頸部力変換器による嚥下評価

頸部力変換器による努力嚥下と非努力嚥下の違い：臨床でのフィードバックシステム発展への影響に関する論文を紹介します。

Coulas VL, Smith RC, Qadri SS, Martin RE.　Differentiating effortful and noneffortful swallowing with a neck force transducer: implications for the development of a clinical feedback system.　Dysphagia. 2009 Mar;24(1):7-12.

図のような頸部力変換器を使用して、嚥下に関連したの頸囲の変化を評価することで、努力嚥下と非努力嚥下の違いを判断できるかという研究です。若年健常女性を対象に実施した結果、陽性、陰性ともピーク電圧が、努力嚥下で有意に高かったです。これをバイオフィードバックに応用できる可能性があります。

この論文も頸囲と嚥下機能に関する内容ではないかと思って読んでみました。サルコペニアによる嚥下障害の方であれば、努力嚥下であってもピーク電圧は低くなる可能性があります。これをサルコペニアの嚥下障害の診断に利用する方法もあるかもしれません。

Abstract

This study sought to determine whether effortful saliva swallows could be differentiated from habitual, noneffortful saliva swallows on the basis of swallow-related changes in neck circumference in humans. Gender differences in swallow-related neck circumference were examined as a secondary question. Twenty-seven healthy adults (14 females; mean age = 26.6 years, SD = 3.9 years) participated in two experimental runs (run duration = 10 min) during which they produced single trials of three visually cued tasks in random order: effortful saliva swallowing, saliva swallowing, and a control task involving repetitive apposition of the dominant thumb and index finger. Neck and ribcage circumference were simultaneously collected from the output of force transducers positioned around the neck and ribcage, respectively. The primary outcome variables were the positive and negative voltage peak amplitudes associated with changes in neck circumference during single-swallow trials. Effects of the swallowing task on positive and negative voltage peaks were examined with separate two-way analysis of variance procedures. Results indicated that both positive (F = 6.49, p < 0.05) and negative (F = 12.05, p neck. This type of physiologic recording may have potential as a biofeedback technique in training dysphagic patients on the effortful swallow maneuver.