Studies about swallowing movement of dysphagic patients and clinical evaluation of disphagia on chew swallow

检测脑血管意外患者咀嚼吞咽任务吞咽反射开始时的弹丸头，并与年龄匹配的志愿者进行比较。当任务是两相食物（TPF;半固体和液体）和液体（钡水）时，吞咽反射开始时的食团头部位置在咽部中显著更靠尾，尽管在半固体食物任务内没有差异。我们发现在六个CVA的情况下，没有人在健康志愿者误吸。液体任务2例，半固体任务1例，TPF任务3例，观察咽部吞咽运动时，从舌运动的角度观察两种不同的方式。一种是咽部吞咽伴舌头运动，在与推注输送或连续咽部吞咽（CPS）相关的连续运动的一部分中观察到。另一种是孤立性咽部吞咽（IPS），即没有舌头的咽部吞咽 ...更多信息 相对于推注输送的运动。我们评估了CVA病例和健康志愿者吞咽中CPS和IPS的发生率。健康志愿者IPS的发生率为10%，CVA病例为15%。在健康志愿者的TPF任务中，在60岁以下的20%试验中观察到IPS，在60岁以上的35%试验中观察到IPS。对于CVA病例，在20%的无抽吸试验病例中观察到IPS，在40%的有抽吸试验病例中观察到IPS。30%的IPS吞咽时出现误吸，10%的CPS吞咽时出现误吸。虽然健康志愿者和CVA患者IPS的发生率几乎相同，但我们在CVA患者的IPS中检测到更多的吸入。本研究采用二维分析方法，对正常志愿者吞咽CPS和IPS时舌骨运动进行了分析。所有IPS均发生在第一次吞咽时，并且在两阶段进食的吞咽顺序中仅发生一次。所有CPS均发生在下颌止点后，1例IPS发生在下颌闭合期，2例发生在下颌张开期。在IPS中，舌骨抬高似乎与下颌运动停止无关。结果与我们作为IPS所做的假设一致，IPS没有与团块输送相关的舌运动。IPS的舌骨运动面积小于CPS。考虑了原因，因为IPS是一种吞咽，用于保护气道，而不是输送推注，咽部的推注量较小。少

We detected the bolus head at the start of swallowing reflex on the task of chew swallow for cerebrovascular accident cases and compared with age-matched volunteers. The bolus head position at the start of swallowing reflex was significantly more caudal in the pharynx when the task was two phase food (TPF; semisolid and liquid) and liquid (Barium water) though there was no difference within the task of semisolid food. We found aspiration in six CVA cases and no one in healthy volunteers. The aspirations were seen in 2 cases on liquid task, 1 case in semisolid task and 3 cases on TPF task.When we observed the motion of pharyngeal swallowing, we found the two different ways from the view points of tongue movement. One was a pharyngeal swallow with tongues movement that was observed in a part of the consecutive motion associated with bolus transport or consecutive pharyngeal swallow (CPS). The other was an isolated pharyngeal swallow (IPS) that was a pharyngeal swallow without the tongue … More movement relative to bolus transport. We evaluated the incidences of CPS and IPS in the swallows of CVA cases and healthy volunteers. The incidence of IPS was 10% for healthy volunteers and 15% for CVA cases. Within the task of TPF for healthy volunteers, IPS was observed in 20% trials for below 60 years old and 35% for over 60. For CVA cases IPS was observed in 20% cases for trials without aspiration and 40% for with aspiration. The aspiration was seen in 30% swallows of IPS while 10% of CPS. Though the incidence of IPS for healthy volunteers and for CVA cases was almost same, we detected more aspirations in the IPS of CVA cases. It suggests that CVA cases have some problems in the mechanism of IPS that considered as protective swallow.We analyzed the hyoid movement of swallowing of CPS and IPS for healthy volunteers by two-dimensional analyses. All IPSs occurred as the 1st swallow and only one time in sequence of swallows of two-phase food eating. All CPS occurred after the mandible stopping at upper point, while one IPS occurred at the closing phase of the mandible, and, two occurred the opening phase of the mandible. In IPS, hyoid elevation did not seem to be related to stopping of jaw movement. The results were consistent with the hypothesis that we made as IPS that has no tongue movement associated with bolus transport. The area of hyoid motion for IPS was smaller than that of CPS. The reason was considered, as the IPS is a swallow to protect air way not for transport of a bolus, the bolus volume in the pharynx was small. Less