的表现不良的指征的干预措施 吞咽困难。这一点意义重大，因为它代表着对 婴儿喂养的机制和失败的机制。因此，这些结果将成为 新生儿吞咽困难的循证干预。这个项目将直接推动我的职业目标 建立联邦资助的研究项目，以了解正常和病理生理学为基础 传感器马达集成。NeoMed是我开发这个研究项目的一个很好的环境，因为 该系有一批从事肌肉骨骼尖端研究的教员。 功能，除了我的研究导师，他是婴儿吞咽困难领域的专家。

Infant feeding is a complex behavior that requires the ability to both acquire milk, as well as transport and swallow it. Preterm infants often exhibit a decreased ability to generate suction pressure to acquire milk, and experience challenges transporting and swallowing milk. Understanding the mechanisms behind these challenges is difficult due to the complexity of infant feeding as well as the fragile nature of preterm infants. Feeding is controlled by multiple cranial nerves and over 25 muscles, yet we know little of how those muscles function due to the ethical and practical restrictions of acquiring data on human infants. Clinicians cannot control for the degree of prematurity in their patients, cannot measure muscle function accurately or precisely, and are limited in the temporal resolution of their data, due to radiation from videofluoroscopic swallowing studies. The objective of this proposal is to use a validated animal model to acquire controlled, high resolution data to study how term and preterm infants respond to interventions to improve feeding performance during feeding. This research will combine bi-planar (3D) high speed (100 fps) videofluoroscopy with chronic indwelling fine-wire electromyography to measure how muscles drive the kinematics, swallow safety, and fluid dynamics of term and preterm infant feeding. The central hypothesis is that term infants will show higher levels of pressure generation and ability to transport viscous fluids, but that the plastic neural system of preterm infants will enable them to exhibit a greater response to increases in pressure generation requirements and increases in viscosity. First, I will measure how the musculoskeletal system responds to changes in pressure generation requirements to acquire food in term and preterm infant pigs (SA1-K99), and then measure the neuromotor response to changes in viscosity in term and preterm infant pigs (SA2-K99). Following these, I will measure neuromotor function of term and preterm infants when feeding on a biomimetic nipple, compared to those currently available commercially (SA3-R00).This research will provide insight into the mechanisms driving feeding performance in infants and provide a foundation for developing interventions based off physiologic, rather than qualitative, indications of poor performance for patients with dysphagia. This is significant because it represents an important advance in the basic understanding of the mechanisms of infant feeding, and mechanisms of failure. As such these results will be the foundation for evidence-based interventions for neonate dysphagia. This project will directly advance my career goals to establish a federally funded research program grounded in understanding normal and pathophysiologic sensorimotor integration. NEOMED is an excellent environment for me to develop this research program, as there are an array of faculty within the department that conduct cutting edge research on musculoskeletal function, in addition to my research mentor, whom is an expert in the field of infant dysphagia.