This system could be useful for evaluating tongue activity during oropharyngeal swallowing.
Background: Although poststroke dysphagia is an important issue for determining prognosis, the pathophysiology of oral-phase dysphagia has yet to be clarified due to a lack of adequate devices and protocols. The present study investigated the relationships between swallowing pressure production by the tongue and dysphagia in stroke patients using a newly developed method of tongue pressure measurement with a sensor sheet system. Methods: Subjects were 64 stroke patients, including 30 patients with dysphagia. A T-shaped sensor sheet with 5 measuring points was attached to the hard palate to record tongue pressure while swallowing 5 ml of water. The average maximal magnitude and incidence of abnormalities such as asynchronous and/or polyphasic patterns in tongue pressure waves in 5 locations were compared between patients with and without dysphagia. Results: The average maximal tongue pressure was significantly smaller in patients with dysphagia than in those without dysphagia. Asynchronous and polyphasic patterns showed a sensitivity of 63 and 87%, and a specificity of 91 and 71%, respectively, for identifying patients with dysphagia. Conclusion: Tongue pressure production during swallowing appears closely related to poststroke dysphagia. Tongue pressure measurement appears useful for evaluating the pathophysiology of oral-phase dysphagia in stroke patients.
Although swallowing movement is known to change with aging, age-related differences in the tongue pressure for propelling a bolus from the oral cavity into the pharynx have yet to be investigated in a physiological condition. We hypothesized that tongue pressure during swallowing changed with aging and, using a 0.1-mm-thick sensor sheet with 5 measuring points, measured it while a 15-mL quantity of water was swallowed by young and elderly dentate individuals. Both groups showed a similar order of tongue pressure production at each point. However, the elderly group showed longer duration at each point, lower maximal magnitude in the anterio-median part of the hard palate, and higher magnitude in the circumferential parts of the hard palate than the young group. These results provide the first quantitative evidence of the age-related changes in tongue movement during natural swallowing, which could be attributed to muscle weakening and morphological changes in the oropharynx.
BackgroundSwallowing dysfunction (also known as dysphagia), which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF) examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement.MethodsSix healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF.ResultsSeven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity.ConclusionsThe present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement.
Background and Purpose-Dysphagia is important for prognosis in patients with stroke because this condition can cause aspiration pneumonia or nutritional deficits. The present study investigated the relationship between tongue motor deficits and dysphagia in patients with acute stroke. Methods-Maximal tongue pressure on the hard palate when swallowing 5 mL of water was measured using a T-shaped sensor sheet with 5 measuring points in 33 dysphagic and 31 nondysphagic patients with acute stroke. Maximum tongue pressures at each measuring point were compared between dysphagic and nondysphagic groups and between paralyzed and nonparalyzed sides. Results-Tongue pressure at each measuring point was significantly smaller in dysphagic patients than in nondysphagic patients with the largest significant difference on the paralyzed side. The magnitude of tongue pressure to predict dysphagia was calculated as 4.6 kPa on the paralyzed side, offering 71.4% sensitivity and 72.3% specificity. Conclusions-Reduced tongue pressure on the paralyzed side may predict dysphagia in patients with acute stroke. (Stroke.
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