Configurable portable/ambulatory instrument for the analysis of the coordination between respiration and swallowing

Neurogastroenterology Motil

Chen

2015

Key Messages• Oropharyngeal dysphagia (OD) is common after a stroke, and OD is a potential cause of aspiration, dehydration, malnutrition, increased length of hospital stay.• The fine coordination between oropharyngeal swallowing and respiration is essential to ensure the safety of swallowing without aspiration, and stroke insults affect swallowing and respiration coordination, but no longitudinal follow-up study of this coordination after unilateral stroke was demonstrated in a literature review.• A non-invasive swallowing assessment method was used to detect oropharyngeal swallowing parameters and respiration coordination simultaneously during the swallowing process.• Results show that oropharyngeal swallowing and respiration coordination in unilateral stroke patients deviate from normal controls after stroke insult and improved during the subacute phase poststroke. AbstractBackground Oropharyngeal dysphagia is common after a stroke. Understanding the physiology of swallowing and its coordination with respiration in stroke recovery is crucially important. Methods A noninvasive swallowing assessment method was used to detect oropharyngeal swallowing and respiration coordination simultaneously during the swallowing process. This system detected movement of the larynx, submental muscle activity, and nasal airflow. Six different sizes of water boluses (maximum of 20 mL) were swallowed and assessed for each subject. Key ResultsWe recruited 59 healthy participants and 38 first ever unilateral stroke patients completed baseline and follow-up assessments at 3, 6, and 9 months poststroke. The results showed that oropharyngeal swallowing parameters in unilateral stroke deviate from normal patterns. For respiration coordination, the unilateral stroke group had longer swallowing apnea duration but similar frequencies of preand postswallowing respiratory phase patterns compared with the healthy controls. The probability of piece-meal deglutition was higher in the stroke group than in the control group. Additionally, there were gradually decreasing piece-meal deglutition probabilities among the stroke patients at follow-up, and none differed statistically from those of the controls at 6 months poststroke. Conclusions & Inferences The non-invasive swallowing and respiration assessment method applied in this study detected the changes manifested in swallowing and respiration during the subacute phase of recovery in 6 months after a unilateral stroke. The study results serve as a baseline for

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Assessment Tools For Swallowing and Respiration Coordinationmentioning

confidence: 99%

See 1 more Smart Citation

Integrated non‐invasive measurements reveal swallowing and respiration coordination recovery after unilateral stroke

Neurogastroenterology Motil

Chen

2015

“…Thus, there has been a trend for the development of new and non‐invasive methodologies to avoid patients' exposure to radiation and stress. Portable instrumentation would also be an advantage . The non‐invasive method proposed in the present study might be useful for bedside assessment to identify risk factors for aspiration, or for elderly people who require home tele‐monitoring .…”

Section: Discussionmentioning

confidence: 99%

“…Portable instrumentation would also be an advantage. [37][38][39][40][57][58][59] The non-invasive method proposed in the present study might be useful for bedside assessment to identify risk factors for aspiration, or for elderly people who require home tele-monitoring. 31 However, the method proposed in the present study has limitations for clinical applications.…”

Section: Discussionmentioning

confidence: 99%

Aging‐related changes in swallowing, and in the coordination of swallowing and respiration determined by novel non‐invasive measurement techniques

Geriatrics Gerontology Int

Chen

Chuang

et al. 2014

Aim:Previous studies have shown that the process of swallowing changes with aging, a phenomenon known as presbyphagia. These subtle and subclinical age-related changes make older adults more vulnerable to dysphagia during disease insults. However, there are limited studies of the swallowing process in older adults, because measurements are typically invasive or require exposure to X-rays. In the present study, we used integrated noninvasive measurements to determine aging-related changes of swallowing, and in the coordination of swallowing and respiration for a population of healthy participants. Methods:The non-invasive system provided measurements of larynx movement with piezoelectric sensors, submental muscle activity with surface electromyography and respiration-swallowing coordination by measurement of nasal airflow. We recruited 112 healthy participants from the community, 35 in a young-age group (age 20-30 years), 38 in a middle-age group (age 31-50 years) and 39 in an old-age group (age 51-70 years). Results:The oropharyngeal swallowing parameters of the old-age group had delayed onset latency and longer swallowing apnea duration relative to the other groups, and these differences were greater for larger boluses. The middle-and old-age groups had less expiratory-expiratory respiratory phase pattern than the young-age group. The probability of piecemeal deglutition was highest in the old-age group and lowest in the young-age group. These results show that the phases of oropharyngeal swallowing and the coordination of swallowing with respiration gradually change with aging. Conclusions:We used integrated non-invasive measurements to document age-related changes in swallowing, and in the coordination of swallowing and respiration in healthy adults. Geriatr Gerontol Int 2015; 15: 736-744.

Non-invasive Assessment of Swallowing and Respiration Coordination for the OSA Patient

Lee

et al. 2016

Dysphagia

The objectives of this study are to investigate swallowing and its coordination with respiration in patients with obstructive sleep apnea (OSA). This is a prospective cohort study conducted in a tertiary referred Medical Center. A non-invasive method of assessing swallowing was used to detect the oropharyngeal swallowing parameters and the coordination with respiration during swallowing. The system used to assess swallowing detected: (1) movement of the larynx using a force-sensing resistor; (2) submental muscle activity using surface electromyography; and (3) coordination with respiration by measuring nasal airflow. Five sizes of water boluses (maximum 20 mL) were swallowed three times, and the data recorded and analyzed for each participant. Thirty-nine normal controls and 35 patients with OSA who fulfilled the inclusion criteria were recruited. The oropharyngeal swallowing parameters of the patients differed from the controls, including longer total excursion duration and shorter duration of submental muscles contraction. A longer swallowing respiratory pause (SRP), temporary coordination with respiration during swallowing, was demonstrated in the patients compared with the controls. The frequency of non-expiratory/expiratory pre- and postswallowing respiratory phase patterns of the patients was similar with the controls. There was significantly more piecemeal deglutition in OSA patients when clumping 10- and 20-mL water boluses swallowing together (p = 0.048). Oropharyngeal swallowing and coordination with respiration affected patients with OSA, and it could be detected using a non-invasive method. The results of this study may serve as a baseline for further research and help advance research methods in obstructive sleep apnea swallowing studies.