VOLITIONAL, BOLUS, AND AGE EFFECTS ON HUMAN SWALLOWING

这项修订后的竞争更新旨在扩大在生物力学方面的工作 分析人类咽部吞咽反应以分析决定因素 口咽吞咽困难的可能性，以及治疗策略的潜力 补偿观察到的功能障碍。年头五年的工作 这个项目导致了口咽吞咽的概念化 作为一组紧密集成的功能元素(关闭 鼻咽，UES张开，喉前庭关闭，舌头负荷 (斜面)、舌头推力和咽部间隙)，每个都受 时间、运动、协调和可修改性的特定约束。 更新的初始目标将是获取密钥的正常值 吞咽的观察性、时间性、机械性和协调性措施 来自适当的对照组(三岁的男性和女性受试者 年龄：20-29岁，40-49岁，70岁或以上)。第二个目标 将专注于确定这些吞噬度量的最小集合 区分正常和异常的吞咽功能(吸入、 鼻咽反流、残留或延迟)。来自吞咽困难的数据 易受特定功能障碍影响的人群将习惯于 对确定每一项的吞咽测量集合进行统计建模 并建立该功能障碍的“风险方程式”。这个 总体假设是评估这一极其复杂的机械 可以将操作简化为相对较小的一组测量，以 表明有任何明显的功能障碍。的第三个具体目标 项目是衡量每个人可能获得的补偿程度 为正常受试者、相关受试者确定的关键吞咽措施 吞噬困难的种群，以及被确定为最低限度的 该变量的功能储备。补偿手段来自于 吞咽治疗师医疗机构，包括吞咽动作的使用， 姿势技巧，以及增加口腔感觉刺激。最后， 计算机辅助图像分析和三维重建将是 用于模拟咽内形状的动力学。分析 工具的三维图形程序可以量化瞬时 咽腔内体积，与来自 咽出口，可能会产生一个有用的参数吞咽效果。

This revised competitive renewal seeks to expand work on the biomechanical analysis of the human pharyngeal swallow response to analyze determinants of oropharyngeal dysphagia, and the potential of therapeutic strategies to compensate for observed dysfunction. Work during the first five years of this project has led to the conceptualization of the oropharyngeal swallow as a tightly integrated group of functional elements (closure of the nasopharynx, UES Opening, laryngeal vestibule closure, tongue loading (ramping), tongue pulsion, and pharyngeal clearance), each subject to specific constraints of timing, motion, coordination, and modifiability. An initial aim of the renewal will be to obtain normal values for key observational, timing, mechanical, and coordinative measures of swallowing from appropriate groups of controls (male and female subjects of three age groups: 20-29, 40-49, and equal to or more than 70 yrs). The second aim will focus on determining the minimal set of these swallow measures that discriminates normal from abnormal swallowing function (aspiration, nasopharyngeal regurgitation, residue, or delay). Data from dysphagic populations susceptible to specific dysfunctions will be used to statistically model the set of swallow measures that determine each dysfunction and to develop an "equation of risk" for that dysfunction. The overall hypothesis is that evaluation of this extremely complex mechanical action can be reduced to a relatively small set of measurements that will indicate any significant dysfunction. The third specific aim of the project is to measure the degree of compensation possible for each of the key swallow measures identified for normal subjects, for the relevant dysphagic population, and for individuals identified as having minimal functional reserve for that variable. Means of compensation are drawn from the swallow therapists armamentarium and include use of swallow maneuvers, postural techniques, and increased oral sensory stimulation. Finally, computer-assisted image analysis and 3 dimensional reconstructions will be utilized to model the dynamics of the intrapharyngeal shape. The analysis tool of the 3-dimensional graphics program can quantify instantaneous intrapharyngeal volume, which coupled with pressure data from the pharyngeal outlet, may yield a useful parameter of swallow efficacy.