Development of Nursing Technique Using Respirographic Biofeedback for Elderly with Dysphagia

作为基础研究，我们研究了年龄对吞咽过程中呼吸变化的影响以及丸剂体积和温度对呼吸和吞咽协调性的影响。受试者吞咽10 ml水，呼吸图和表面肌电图（EMG）的舌骨上肌同时记录。比较青年组（n=20，平均年龄19.5*2.7岁）、老年前期组（n = 10，平均年龄64.8*3.2岁）和老年组（n=17，平均年龄85.6*2.9岁）的呼吸模式、吞咽呼吸暂停持续时间和肌肉活动肌电图。呼吸模式中，老年组呼气-呼吸暂停-呼气相（eae型）频率（42.6%）明显低于其他各组（p<0.05）。老年组吞咽呼吸暂停持续时间（1.36 × 0.46秒）明显长于其他各组（p<0.01）。青年组在呼吸暂停发作后0.04 × 0.08秒达到肌电峰值，老年组在呼吸暂停发作后0.04 × 0.08秒达到肌电峰值， ...更多信息 肌电峰值出现时间明显延迟（0.26 × 0.30秒）（P<0.01）。在15名正常受试者（平均年龄20.4*3.1岁）中，随着推注体积（10，20 ml）和推注温度（5，25，50 ℃）的变化，同时记录呼吸图和肌电图。在10 ml剂量下，eae型发生率（71.3%）显著增加（P<0.05），吞咽呼吸暂停持续时间（0.85 × 0.17秒）显著缩短（P<0.01）。我们还研究了呼吸描记生物反馈对声门上吞咽的影响。在实验1中，进行声门上吞咽以减少受试者（女性，21岁）以3.4次反射吞咽10 ml水的吞咽反射频率。在实验2中，进行声门上吞咽以通过在另一受试者（女性，70岁）呼气开始时触发吞咽反射来改变呼吸模式。通过实验设计（阿坝，ABAB）判断这些效果，呼吸描记生物反馈可以增加声门上吞咽的频率。少

As a basic study, we investigated the effects of aging on the changes of respiration during swallowing and the effects of bolus volume and temperature on coordination of breathing and swallowing. The subjects swallowed 10 ml water, and respirograms and surface electromyograms (EMGs) of the suprahyoid muscles were simultaneously recorded. The respiration patterns, duration of deglutition apnea, and EMGs of the muscle activity were compared among three groups : young group (n=20, mean age 19.5*2.7 years), presenile group (n= 10, 64.8*3.2 years) and senile group (n=17, 85.6*2.9 years). In respiration patterns, the frequency of the Expiration-Apnea-Expiration pattern (eae type) in the senile group (42.6%) was significantly lower than in the other groups (p<0.05). The duration of deglutition apnea in the senile group (1.36*0.46 sec) was significantly longer than in the other groups (p<O.O1). In the young group, the peak EMG was achieved 0.04*0.08 sec after the onset of apnea, In the senile … More group, the achievement of the peak EMG was significantly delayed (0.26*0.30 sec) (p<O.O1). As the bolus volume (10, 20 ml) and the bolus temperature (5, 25, 50ﾟC) were varied, respirograms and EMGs were simultaneously recorded in 15 normal subjects (mean age 20.4*3.1 years). In 10 ml bolus volume, the frequency of eae type (71.3%) was significantly increased (p<O.O5), and the duration of deglutition apnea was significantly shortened (0.85*0.17 sec) (p<O.O1). We also investigated the effects of respirographic biofeedback on supraglottic swallow. In experiment 1, supraglottic swallow was performed to reduce the frequency of the swallowing reflex for a subject (female, 21 years old) swallowing 10 ml water with 3.4 reflexes. In experiment 2, the supraglottic swallow was performed to modify the respiratory pattern by triggering the swallowing reflex at the beginning of expiration in another subject (female, 70 years old). These effects were judged by experimental design (ABA, ABAB), and the frequency of performed supraglottic swallow could be increased by respirographic biofeedback. Less