Muscles Underlying Pharyngeal Swallowing and the Therapies that Rehabilitate Them

咽吞咽下的肌肉及其康复疗法

• 批准号: 8214108
• 负责人: William Gordon Pearson
• 金额: $ 2.49万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-03 至 2012-09-25
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8214108
• 关键词: Atlases; Biomechanics; Bolus Infusion; Data; Deglutition; Development; Electromyography; Event; Exercise; Exercise stress test; Functional Magnetic Resonance Imaging; Future; Goals; Head and neck structure; Human; Investigation; Magnetic Resonance Imaging; Maps; Masticatory muscles; Methodology; Methods; Motion; Muscle; Muscle Contraction; Muscle function; Outcome; Patients; Pharyngeal structure; Physical therapy exercises; Quality of life; Rehabilitation therapy; Research Personnel; Rest; Signal Transduction; Soft Palate; Specialist; Specificity; Structure; Surface; Techniques; Testing; Time; Upper Esophageal Sphincter; Work; clinical effect; design; hypopharynx; improved; interest; novel; pressure; public health relevance; respiratory; strength training

DESCRIPTION (provided by applicant): The purpose of this investigation is to utilize mfMRI sequences to identify and evaluate swallowing muscles and the various rehabilitative techniques that exercise them. Rehabilitative swallowing exercises are designed to strengthen specific muscles that execute particular biomechanical events. Furthermore, for an exercise to be effective, the exercise should induce greater muscle contraction than with regular use. This is called the principle of overload. The current problem to be solved is that the muscles used in swallowing have not been thoroughly investigated and verified. We propose that mfMRI can be used to verify the muscles used in swallowing, and also to evaluate rehabilitative swallowing exercises in terms of their specificity and ability to achieve overload. To achieve this purpose we propose to: 7 Obtain structural data of the swallowing apparatus by using anatomical and dynamic MRI sequences to map key anatomical landmarks and constrain reliable regions of interest of swallowing muscles as a reference point for identifying muscles in mfMRI. 7 Document the activation of swallowing muscles using mfMRI. To do this we will first verify the ability mfMRI to identify muscles activated in the head and neck region by testing the muscles of mastication, which are more easily identified. We will then compare swallowing muscles that are active versus at rest in mfMRI. Finally we will develop a rudimentary atlas of regions of interest representing muscles utilized in swallowing. 7 Determine if the Shaker, Mendelshon, and Effortful Swallow rehabilitative techniques are effective swallowing therapies by testing if these exercise use the same specific muscles used in swallowing and if they are used to a greater degree in exercise than in regular use. In strength training this is known as the principles of specificity and overload. Unique to this proposal is the use of mfMRI as an assessment of the anatomical structure underlying swallowing function and the exercises that are designed to rehabilitate them. PUBLIC HEALTH RELEVANCE: Favorable swallowing is an important quality of life issue. Swallowing specialists work with patients to improve swallowing ability through rehabilitative exercises. However, current methods used to evaluate the musculature underlying swallowing and swallowing therapies are limited. This project will develop the application of muscle functional MRI as a methodology to investigate muscle function underlying swallowing and to evaluate the exercises designed to improve swallowing function. !

描述（由申请人提供）：本研究的目的是利用MFMRI序列来识别和评估吞咽肌肉以及行使它们的各种康复技术。康复性吞咽运动旨在增强执行特定生物力学事件的特定肌肉。此外，要进行锻炼，该运动应引起比定期使用更大的肌肉收缩。这称为超负荷原则。目前要解决的问题是吞咽中使用的肌肉尚未得到彻底研究和验证。我们建议MFMRI可用于验证吞咽中使用的肌肉，并根据其特异性和实现过载的能力来评估康复性吞咽练习。为了实现此目的，我们建议：7通过使用解剖学和动态MRI序列来绘制关键的解剖学地标，并限制吞咽肌肉兴趣的可靠区域，以作为识别MFMRI中肌肉的参考点，从而获得吞咽设备的结构数据。 7使用MFMRI记录吞咽肌肉的激活。为此，我们首先将通过测试更容易识别的咀嚼肌肉来验证MFMRI鉴定在头部和颈部区域激活的肌肉的能力。然后，我们将比较在MFMRI中活跃与静止的吞咽肌肉。最后，我们将开发一个基本的地图集，代表吞咽中使用的肌肉。 7通过测试这些运动是否使用与吞咽相同的特定肌肉，以及在运动中使用的程度比常规使用程度更大的锻炼方法，确定振动筛，门德尔申和努力的吞咽康复技术是否是有效吞咽疗法的。在力量训练中，这被称为特异性和超负荷的原理。该提案独有的是将MFMRI用作吞咽功能基础的解剖结构以及旨在恢复它们的练习的评估。 公共卫生相关性：有利的吞咽是重要的生活质量问题。吞咽专家与患者一起通过康复运动来提高吞咽能力。但是，当前用于评估吞咽和吞咽疗法的肌肉组织的方法有限。该项目将开发肌肉功能性MRI的应用，以研究吞咽吞咽的基础肌肉功能的方法，并评估旨在改善吞咽功能的练习。呢

项目成果

Image-based measurement of post-swallow residue: the normalized residue ratio scale.

• DOI: 10.1007/s00455-012-9426-9
• 发表时间: 2013-06
• 期刊: DYSPHAGIA
• 影响因子: 2.6
• 作者: Pearson, William G., Jr.;Molfenter, Sonja M.;Smith, Zachary M.;Steele, Catriona M.
• 通讯作者: Steele, Catriona M.