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的评估和澄清康复对吞咽障碍的疗效。我发明了一种新的评估吞咽的仪器，目的是观察舌头对上颚的压力、喉部的运动和吞咽的声音。使用现成的薄膜压力传感器或定制的腭板带两个压力传感器测量舌压。将喉部运动定义为喉部的相对向前运动，自制带应变片的颈带用于喉部运动的测量。在甲状下软骨中心皮肤上安装麦克风或加速度传感器，记录吞咽声音。研究了年龄和健康状况对吞咽功能的影响。受照顾老人的最大舌压低于其他组。受到照顾的老年人的舌头和喉部运动的时间模式比其他组的更长。我们探讨了使用器械治疗吞咽障碍的康复方法的疗效。康复所用的方法有三种：腭板调整、体位调整、食物口味调整。腭板越厚，舌压最大值越长。仰卧位喉部运动小于直立位喉部运动。30个仰卧位的舌喉运动时间模式与直立位相似，但仰卧位的舌喉运动时间较短。这食物的味道几乎不影响吞咽。新的评估方法对吞咽的评估是有效的。我们发现，年龄和健康状况、腭形和体位的变化对吞咽有影响。

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.