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.

项目概要 健康婴儿从母乳或奶瓶喂养成功过渡到纹理食品需要 复杂的神经肌肉控制的发展。这种转变也必须在快速发展的背景下发生 生长和发育以及营养需求的增加。为了启动这个过程，补充食品是 通常在 4-6 个月大时出现，并持续整个幼儿期。推迟引入 超过 10 个月的辅食会使原本健康的孩子面临持续喂养的风险 问题会一直发展到学龄期。这表明长期流质饮食从根本上 改变进食表现以及潜在的口腔和咽部功能和协调。现在， 然而，关于如果这种情况发生，最好实施哪种康复策略的数据有限。 口腔感觉运动发育的关键窗口已经过去。我们的理解有限，部分原因在于 在检查燕子时为健康婴儿和儿童提供人类受试者研究保护 喂养过程中的生长及其相对缓慢的生长速度使得纵向研究不可行。这 拟议的工作将确定喂养性能及其基础生理学和生物力学是否 在生长和发育的关键时期长期使用质地改良饮食后可以恢复 动物模型中口腔感觉运动的成熟。该项目将比较喂养和吞咽呼吸 将在早期成熟期间采用质地改良饮食饲养的动物的性能结果耦合起来，然后 使用两种康复策略之一过渡到纹理食品：直接过渡或渐进 过渡。这两种康复策略的结果将与正常断奶年龄进行比较 匹配的对照动物（具体目标 1）。该项目还将检查口腔（下颌和 每组喂食期间的舌头）和舌喉运动及其运动控制（直接过渡， 渐进式过渡、控制）（具体目标 2）。同步高速双平面透视， 婴儿、幼年和亚成年动物 4 个月内的肌电图和呼吸数据将提供 跨关键发育阶段的序列和周期水平分析。结果将使我们能够区分 动物从进化到进化的过程中，生长和发育、功能和表现之间的关系 口腔发育的关键窗口期关闭后，液体饮食改为固体饮食。这项研究对于 优化难以接受补充食品的健康婴儿的具体康复策略。 这项研究还为治疗其他人群（例如健康早产儿和 患有影响口咽协调的潜在疾病且使断奶变得复杂的儿童 以及向固体食物的成功过渡。