VOLITIONAL, BOLUS, AND AGE EFFECTS ON HUMAN SWALLOWING

描述（改编自申请人摘要）：本项目的目的 是量化吞咽反应的变化程度 可由推注体积、粘度和 温度以及吞咽前热刺激和意志 对吞咽动作的控制。 将收集以下各组的数据 年龄段为20-29岁、40-49岁、70-79岁的志愿受试者。 两 选择老年组为计划的 与这几十年来聚集在一起的中风患者进行比较。 年轻 组完成了年龄谱，便于分析年龄对 吞咽反应，也可以作为一组自愿的受试者， 来尝试意志控制 描述了几种协议 同时使用电视透视和咽测压作为受试者 吞下一系列的体积、粘度和药丸。 意志 研究的方法包括那些建议用于吞咽困难的方法， 患者：峰值吸气时屏气，喉长时间 抬高和用力吞咽 此外，吞咽前热刺激的效果将是 系统评价并与推注操作进行比较 温度 测压和视频荧光透视数据将同步 并记录下来。 数据分析将利用计算机新技术 辅助视频和测压分析。 荧光镜检查的主要目的 分析将包括动作分析以及时序分析。 每次吞咽的每个参数的数据将以数字表示， 以0.03秒时间间隔作为列标题组织的电子表格 和数据参数行。 这种分析方法允许关键的 比较同时发生的事件，并建立一个全面的 用于吞咽困难患者评价的比较数据集。 此外，治疗策略和预吞咽的机制 将描述刺激可能有益于吞咽困难。 因此， 咽部吞咽的运动范围和时间方面， 口咽结构的运动受与推注有关的变量的影响， 年龄和意志控制是咽部吞咽可以是 概念上是由几个密切协调，但 潜在的可修改的组件，而不是作为一个单一的原型， 活动 所描述的协议检查了正常受试者 能够改变颈咽开口，喉闭合， 蠕动力和推注推进力。 这些的意义 研究结果涉及适用于吞咽困难的治疗策略 个体 一个受损的病人可能有麻烦的一个方面， 吞咽例如喉闭合或上食管括约肌打开， 但如果可以选择性地 补偿。

DESCRIPTION (Adapted from applicant's abstract): The aim of this project is to quantify the extent to which modifications of the swallow response can be provoked by the systematic variation of bolus volume, viscosity, and temperature as well as by pre-swallow thermal stimulation and volitional manipulation of the act of swallowing. Data will be collected on groups of volunteer subjects in the 20-29, 40-49, 70-79, yr age brackets. The two older groups were selected to provide a normal data base for a planned comparison with stroke victims who cluster in these decades. The younger group completes the age spectrum facilitating analysis of age effects on the swallow response and also serves as a willing group of subjects on whom to experiment with volitional control. Several protocols are described using videofluoroscopy concurrently with pharyngeal manometry as subjects swallow a spectrum of volumes, viscosities, and pills. Volitional maneuvers to be studied include those suggested to be of use in dysphagic patients: breath holding at peak inhalation, prolonged laryngeal elevation, and forceful swallowing. Furthermore, the effect of pre-swallow thermal stimulation will be systematically evaluated and compared to manipulations of bolus temperature. Manometric and videofluoroscopic data will be synchronized and recorded. Data analysis will utilize new techniques of computer assisted video and manometric analysis. A major thrust of the fluoroscopy analysis will be to incorporate motion analysis as well as timing analysis. Data on each parameter for each swallow will be numerically expressed in spreadsheets organized with 0.03 sec time intervals as the column headings and rows for data parameters. This analytic method allows for critical comparisons of concurrent events as well as establishing a comprehensive data set for comparison in the evaluation of dysphagic patients. Furthermore, mechanisms whereby therapeutic maneuvers and pre-swallow stimulation may benefit dysphagia will be described. Thus, the plasticity of the pharyngeal swallow in terms of the range of motion and timing of motion of oropharyngeal structures as affected by bolus-related variables, age, and volitional control is that the pharyngeal swallow can be conceptualized as being composed of several closely coordinated, but potentially modifiable components, rather than as a single stereotyped event. The protocols described examine the extent to which normal subjects are capable of varying cricopharyngeal opening, laryngeal closure, peristaltic force, and bolus propulsion. The significance of these findings relates to therapeutic strategies applied to dysphagic individuals. An impaired patient may have trouble with one aspect of the swallow such as laryngeal closure or upper esophageal sphincter opening, but still be capable of oral feeding if that defect can be selectively compensated for.