A Comparison of Treatment Strategies for Recovery of Swallow and Swallow-Respiratory Coupling Following a Prolonged Liquid Diet in a Young Animal Model

幼年动物模型中长期流质饮食后吞咽恢复和吞咽呼吸耦合治疗策略的比较

• 批准号: 10590479
• 负责人: Susan H Williams
• 金额: $ 26.86万
• 依托单位: OHIO UNIVERSITY ATHENS
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10590479
• 关键词: Adolescent; Affect; Age; Age Months; Age Years; Animal Model; Animals; Behavior; Behavioral; Biological Assay; Biomechanics; Bottle feeding; Breastfed infant; Child; Clinical; Complex; Control Animal; Coupling; Data; Deglutition; Development; Diet; Electromyography; Exhalation; Exposure to; Family suidae; Feeding behaviors; Fluoroscopy; Food; Foundations; Frequencies; Functional disorder; Funding; Future; Growth; Growth and Development function; Health; Human; Human Subject Research; Impairment; Infant; Ingestion; Inhalation; Jaw; Length; Liquid substance; Longitudinal Studies; Mastication; Modeling; Motor; Movement; Muscle; Neurologic; Nutritional; Nutritional Support; Oral; Oral Stage; Oropharyngeal; Outcome; Pattern; Performance; Pharyngeal structure; Phase; Physiological; Physiology; Population; Premature Infant; Probability; Process; Property; Recovery; Rehabilitation therapy; Research; Respiration; Risk; School-Age Population; Sensory; Solid; Speed; Structural defect; Structure; System; Testing; Texture; Tongue; Tooth structure; Variant; Weaning; Work; clinical decision-making; clinical practice; critical period; dietary; disability; early childhood; feeding; improved; juvenile animal; kinematics; motor control; neuromuscular; nutrition; orofacial; rapid growth; rehabilitation strategy; remediation; respiratory; sensory input; sensory integration; skills; suckling; treatment comparison; treatment strategy

Project Summary Successful transition of healthy infants from breast- or bottle-feeding to textured foods requires the development of complex neuromuscular control. This transition must also occur within the context of rapid growth and development and increased nutritional demands. To initiate this process, complementary foods are typically introduced by 4-6 months of age and continue throughout early childhood. Delaying the introduction of complementary foods past 10 months of age places an otherwise healthy child at risk for persistent feeding problems to develop well into the school-age years. This suggests that prolonged liquid diets fundamentally alter feeding performance and the underlying oral and pharyngeal function and coordination. Currently, however, limited data is available on precisely what rehabilitation strategy would be best to implement if this critical window of oral sensorimotor development has passed. Our limited understanding is due, in part, to human subject research protections in place for healthy infants and children when examining the swallow during feeding and to their relatively slow growth rates which make longitudinal studies infeasible. The proposed work will determine whether feeding performance and its underlying physiology and biomechanics can be recovered following long-term use of a texture-modified diet during the critical periods of growth and oral sensorimotor maturation in an animal model. This project will compare feeding and swallow-respiratory coupling performance outcomes for animals reared on a texture-modified diet during early maturation and then transitioned to textured foods using one of two rehabilitation strategies: direct transition or progressive transition. The outcomes of these two rehabilitation strategies will be compared to normally-weaned age- matched control animals (Specific Aim 1). This project will also examine the coordination of oral (jaw and tongue) and hyolaryngeal movements and their motor control during feeding in each group (direct transition, progressive transition, controls) (Specific Aim 2). Synchronized high speed biplanar fluoroscopy, electromyography, and respiration data over 4 months in infant, juvenile, and subadult animals will provide sequence- and cycle-level analyses across critical developmental stages. Results will enable us to tease apart the relationship between growth and development, function, and performance as animals transition from a liquid to a solid diet after critical windows of oral development have closed. This research is essential for optimizing specific rehabilitation strategies for healthy infants who struggle to accept complementary foods. This research also lays the groundwork for treating other populations such as healthy preterm infants and children who present with underlying conditions affecting oropharyngeal coordination that complicate weaning and the successful transition to solid foods.

项目摘要 健康的婴儿从乳房或奶瓶喂养到纹理食品的成功过渡需要 复杂的神经肌肉控制的发展。这种过渡也必须在快速的背景下发生 增长和发展以及增加的营养需求。为了启动此过程，互补食品是 通常是在4-6个月大的时候引入，并且在整个幼儿期间持续。延迟引入 互补食品过去10个月，这是一个原本健康的孩子，面临持续喂养的风险 在学龄前发展的问题。这表明从根本上延长了液体饮食 改变喂养性能以及基础口头和咽功能和协调。现在， 但是，如果这是有限的数据，则可以确切地获得哪种康复策略，如果此策略最好实施 口服感觉运动发展的关键窗口已经过去。我们有限的理解部分是由于 检查吞咽时，人类主题研究保护适用于健康的婴儿和儿童 在进食期间及其相对较慢的生长速率，这使得纵向研究不可行。这 拟议的工作将确定进食性能及其基本生理学和生物力学是否 在长期使用质地改性饮食的关键时期，可以回收 动物模型中的口服感觉运动成熟。该项目将比较喂食和吞咽呼吸器 在早期成熟期间以质地改性饮食饲养的动物的耦合性能结果，然后 使用两种康复策略之一过渡到纹理食品：直接过渡或进步 过渡。将这两种康复策略的结果与正常的年龄进行比较 匹配的对照动物（特定目标1）。该项目还将检查口头的协调（下巴和 舌头）和hyolaryngeal运动及其在每组进食过程中的运动控制（直接过渡， 渐进过渡，控制）（特定目标2）。同步的高速双翼荧光镜检查， 婴儿，少年和亚成人的肌电图和呼吸数据将在4个月内提供 跨关键发育阶段的序列和周期水平分析。结果将使我们能够分开 随着动物从A过渡的生长与发展，功能和表现之间的关系 关闭口腔发育的关键窗户后，液体饮食良好。这项研究对于 为难以接受互补食品的健康婴儿优化特定的康复策略。 这项研究还为治疗其他人群（例如健康的早产儿）和 出现影响口咽配位的儿童，使断奶复杂化 以及成功过渡到固体食品。