Tongue-pressure timing for liquid flow detection and control in swallowing

用于吞咽液体流量检测和控制的舌压计时

• 批准号: 8304114
• 负责人: Catriona Margaret Steele
• 金额: $ 18.65万
• 依托单位: TORONTO REHABILITATION INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8304114
• 关键词: Address; Adopted; Adult; Affect; Behavior; Bolus Infusion; Clinical Management; Clinical Protocols; Coffee; Deglutition; Deglutition Disorders; Dehydration; Detection; Development; Drug Formulations; Effectiveness; Elderly; Evaluation; Funding; Future; Goals; Guidelines; Health; Impairment; Indium; Individual; Industry; Injury; Intervention; Investigation; Learning; Liquid substance; Malnutrition; Measures; Neurologic; Oral cavity; Patients; Persons; Pharyngeal structure; Phase; Physiology; Play; Pneumonia; Practice Guidelines; Property; Protocols documentation; Quality of life; Research; Risk; Role; Stimulus; Stroke; Testing; Therapeutic; Thick; Time; Tongue; Training; Viscosity; Work; base; clinical practice; disability; drinking water; evidence base; experience; improved; liquid formulation; pressure; programs; public health relevance; sensory discrimination; young adult

DESCRIPTION (provided by applicant): Swallowing is something that most of us take for granted. We drink water when we are thirsty, and swallow our morning coffee without a second thought. Yet, dysphagia (swallowing difficulty) is a serious, costly and significant health concern, particularly for the elderly and people with neurologic injuries. Dysphagia puts individuals at risk for malnutrition, dehydration and pneumonia and adversely affects quality of life. People with dysphagia have particular difficulty swallowing thin liquids safely; the fast flow of liquids makes them difficult to control. The tongue plays a critical role in containing liquids in the mouth, and in directing and controlling flow through the pharynx (throat). We are engaged in a program of research to better understand tongue function in swallowing, particularly with respect to controlling the flow of liquids. This research is guiding the development and testing of interventions with the goal of rehabilitating tongue function, so that people with dysphagia might return to swallowing thin liquids safely. To date, we have learned that modulations of the time-scale of tongue-pressure application (tongue-pressure-timing) are a critical element in liquid swallowing. Healthy young adults modulate tongue-pressure-timing across liquids of differing viscosity. We are requesting funding for the next phase in this research, to examine tongue-pressure timing in healthy adults (young and elderly) and individuals with dysphagia. The proposed research is based on the idea that the primary purpose of tongue-pressure application to a liquid stimulus is to measure and control the flow properties of that liquid. We hypothesize that, in comparison to healthy young adults, healthy seniors and people with dysphagia will demonstrate differences in tongue-pressure timing. We expect that people with abnormal tongue-pressure timing (vs. healthy young controls) will be less able to detect differences in liquid viscosity and will show reduced tongue-pressure timing modulation in swallowing across viscosity. We specifically seek to confirm that impairments in tongue- pressure-timing co-occur with impairments in the detection of viscosity differences. We also want to conduct a preliminary test of an intervention protocol that we have developed, emphasizing the modulation of tongue- pressure-timing. We hypothesize that this intervention will: a) shift tongue-pressure timing values closer to those of healthy young adults; b) facilitate improved viscosity detection; and c) improve liquid bolus control. This study will answer a critical question for the clinical management of dysphagia, namely how large must a viscosity difference be to influence swallowing function? This will inform industry standards for the formulation of thickened liquids for dysphagia. The results of this study will support the development of evidence-based clinical protocols for tongue-pressure evaluation. Finally, this study will produce preliminary evidence of the effectiveness of tongue-pressure timing training to ameliorate bolus control difficulties in dysphagia. PUBLIC HEALTH RELEVANCE: Dysphagia (swallowing difficulty) is a serious health concern for the elderly and for individuals with stroke or other neurological conditions. This study will advance our understanding of the role of tongue pressure application in swallowing, and will advise future best-practice guidelines for dysphagia assessment and intervention. The results will guide the formulation of therapeutically useful, just-thick-enough liquids and will advance our ability to address liquid bolus control difficulties, - a major component of swallowing disability.

描述（申请人提供）：吞咽是我们大多数人认为是理所当然的。口渴时我们喝水，吞咽我们的早晨咖啡而没有再考虑。然而，吞咽困难（吞咽困难）是一个严重，昂贵且重大的健康问题，特别是对于老年人和神经系统损伤的人。 吞咽困难使个人有营养不良，脱水和肺炎的风险，并对生活质量产生不利影响。 吞咽困难的人安全吞咽稀释液体特别困难。液体的快速流使它们难以控制。舌头在口腔中含有液体以及指导和控制通过咽部（喉咙）的流动方面起着至关重要的作用。我们从事一项研究计划，以更好地了解吞咽中的舌头功能，尤其是在控制液体流动方面。这项研究是指导干预措施的开发和测试，目的是恢复舌头功能，以便吞咽困难的人可以安全地返回吞咽稀疏的液体。迄今为止，我们了解到，舌头施​​用时间尺度（舌头压榨）的调制是液体吞咽中的关键元素。健康的年轻成年人调节不同粘度液体的舌头压力。我们要求为这项研究的下一阶段提供资金，以检查健康的成年人（年轻人和老年人）和吞咽困难的人的舌头时机。 拟议的研究是基于这样的想法：舌头压力施加到液体刺激上的主要目的是测量和控制该液体的流量特性。我们假设，与健康的年轻人相比，健康的老年人和吞咽困难的人会表现出舌头压力时机的差异。我们预计患有异常的舌头压力时间（与健康的年轻控制措施）的人无法检测到液体粘度的差异，并且在整个粘度的吞咽中会显示舌头压力的调制降低。我们特别寻求确认在舌压接种时与检测粘度差异的损害相关的损害。我们还希望对我们开发的干预方案进行初步测试，以强调舌压的调节。我们假设这种干预措施将：a）更接近健康年轻人的舌头压力时序值； b）促进粘度检测的改善；和c）改善液体推注控制。这项研究将回答一个吞咽困难的临床管理的关键问题，即粘度差要影响吞咽功能有多大？这将为行业标准提供为吞咽困难的增厚液体制定的标准。这项研究的结果将支持开发基于证据的临床方案进行舌头压力评估。最后，这项研究将产生初步证据，证明舌头压力的计时训练有效性，以改善吞咽困难的推注控制困难。 公共卫生相关性：吞咽困难（吞咽困难）是老年人和中风或其他神经系统疾病的人的严重健康问题。这项研究将促进我们对舌头施用在吞咽中的作用的理解，并将为吞咽困难评估和干预的未来最佳实践指南提供建议。结果将指导治疗上有用的，厚实的液体的制定，并提高我们解决液体推注控制困难的能力，这是吞咽残疾的主要组成部分。