Physiological Flow of Liquids Used in Dysphagia Management (previously Tongue-Pressure Timing for Liquid Flow Detection and Control in Swallowing)

 描述(申请人提供)：增稠液体的做法已成为最常用的吞咽障碍(吞咽困难)干预措施之一。然而，用来描述稠化液体(如花蜜稠度和蜂蜜稠度)的术语是主观的，我们缺乏关于液体浓度的变化如何影响吞咽功能和生理的经验证据。国际吞咽困难饮食标准化倡议是一个多学科工作组(www.iddsi.org)，最近开发了一种新的术语分类，用于标记吞咽困难管理中使用的不同水平的液体稠度；这些术语与操作定义和实用的重力流量测量技术相结合，可供护理人员和临床医生在准备或供应时确认任何液体的类别。当前建议的目标是测量代表液体稠度的IDDSI水平(稀薄、微厚、微厚、中厚和极厚)的液体的体外生理流量。液体流动的生理测量既需要了解液体的流变性(重力流动；粘度)，也需要了解吞咽过程中对液体施加的力(舌头压力；吞咽肌肉收缩)。药丸的其他感官属性(如滑度、颗粒度和凝聚力)也可能是相关的。我们将测量这些特性，并研究健康成年人的推注流动，以建立在健康舌压产生的背景下预期流动的参考视角。然后，我们将收集不同病因(中风、后天性脑损伤、口咽癌、颈椎手术后和神经退行性疾病)的吞咽困难患者的比较指标，以确定吞咽运动功能的变化如何影响液体流动。这些测量将提供信息，指导临床医生确定推荐给吞咽困难患者的最佳增厚水平。这项研究具有非常重要的意义，因为它将为理解增稠液体对吞咽的影响奠定新的基础。这对于推进临床实践和为未来的治疗效果研究奠定基础是至关重要的。

 DESCRIPTION (provided by applicant): The practice of thickening liquids has become one of the most frequently used interventions for swallowing impairment (dysphagia). However, the terminology used to describe thickened liquids (such as nectar-thick and honey-thick) is subjective and we lack empirical evidence about how alterations in liquid consistency affect swallowing function and physiology. The International Dysphagia Diet Standardisation Initiative is a multidisciplinary task force (www.iddsi.org) that has recently developed a new taxonomy of terms to label different levels of liquid consistency used in dysphagia management; these are paired with operational definitions and practical gravity-flow measurement techniques that can be used by caregivers and clinicians to confirm the category of any liquid at the time of preparation or serving. The goal of the current proposal is to measure the in vitro physiological flow of liquids representative of the IDDSI levels of liquid consistency (thin, slightly-thick, milly-thick, moderately-thick and extremely-thick). Physiological measures of liquid flow require an understanding both of the rheological properties of the liquid (gravity-flow; viscosity) and the forces that are applied to the liquid during swallowing (tongue pressure; swallowing muscle contraction). Additional sensory attributes of the bolus (such as slipperiness, graininess and cohesiveness) are also likely to be relevant. We will measure these properties and study bolus flow in healthy adults to establish a reference perspective of expected flow in the context of healthy tongue pressure generation. We will then collect comparative measures in individuals with dysphagia of different etiologies (stroke, acquired brain injury, oropharyngeal cancer, post cervical spine surgery, and neurodegenerative disease) to determine how alterations in swallowing motor function impact liquid flow. These measurements will provide information to guide clinicians in determining optimal levels of thickening to recommend for patients with dysphagia. This research is highly significant because it will establish a new foundation of understanding with respect to the influence of thickened liquids on swallowing. This is essential for advancing clinical practice and setting the stage for future treatment efficacy research.