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Sample records for dual-axis swallowing accelerometry

  1. Effects of liquid stimuli on dual-axis swallowing accelerometry signals in a healthy population

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    Sejdić Ervin

    2010-02-01

    Full Text Available Abstract Background Dual-axis swallowing accelerometry has recently been proposed as a tool for non-invasive analysis of swallowing function. Although swallowing is known to be physiologically modifiable by the type of food or liquid (i.e., stimuli, the effects of stimuli on dual-axis accelerometry signals have never been thoroughly investigated. Thus, the objective of this study was to investigate stimulus effects on dual-axis accelerometry signal characteristics. Signals were acquired from 17 healthy participants while swallowing 4 different stimuli: water, nectar-thick and honey-thick apple juices, and a thin-liquid barium suspension. Two swallowing tasks were examined: discrete and sequential. A variety of features were extracted in the time and time-frequency domains after swallow segmentation and pre-processing. A separate Friedman test was conducted for each feature and for each swallowing task. Results Significant main stimulus effects were found on 6 out of 30 features for the discrete task and on 5 out of 30 features for the sequential task. Analysis of the features with significant stimulus effects suggested that the changes in the signals revealed slower and more pronounced swallowing patterns with increasing bolus viscosity. Conclusions We conclude that stimulus type does affect specific characteristics of dual-axis swallowing accelerometry signals, suggesting that associated clinical screening protocols may need to be stimulus specific.

  2. Segmentation of dual-axis swallowing accelerometry signals in healthy subjects with analysis of anthropometric effects on duration of swallowing activities.

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    Sejdić, Ervin; Steele, Catriona M; Chau, Tom

    2009-04-01

    Dysphagia (swallowing difficulty) is a serious and debilitating condition that often accompanies stroke, acquired brain injury, and neurodegenerative illnesses. Individuals with dysphagia are prone to aspiration (the entry of foreign material into the airway), which directly increases the risk of serious respiratory consequences such as pneumonia. Swallowing accelerometry is a promising noninvasive tool for the detection of aspiration and the evaluation of swallowing. In this paper, dual-axis accelerometry was implemented since the motion of the hyolaryngeal complex occurs in both anterior-posterior and superior-inferior directions during swallowing. Dual-axis cervical accelerometry signals were acquired from 408 healthy subjects during dry, wet, and wet chin tuck swallowing tasks. The proposed segmentation algorithm is based on the idea of sequential fuzzy partitioning of the signal and is well suited for long signals with nonstationary variance. The algorithm was validated with simulated signals with known swallowing locations and a subset of 295 real swallows manually segmented by an experienced speech language pathologist. In both cases, the algorithm extracted individual swallows with over 90% accuracy. The time duration analysis was carried out with respect to gender, body mass index (BMI), and age. Demographic and anthropometric variables influenced the duration of these segmented signals. Male participants exhibited longer swallows than female participants (p=0.05). Older participants and participants with higher BMIs exhibited swallows with significantly longer (p=0.05) duration than younger participants and those with lower BMIs, respectively.

  3. Quantitative classification of pediatric swallowing through accelerometry.

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    Merey, Celeste; Kushki, Azadeh; Sejdić, Ervin; Berall, Glenn; Chau, Tom

    2012-06-09

    Dysphagia or swallowing disorder negatively impacts a child's health and development. The gold standard of dysphagia detection is videofluoroscopy which exposes the child to ionizing radiation, and requires specialized clinical expertise and expensive institutionally-based equipment, precluding day-to-day and repeated assessment of fluctuating swallowing function. Swallowing accelerometry is the non-invasive measurement of cervical vibrations during swallowing and may provide a portable and cost-effective bedside alternative. In particular, dual-axis swallowing accelerometry has demonstrated screening potential in older persons with neurogenic dysphagia, but the technique has not been evaluated in the pediatric population. In this study, dual-axis accelerometric signals were collected simultaneous to videofluoroscopic records from 29 pediatric participants (age 6.8 ± 4.8 years; 20 males) previously diagnosed with neurogenic dysphagia. Participants swallowed 3-5 sips of barium-coated boluses of different consistencies (normally, from thick puree to thin liquid) by spoon or bottle. Videofluoroscopic records were reviewed retrospectively by a clinical expert to extract swallow timings and ratings. The dual-axis acceleration signals corresponding to each identified swallow were pre-processed, segmented and trimmed prior to feature extraction from time, frequency, time-frequency and information theoretic domains. Feature space dimensionality was reduced via principal components. Using 8-fold cross-validation, 16-17 dimensions and a support vector machine classifier with an RBF kernel, an adjusted accuracy of 89.6% ± 0.9 was achieved for the discrimination between swallows with and with out airway entry. Our results suggest that dual-axis accelerometry has merit in the non-invasive detection of unsafe swallows in children and deserves further consideration as a pediatric medical device.

  4. Quantitative classification of pediatric swallowing through accelerometry

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    Celeste Merey

    2012-06-01

    Full Text Available Abstract Background Dysphagia or swallowing disorder negatively impacts a child’s health and development. The gold standard of dysphagia detection is videofluoroscopy which exposes the child to ionizing radiation, and requires specialized clinical expertise and expensive institutionally-based equipment, precluding day-to-day and repeated assessment of fluctuating swallowing function. Swallowing accelerometry is the non-invasive measurement of cervical vibrations during swallowing and may provide a portable and cost-effective bedside alternative. In particular, dual-axis swallowing accelerometry has demonstrated screening potential in older persons with neurogenic dysphagia, but the technique has not been evaluated in the pediatric population. Methods In this study, dual-axis accelerometric signals were collected simultaneous to videofluoroscopic records from 29 pediatric participants (age 6.8 ± 4.8 years; 20 males previously diagnosed with neurogenic dysphagia. Participants swallowed 3-5 sips of barium-coated boluses of different consistencies (normally, from thick puree to thin liquid by spoon or bottle. Videofluoroscopic records were reviewed retrospectively by a clinical expert to extract swallow timings and ratings. The dual-axis acceleration signals corresponding to each identified swallow were pre-processed, segmented and trimmed prior to feature extraction from time, frequency, time-frequency and information theoretic domains. Feature space dimensionality was reduced via principal components. Results Using 8-fold cross-validation, 16-17 dimensions and a support vector machine classifier with an RBF kernel, an adjusted accuracy of 89.6% ± 0.9 was achieved for the discrimination between swallows with and with out airway entry. Conclusions Our results suggest that dual-axis accelerometry has merit in the non-invasive detection of unsafe swallows in children and deserves further consideration as a pediatric medical device.

  5. Anatomical Directional Dissimilarities in Tri-axial Swallowing Accelerometry Signals.

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    Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L; Perera, Subashan; Sejdic, Ervin

    2017-05-01

    Swallowing accelerometry is a noninvasive approach currently under consideration as an instrumental screening test for swallowing difficulties, with most current studies focusing on the swallowing vibrations in the anterior-posterior (A-P) and superior-inferior (S-I) directions. However, the displacement of the hyolaryngeal structure during the act of swallowing in patients with dysphagia involves declination of the medial-lateral (M-L), which suggests that the swallowing vibrations in the M-L direction have the ability to reveal additional details about the swallowing function. With this motivation, we performed a broad comparison of the swallowing vibrations in all three anatomical directions. Tri-axial swallowing accelerometry signals were concurrently collected from 72 dysphagic patients undergoing videofluoroscopic evaluation of swallowing (mean age: 63.94 ± 12.58 years period). Participants swallowed one or more thickened liquids with different consistencies including thin-thick liquids, nectar-thick liquids, and pudding-thick liquids with either a comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5-ml spoon. Swallows were grouped based on the viscosity of swallows and the participant's stroke history. Then, a comprehensive set of features was extracted in multiple signal domains from 881 swallows. The results highlighted inter-axis dissimilarities among tri-axial swallowing vibrations including the extent of variability in the amplitude of signals, the degree of predictability of signals, and the extent of disordered behavior of signals in time-frequency domain. First, the upward movement of the hyolaryngeal structure, representing the S-I signals, were actually more variable in amplitude and showed less predictable behavior than the sideways and forward movements, representing the A-P and M-L signals, during swallowing. Second, the S-I signals, which represent the upward movement of the hyolaryngeal structure

  6. Understanding differences between healthy swallows and penetration-aspiration swallows via compressive sensing of tri-axial swallowing accelerometry signals.

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    Sejdić, Ervin; Dudik, Joshua M; Kurosu, Atsuko; Jestrović, Iva; Coyle, James L

    2014-05-23

    Swallowing accelerometry is a promising tool for non-invasive assessment of swallowing difficulties. A recent contribution showed that swallowing accelerometry signals for healthy swallows and swallows indicating laryngeal penetration or tracheal aspiration have different time-frequency structures, which may be problematic for compressive sensing schemes based on time-frequency dictionaries. In this paper, we examined the effects of different swallows on the accuracy of a compressive sensing scheme based on modulated discrete prolate spheroidal sequences. We utilized tri-axial swallowing accelerometry signals recorded from four patients during routinely schedule videofluoroscopy exams. In particular, we considered 77 swallows approximately equally distributed between healthy swallows and swallows presenting with some penetration/aspiration. Our results indicated that the swallow type does not affect the accuracy of a considered compressive sensing scheme. Also, the results confirmed previous findings that each individual axis contributes different information. Our findings are important for further developments of a device which is to be used for long-term monitoring of swallowing difficulties.

  7. The effects of compressive sensing on extracted features from tri-axial swallowing accelerometry signals

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    Sejdić, Ervin; Movahedi, Faezeh; Zhang, Zhenwei; Kurosu, Atsuko; Coyle, James L.

    2016-05-01

    Acquiring swallowing accelerometry signals using a comprehensive sensing scheme may be a desirable approach for monitoring swallowing safety for longer periods of time. However, it needs to be insured that signal characteristics can be recovered accurately from compressed samples. In this paper, we considered this issue by examining the effects of the number of acquired compressed samples on the calculated swallowing accelerometry signal features. We used tri-axial swallowing accelerometry signals acquired from seventeen stroke patients (106 swallows in total). From acquired signals, we extracted typically considered signal features from time, frequency and time-frequency domains. Next, we compared these features from the original signals (sampled using traditional sampling schemes) and compressively sampled signals. Our results have shown we can obtain accurate estimates of signal features even by using only a third of original samples.

  8. The effects of compressive sensing on extracted features from tri-axial swallowing accelerometry signals.

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    Sejdić, Ervin; Movahedi, Faezeh; Zhang, Zhenwei; Kurosu, Atsuko; Coyle, James L

    2016-04-17

    Acquiring swallowing accelerometry signals using a comprehensive sensing scheme may be a desirable approach for monitoring swallowing safety for longer periods of time. However, it needs to be insured that signal characteristics can be recovered accurately from compressed samples. In this paper, we considered this issue by examining the effects of the number of acquired compressed samples on the calculated swallowing accelerometry signal features. We used tri-axial swallowing accelerometry signals acquired from seventeen stroke patients (106 swallows in total). From acquired signals, we extracted typically considered signal features from time, frequency and time-frequency domains. Next, we compared these features from the original signals (sampled using traditional sampling schemes) and compressively sampled signals. Our results have shown we can obtain accurate estimates of signal features even by using only a third of original samples.

  9. Time-Frequency Analysis and Hermite Projection Method Applied to Swallowing Accelerometry Signals

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    Ervin Sejdić

    2010-01-01

    Full Text Available Fast Hermite projections have been often used in image-processing procedures such as image database retrieval, projection filtering, and texture analysis. In this paper, we propose an innovative approach for the analysis of one-dimensional biomedical signals that combines the Hermite projection method with time-frequency analysis. In particular, we propose a two-step approach to characterize vibrations of various origins in swallowing accelerometry signals. First, by using time-frequency analysis we obtain the energy distribution of signal frequency content in time. Second, by using fast Hermite projections we characterize whether the analyzed time-frequency regions are associated with swallowing or other phenomena (vocalization, noise, bursts, etc.. The numerical analysis of the proposed scheme clearly shows that by using a few Hermite functions, vibrations of various origins are distinguishable. These results will be the basis for further analysis of swallowing accelerometry to detect swallowing difficulties.

  10. Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier

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    Nikjoo Mohammad S

    2011-11-01

    Full Text Available Abstract Background Swallowing accelerometry has been suggested as a potential non-invasive tool for bedside dysphagia screening. Various vibratory signal features and complementary measurement modalities have been put forth in the literature for the potential discrimination between safe and unsafe swallowing. To date, automatic classification of swallowing accelerometry has exclusively involved a single-axis of vibration although a second axis is known to contain additional information about the nature of the swallow. Furthermore, the only published attempt at automatic classification in adult patients has been based on a small sample of swallowing vibrations. Methods In this paper, a large corpus of dual-axis accelerometric signals were collected from 30 older adults (aged 65.47 ± 13.4 years, 15 male referred to videofluoroscopic examination on the suspicion of dysphagia. We invoked a reputation-based classifier combination to automatically categorize the dual-axis accelerometric signals into safe and unsafe swallows, as labeled via videofluoroscopic review. From these participants, a total of 224 swallowing samples were obtained, 164 of which were labeled as unsafe swallows (swallows where the bolus entered the airway and 60 as safe swallows. Three separate support vector machine (SVM classifiers and eight different features were selected for classification. Results With selected time, frequency and information theoretic features, the reputation-based algorithm distinguished between safe and unsafe swallowing with promising accuracy (80.48 ± 5.0%, high sensitivity (97.1 ± 2% and modest specificity (64 ± 8.8%. Interpretation of the most discriminatory features revealed that in general, unsafe swallows had lower mean vibration amplitude and faster autocorrelation decay, suggestive of decreased hyoid excursion and compromised coordination, respectively. Further, owing to its performance-based weighting of component classifiers, the static

  11. Swallowing

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    ... the process of swallowing include the tongue, teeth, epiglottis, and esophagus. The teeth are used to grind ... an important small flap of tissue called the epiglottis, folds over the voice box (larynx) at the ...

  12. Dual Axis Light Sensor for Tracking Sun

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    Shibata, Miki; Tambo, Toyokazu

    We have developed convenient light sensors to control a platform of solar cell panel. Dual axis light sensor in the present paper has structure of 5 PD (photodiode) light sensor which is composed of 5 photodiodes attached on a frustum of pyramid(1). Light source can be captured in front of the sensor by rotating the X and Y axis as decreasing the output deviation between two pairs of outside photodiodes. We here report the mechanism of sun tacking using the dual axis 5 PD light sensor and the fundamental results performed in the dark room.

  13. design and implementation of a microcontroller based dual axis ...

    African Journals Online (AJOL)

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    DESIGN AND IMPLEMENTATION OF A MICROCONTROLLER BASED. DUAL AXIS .... Output mechanical transducer (Servo Motor). 2.1 Power .... Fig 5: Servo Motor Algorithm. Figure 6: .... Optimization and Performance Evaluation of a Single.

  14. Energy Efficient Hybrid Dual Axis Solar Tracking System

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    Rashid Ahammed Ferdaus

    2014-01-01

    Full Text Available This paper describes the design and implementation of an energy efficient solar tracking system from a normal mechanical single axis to a hybrid dual axis. For optimizing the solar tracking mechanism electromechanical systems were evolved through implementation of different evolutional algorithms and methodologies. To present the tracker, a hybrid dual-axis solar tracking system is designed, built, and tested based on both the solar map and light sensor based continuous tracking mechanism. These light sensors also compare the darkness and cloudy and sunny conditions assisting daily tracking. The designed tracker can track sun’s apparent position at different months and seasons; thereby the electrical controlling device requires a real time clock device for guiding the tracking system in seeking solar position for the seasonal motion. So the combination of both of these tracking mechanisms made the designed tracker a hybrid one. The power gain and system power consumption are compared with a static and continuous dual axis solar tracking system. It is found that power gain of hybrid dual axis solar tracking system is almost equal to continuous dual axis solar tracking system, whereas the power saved in system operation by the hybrid tracker is 44.44% compared to the continuous tracking system.

  15. A novel dual-axis reconstruction algorithm for electron tomography

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    Tong, Jenna; Midgley, Paul [Department of Materials Science and Metallurgy, University of Cambridge, Pembroke Street, Cambridge, CB2 3QZ (United Kingdom)

    2006-02-22

    A new algorithm for computing electron microscopy tomograms which combines iterative methods with dual-axis geometry is presented. Initial modelling using test data shows several improvements over both the weighted back-projection (WBP) and Simultaneous Iterative Reconstruction Technique (SIRT) method, and, with increased stability and tomogram fidelity under high-noise conditions.

  16. Dual axis operation of a micromachined rate gyroscope

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    Juneau, T. [BSAC, Berkeley, CA (United States); Pisano, A.P. [Univ. California, Berkeley, CA (United States). Dept. of Mechanical Engineering; Smith, J. [Sandia National Lab., Albuquerque, NM (United States)

    1997-04-01

    Since micromachining technology has raised the prospect of fabricating high performance sensors without the associated high cost and large size, many researchers have investigated micromachined rate gyroscopes. The vast majority of research has focused on single input axis rate gyroscopes, but this paper presents work on a dual input axis micromachined rate gyroscope. The key to successful simultaneous dual axis operation is the quad symmetry of the circular oscillating rotor design. Untuned gyroscopes with mismatched modes yielded random walk as low as 10{degrees}/{radical}hour with cross sensitivity ranging from 6% to 16%. Mode frequency matching via electrostatic tuning allowed performance better than 2{degrees}/{radical}hour, but at the expense of excessive cross sensitivity.

  17. Shot H3837: Darht's First Dual-Axis Explosive Experiment

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    Mendez, Jacob; McNeil, Wendy Vogan; Harsh, James; Hull, Lawrence

    2011-06-01

    Test H3837 was the first explosive shot performed in front of both flash x-ray axes at the Los Alamos Dual Axis Radiographic HydroTest (DARHT) facility. Executed in November 2009, the shot was an explosively-driven metal flyer plate in a series of experiments designed to explore equation-of-state properties of shocked materials. Imaging the initial shock wave traveling through the flyer plate, DARHT Axis II captured the range of motion from the shock front emergence in the flyer to breakout at the free surface; the Axis I pulse provided a perpendicular perspective of the shot at a time coinciding with the third pulse of Axis II. Since the days of the Manhattan Project, penetrating radiography with multiple frames from different viewing angles has remained a high-profile goal at the Laboratory. H3837 is merely the beginning of a bright future for two-axis penetrating radiography.

  18. Status of the Dual-Axis Radiographic Hydrodynamics Test Facility

    Energy Technology Data Exchange (ETDEWEB)

    Burns, M.J.; Allison, P.W.; Carlson, R.L.; Downing, J.N.; Moir, D.C.; Shurter, R.P.

    1996-09-01

    The Dual-Axis Radiographic Hydrodynamics Test (DARHT) Facility will employ two electron linear induction accelerators to produce intense, bremsstrahlung x-ray pulses for flash radiography with sub-millimeter spatial resolution of very dense (attentuations>10{sup 5}), dynamic objects. We will produce an intense x-ray pulse using a 19.75-MeV, 3.5-4 kA, 60-ns flattop electron beam focused on a tungsten target. A 3.75-MeV injector with either a cold velvet cathode or a laser-driven photocathode will produce a beam to be accelerated through a series of 64 ferrite-loaded induction cells with solenoid focusing. Accelerator technology demonstrations have been underway for several years at the DARHT Integrated Test Stand and results including beam energy, emittance, and beam breakup measurements are discussed.

  19. DARHT status and preparations for dual-axis hydrotesting (u)

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    Bowman, David W [Los Alamos National Laboratory

    2010-01-01

    The status of the DARHT facility, including a history of events that have taken place since the end of the DARHT Second Axis Refurbishment Project, is discussed. Technical and operational enhancements that have been made will be addressed, and recent technical challenges, such as the RF noise in the kicker region, are discussed. Historical data on reliability of the second axis is discussed, as well as operational changes made to enhance reliability. In addition, the path forward for integrating the second axis into overall DARHT operations in preparation for a hydrotest is addressed. Timing integration tests are accompanied by a series of tests to evaluate neutron contamination and cross-axis scatter, with attempts being made to provide adequate shielding to minimize the effects of neutrons and cross-beam scatter. The discussion includes results of the testing performed to-date, and concludes with a discussion of the path forward for dual-axis hydrotesting at DARHT.

  20. Cervical accelerometry in preterm infants.

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    Reynolds, Eric W; Vice, Frank L; Bosma, James F; Gewolb, Ira H

    2002-09-01

    The objective of this study was to develop a method to use digital signal processing (DSP) technology to describe quantitatively and statistically swallow-associated sounds in preterm infants and to use this method to analyze changes as infants mature. Twelve recordings of accelerometric and physiological data on bottle-feeding preterm infants between 32 and 39 weeks' postmenstrual age (PMA) were analyzed. Cervical auscultation was performed using an accelerometer attached over the larynx. Acoustic data were recorded and graphically displayed using DSP software. Initial discrete sounds (IDSs) were identified and used to construct an average waveform from which a 'variance index' (VI) was calculated for each infant. The shape of the IDS waveforms became progressively more uniform with advancing PMA, as indicated by a significant inverse correlation between VI and PMA (r=0.739; p=0.006). DSP technology facilitated the development of a new method to quantitatively analyze feeding in preterm infants. This method provides an elegant tool to track maturation of infant feeding and assessing feeding readiness. This technique makes the interpretation of cervical auscultation data less subjective by replacing the verbal description of the sounds of feeding with quantitative numeric values. It is anticipated that this method can be automated to facilitate further the analysis of cervical accelerometry data.

  1. Contact lens intolerance: refitting with dual axis lens for corneal refractive therapy

    Science.gov (United States)

    López-López, María; Pelegrín-Sánchez, José Miguel; Sobrado-Calvo, Paloma; García-Ayuso, Diego

    2011-01-01

    Corneal refractive therapy is a non-surgical procedure whose main purpose is to improve uncorrected visual acuity during the day, without spectacles or contact lenses. We report an adult woman who shows contact lens intolerance and does not want to wear eyeglasses. We used dual axis contact lens to improve lens centration. We demonstrate a maintained unaided visual acuity during one year of treatment. In conclusion, we can consider refitting with dual axis lens for corneal refractive therapy as a non-surgical option for patients who show contact lens intolerance.

  2. Dual Axis Radiographic Hydrodynamic Test Facility mitigation action plan. Annual report for 1998

    Energy Technology Data Exchange (ETDEWEB)

    Haagenstad, T.

    1999-01-15

    This Mitigation Action Plan Annual Report (MAPAR) has been prepared as part of implementing the Dual Axis Radiographic Hydrodynamic Test Facility (DARHT) Mitigation Action Plan (MAP) to protect workers, soils, water, and biotic and cultural resources in and around the facility.

  3. Handheld multispectral dual-axis confocal microscope for cervical cancer screening

    Science.gov (United States)

    Sarapukdee, Pongsak; Rattanavarin, Santi; Jarujareet, Ungkarn; Khemthongcharoen, Numfon; Jolivot, Romuald; Jung, Il Woong; López, Daniel; Mandella, Michael J.; Piyawattanametha, Wibool

    2013-03-01

    Our work demonstrates a MEMS based handheld dual-axis confocal microscope for cervical cancer screening. Imaging demonstration is performed with plant and animal tissue biopsies. The data is collected and displayed in real time with 2-5 Hz frame rates.

  4. Sun-Relative Pointing for Dual-Axis Solar Trackers Employing Azimuth and Elevation Rotations

    Energy Technology Data Exchange (ETDEWEB)

    Riley, Daniel [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hansen, Clifford W. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-12-30

    Dual axis trackers employing azimuth and elevation rotations are common in the field of photovoltaic (PV) energy generation. Accurate sun-tracking algorithms are widely available. However, a steering algorithm has not been available to accurately point the tracker away from the sun such that a vector projection of the sun beam onto the tracker face falls along a desired path relative to the tracker face. We have developed an algorithm which produces the appropriate azimuth and elevation angles for a dual axis tracker when given the sun position, desired angle of incidence, and the desired projection of the sun beam onto the tracker face. Development of this algorithm was inspired by the need to accurately steer a tracker to desired sun-relative positions in order to better characterize the electro-optical properties of PV and CPV modules.

  5. Tracking formulas and strategies for a receiver oriented dual-axis tracking toroidal heliostat

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Minghuan; Wang, Zhifeng; Liang, Wenfeng; Zhang, Xiliang; Zang, Chuncheng [Key Laboratory of Solar Thermal Energy and Photovoltaic System of Chinese Academy of Sciences, Institute of Electrical Engineering, Beijing 100190 (China); Lu, Zhenwu; Wei, Xiudong [Changchun Institute of Optics, Fine Mechanics and Physics, Chinese Academy of Sciences (CAS), Jilin 130033 (China)

    2010-06-15

    A 4 m x 4 m toroidal heliostat with receiver oriented dual-axis tracking, also called spinning-elevation tracking, was developed as an auxiliary heat source for a hydrogen production system. A series of spinning-elevation tracking formulas have been derived for this heliostat. This included basic tracking formulas, a formula for the elevation angle for heliostat with a mirror-pivot offset, and a more general formula for the biased elevation angle. This paper presents the new tracking formulas in detail and analyzes the accuracy of applying a simplifying approximation. The numerical results show these receiver oriented dual-axis tracking formula approximations are accurate to within 2.5 x 10{sup -6} m in image plane. Some practical tracking strategies are discussed briefly. Solar images from the toroidal heliostat at selected times are also presented. (author)

  6. Design of Dual Axis Laser Scanning Diameter Measuring Gauge System with PID Co

    Institute of Scientific and Technical Information of China (English)

    LI Xin-qiu; LI Zhi-wei; LIU Da-jiang

    2009-01-01

    Dual axis laser scanning diameter measuring gauge system(DALSDMGS)with PID controller,which can be used for online non-contact diameter measuring and control on the hose,wire and rod production line,is introduced.The measure principle and implementation of this system are also presented.A PID control module with PID parameters tuning is included in the measuring and control system,which functions as a PID automatic controller of the diameter.

  7. Evaluation of the prototype dual-axis wall attitude measurement sensor

    Science.gov (United States)

    Wong, Douglas T.

    1994-01-01

    A prototype dual-axis electrolytic tilt sensor package for angular position measurements was built and evaluated in a laboratory environment. The objective was to investigate the use of this package for making wind tunnel wall attitude measurements for the National Transonic Facility (NTF) at NASA Langley Research Center (LaRC). The instrumentation may replace an existing, more costly, and less rugged servo accelerometer package (angle-of-attack package) currently in use. The dual-axis electrolytic tilt sensor package contains two commercial electrolytic tilt sensors thermally insulated with NTF foam, all housed within a stainless steel package. The package is actively heated and maintained at 160 F using foil heating elements. The laboratory evaluation consisted of a series of tests to characterize the linearity, repeatability, cross-axis interaction, lead wire effect, step response, thermal time constant, and rectification errors. Tests revealed that the total RMS errors for the x-axis sensor is 0.084 degree, and 0.182 degree for the y-axis sensor. The RMS errors are greater than the 0.01 degree specification required for NTF wall attitude measurements. It is therefore not a viable replacement for the angle-of-attack package in the NTF application. However, with some physical modifications, it can be used as an inexpensive 5-degree range dual-axis inclinometer with overall accuracy approaching 0.01 degree under less harsh environments. Also, the data obtained from the tests can be valuable for wind tunnel applications of most types of electrolytic tilt sensors.

  8. A dual-axis tilt acquisition geometry for digital musculoskeletal tomosynthesis

    Science.gov (United States)

    Levakhina, Yulia M.; Duschka, Robert L.; Vogt, Florian M.; Barkhausen, Joerg; Buzug, Thorsten M.

    2013-07-01

    Digital tomosynthesis (DT) is a limited angle tomographic x-ray technique. It is an attractive low-dose alternative to computed tomography (CT) in many imaging applications. However, the DT dataset is incomplete, which leads to out-of-focus artifacts and limited axial resolution. In this paper, a novel dual-axis tilt acquisition geometry is proposed and evaluated. This geometry solves some issues in tomosynthesis with the traditional scanning geometry by scanning the object with a set of perpendicular arcs. In this geometry the acquisition in the additional perpendicular direction is done using a tiltable object supporting platform. The proposed geometry allows for capturing more singularities of the Radon transform, filling the Fourier space with more data and better approximating the Tuy-Smith conditions. In order to evaluate the proposed system, several studies have been carried out. To validate the simulation setup the performance of the traditional scanning geometry has been simulated and compared to known results from the literature. It has also been shown that the possible improvement of the image quality in the traditional geometry is limited. These limitations can be partially overcome by using the proposed dual-axis tilt geometry. The novel geometry is superior and with the same number of projections better reconstructed images can be obtained. All studies have been made using a software tomosynthesis simulator. A micro-CT reconstruction of a bone has been used as a software phantom. Simultaneous algebraic reconstruction has been used to reconstruct simulated projections. As a conclusion, acquiring data outside the standard arc allows for improving performance of musculoskeletal tomosynthesis. With the proposed dual-axis acquisition geometry a performance gain is achieved without an increase in dose and major modifications to the instrumentation of existing tomosynthesis devices.

  9. Painful swallowing

    Science.gov (United States)

    ... Ulcer in the esophagus, especially due to the antibiotic doxycycline Other causes of swallowing problems include: Mouth or throat ulcers Something stuck in the throat (for example, fish or chicken bones) Tooth infection or abscess

  10. Development of Dual-Axis MEMS Accelerometers for Machine Tools Vibration Monitoring

    Directory of Open Access Journals (Sweden)

    Chih-Yung Huang

    2016-07-01

    Full Text Available With the development of intelligent machine tools, monitoring the vibration by the accelerometer is an important issue. Accelerometers used for measuring vibration signals during milling processes require the characteristics of high sensitivity, high resolution, and high bandwidth. A commonly used accelerometer is the lead zirconate titanate (PZT type; however, integrating it into intelligent modules is excessively expensive and difficult. Therefore, the micro electro mechanical systems (MEMS accelerometer is an alternative with the advantages of lower price and superior integration. In the present study, we integrated two MEMS accelerometer chips into a low-pass filter and housing to develop a low-cost dual-axis accelerometer with a bandwidth of 5 kHz and a full scale range of ±50 g for measuring machine tool vibration. In addition, a platform for measuring the linearity, cross-axis sensitivity and frequency response of the MEMS accelerometer by using the back-to-back calibration method was also developed. Finally, cutting experiments with steady and chatter cutting were performed to verify the results of comparing the MEMS accelerometer with the PZT accelerometer in the time and frequency domains. The results demonstrated that the dual-axis MEMS accelerometer is suitable for monitoring the vibration of machine tools at low cost.

  11. Attitude Heading Reference System Using MEMS Inertial Sensors with Dual-Axis Rotation

    Directory of Open Access Journals (Sweden)

    Li Kang

    2014-09-01

    Full Text Available This paper proposes a low cost and small size attitude and heading reference system based on MEMS inertial sensors. A dual-axis rotation structure with a proper rotary scheme according to the design principles is applied in the system to compensate for the attitude and heading drift caused by the large gyroscope biases. An optimization algorithm is applied to compensate for the installation angle error between the body frame and the rotation table’s frame. Simulations and experiments are carried out to evaluate the performance of the AHRS. The results show that the proper rotation could significantly reduce the attitude and heading drifts. Moreover, the new AHRS is not affected by magnetic interference. After the rotation, the attitude and heading are almost just oscillating in a range. The attitude error is about 3° and the heading error is less than 3° which are at least 5 times better than the non-rotation condition.

  12. Attitude heading reference system using MEMS inertial sensors with dual-axis rotation.

    Science.gov (United States)

    Kang, Li; Ye, Lingyun; Song, Kaichen; Zhou, Yang

    2014-09-29

    This paper proposes a low cost and small size attitude and heading reference system based on MEMS inertial sensors. A dual-axis rotation structure with a proper rotary scheme according to the design principles is applied in the system to compensate for the attitude and heading drift caused by the large gyroscope biases. An optimization algorithm is applied to compensate for the installation angle error between the body frame and the rotation table's frame. Simulations and experiments are carried out to evaluate the performance of the AHRS. The results show that the proper rotation could significantly reduce the attitude and heading drifts. Moreover, the new AHRS is not affected by magnetic interference. After the rotation, the attitude and heading are almost just oscillating in a range. The attitude error is about 3° and the heading error is less than 3° which are at least 5 times better than the non-rotation condition.

  13. Dual axis translation apparatus and system for translating an optical beam and related method

    Science.gov (United States)

    Cassidy, Kelly

    1991-01-01

    A dual axis translation device and system in accordance with this invention, for translating an optical beam along both an x-axis and a y-axis which are perpendicular to one another, has a beam directing means acting on said optical beam for directing the beam along a particular path transverse to said x and y axes. An arrangement supporting said beam directing means for movement in the x and y direction within a given plane is provided. The arrangement includes a first means for translating said beam directing means along the x-axis in said given plane in order to translate the beam along said x-axis. The arrangement comprises a second means for translating said beam directing means along the y-axis in said given plane in order to translate the beam along said y-axis.

  14. Dual-axis, high data-rate atom interferometer via cold ensemble exchange

    CERN Document Server

    Rakholia, Akash V; Biedermann, Grant W

    2014-01-01

    We demonstrate a dual-axis accelerometer and gyroscope atom interferometer, which forms the building blocks of a six-axis inertial measurement unit. By recapturing the atoms after the interferometer sequence, we maintain a large atom number at high data-rates of 50 to 100 measurements per second. Two cold ensembles are formed in trap zones located a few centimeters apart, and are launched toward one-another. During their ballistic trajectory, they are interrogated with a stimulated Raman sequence, detected, and recaptured in the opposing trap zone. We achieve sensitivities at $\\mathrm{\\mu \\mathit{g} / \\sqrt{Hz}}$ and $\\mathrm{\\mu rad / s / \\sqrt{Hz}}$ levels, making this a compelling prospect for expanding the use of atom interferometer inertial sensors beyond benign laboratory environments.

  15. Robust motion control design for dual-axis motion platform using evolutionary algorithm

    Indian Academy of Sciences (India)

    Horn-Yong Jan; Chun-Liang Lin; Ching-Huei Huang; Thong-Shing Hwang

    2008-12-01

    This paper presents a new approach to deal with the dual-axis control design problem for a mechatronic platform. The cross-coupling effect leading to contour errors is effectively resolved by incorporating a neural net-based decoupling compensator. Conditions for robust stability are derived to ensure the closedloop system stability with the decoupling compensator. An evolutionary algorithm possessing the universal solution seeking capability is proposed for finding the optimal connecting weights of the neural compensator and PID control gains for the and axis control loops. Numerical studies and a real-world experiment for a watch cambered surface polishing platform have verified performance and applicability of our proposed design.

  16. Accurate Compensation of Attitude Angle Error in a Dual-Axis Rotation Inertial Navigation System

    Science.gov (United States)

    Jiang, Rui; Yang, Gongliu; Zou, Rui; Wang, Jing; Li, Jing

    2017-01-01

    In the dual-axis rotation inertial navigation system (INS), besides the gyro error, accelerometer error, rolling misalignment angle error, and the gimbal angle error, the shaft swing angle and the axis non-orthogonal angle also affect the attitude accuracy. Through the analysis of the structure, we can see that the shaft swing angle and axis non-orthogonal angle will produce coning errors which cause the fluctuation of the attitude. According to the analysis of the rotation vector, it can be seen that the coning error will generate additional drift velocity along the rotating shaft, which can reduce the navigation precision of the system. In this paper, based on the establishment of the modulation average frame, the vector projection is carried out, and then the attitude conversion matrix and the attitude error matrix mainly including the shaft swing angle and axis non-orthogonal are obtained. Because the attitude angles are given under the static condition, the shaft swing angle and the axis non-orthogonal angle are estimated by the static Kalman filter (KF). This kind of KF method has been widely recognized as the standard optimal estimation tool for estimating the parameters such as coning angles (α1 , α2), initial phase angles (ϕ1,ϕ2), and the non-perpendicular angle (η). In order to carry out the system level verification, a dual axis rotation INS is designed. Through simulation and experiments, the results show that the amplitudes of the attitude angles’ variation are reduced by about 20%–30% when the shaft rotates. The attitude error equation is reasonably simplified and the calibration method is accurate enough. The attitude accuracy is further improved. PMID:28304354

  17. Dual-Axis Solar Tracking System for Maximum Power Production in PV Systems

    Directory of Open Access Journals (Sweden)

    Muhd.Ikram Mohd. Rashid

    2015-12-01

    Full Text Available The power developed in a solar energy system depends fundamentally upon the amount of sunlight captured by the photovoltaic modules/arrays. This paper describes a simple electro-mechanical dual axis solar tracking system designed and developed in a study. The control of the two axes was achieved by the pulses generated from the data acquisition (DAQ card fed into four relays. This approach was so chosen to effectively avoid the error that usually arises in sensor-based methods. The programming of the mathematical models of the solar elevation and azimuth angles was done using Borland C++ Builder. The performance and accuracy of the developed system was evaluated with a PV panel at latitude 3.53o N and longitude 103.5o W in Malaysia. The results obtained reflect the effectiveness of the developed tracking system in terms of the energy yield when compared with that generated from a fixed panel. Overall, 20%, 23% and 21% additional energy were produced for the months of March, April and May respectively using the tracker developed in this study.

  18. Development of a MEMS dual-axis differential capacitance floating element shear stress sensor

    Energy Technology Data Exchange (ETDEWEB)

    Barnard, Casey [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Griffin, Benjamin [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    A single-axis MEMS wall shear stress sensor with differential capacitive transduction method is produced. Using a synchronous modulation and demodulation interface circuit, the system is capable of making real time measurements of both mean and fluctuating wall shear stress. A sensitivity of 3.44 mV/Pa is achieved, with linearity in response demonstrated up to testing limit of 2 Pa. Minimum detectable signals of 340 μPa at 100 Hz and 120 μPa at 1 kHz are indicated, with a resonance of 3.5 kHz. Multiple full scale wind tunnel tests are performed, producing spectral measurements of turbulent boundary layers in wind speeds ranging up to 0.5 Ma (18 Pa of mean wall shear stress). The compact packaging allows for minimally invasive installation, and has proven relatively robust over multiple testing events. Temperature sensitivity, likely due to poor CTE matching of packaged materials, is an ongoing concern being addressed. These successes are being directly leveraged into a development plan for a dual-axis wall shear stress sensor, capable of producing true vector estimates at the wall.

  19. In vivo near-infrared dual-axis confocal microendoscopy in the human lower gastrointestinal tract

    Science.gov (United States)

    Piyawattanametha, Wibool; Ra, Hyejun; Qiu, Zhen; Friedland, Shai; Liu, Jonathan T. C.; Loewke, Kevin; Kino, Gordon S.; Solgaard, Olav; Wang, Thomas D.; Mandella, Michael J.; Contag, Christopher H.

    2012-02-01

    Near-infrared confocal microendoscopy is a promising technique for deep in vivo imaging of tissues and can generate high-resolution cross-sectional images at the micron-scale. We demonstrate the use of a dual-axis confocal (DAC) near-infrared fluorescence microendoscope with a 5.5-mm outer diameter for obtaining clinical images of human colorectal mucosa. High-speed two-dimensional en face scanning was achieved through a microelectromechanical systems (MEMS) scanner while a micromotor was used for adjusting the axial focus. In vivo images of human patients are collected at 5 frames/sec with a field of view of 362×212 μm2 and a maximum imaging depth of 140 μm. During routine endoscopy, indocyanine green (ICG) was topically applied a nonspecific optical contrasting agent to regions of the human colon. The DAC microendoscope was then used to obtain microanatomic images of the mucosa by detecting near-infrared fluorescence from ICG. These results suggest that DAC microendoscopy may have utility for visualizing the anatomical and, perhaps, functional changes associated with colorectal pathology for the early detection of colorectal cancer.

  20. Induction cell breakdown experiments for the Dual-Axis Radiographic Hydrotest (DARHT) Facility

    Energy Technology Data Exchange (ETDEWEB)

    Earley, L.M.; Barnes, G.A.; Eversole, S.A.; Kauppila, T.J.; Keel, G.; Liska, D.J.; Moir, D.C.; Parsons, W.M.; Rader, D.C.

    1991-01-01

    Linear induction cells for the Dual-Axis Radiographic Hydrotest (DARHT) Facility have been tested to determine their high-voltage breakdown characteristics. A variety of full scale insulators were tested both in actual cells and in fixtures simulating induction cells. All insulators were constructed using cross-linked polystyrene (Rexolite). High-voltage pulses up to 550 kV were applied to the insulators using both a 60-ns pulse Blumlein and a 200-ns pulse cable Marx. Two different vacuum gaps were used in these tests, 1.46 and 1.91 cm. The tests were performed at various vacuum levels ranging from 1 {times} 10{sup {minus}6} to 5 {times} 10{sup {minus}8} torr. Breakdown tests of the insulators were also performed with an electron beam generated in the vacuum gap through the use of a velvet emitter. The gap voltage and current were measured using calibrated E-dot and B-dot probes. 15 refs., 7 figs.

  1. Dual axis radiographic hydrodynamic test facility. Final environmental impact statement, Volume 2: Public comments and responses

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    On May 12, 1995, the U.S. Department of Energy (DOE) issued the draft Dual Axis Radiographic Hydrodynamic Test Facility Environmental Impact Statement (DARHT EIS) for review by the State of New Mexico, Indian Tribes, local governments, other Federal agencies, and the general public. DOE invited comments on the accuracy and adequacy of the draft EIS and any other matters pertaining to their environmental reviews. The formal comment period ran for 45 days, to June 26, 1995, although DOE indicated that late comments would be considered to the extent possible. As part of the public comment process, DOE held two public hearings in Los Alamos and Santa Fe, New Mexico, on May 31 and June 1, 1995. In addition, DOE made the draft classified supplement to the DARHT EIS available for review by appropriately cleared individuals with a need to know the classified information. Reviewers of the classified material included the State of New Mexico, the U.S. Environmental Protection Agency, the Department of Defense, and certain Indian Tribes. Volume 2 of the final DARHT EIS contains three chapters. Chapter 1 includes a collective summary of the comments received and DOE`s response. Chapter 2 contains the full text of the public comments on the draft DARHT EIS received by DOE. Chapter 3 contains DOE`s responses to the public comments and an indication as to how the comments were considered in the final EIS.

  2. Transverse beam motion on the second axis of the dual axis radiographic hydrodynamic test facility

    Energy Technology Data Exchange (ETDEWEB)

    Caporaso, G J; Chen, Y J; Fawley, W M; Paul, A C

    1999-03-23

    The accelerator on the second-axis of the Dual-Axis Radiographic Hydrodynamic Test (DARHT-II) facility will generate a 20 MeV, 2-4 kA, 2 µs long electron beam with an energy variation {<=} ± 0.5%. Four short current pulses with various lengths will be selected out of this 2 µs long current pulse and delivered to an x-ray converter target. The DARHT-II radiographic resolution requires these electron pulses to be focused to sub-millimeter spots on Bremsstrahlung targets with peak-to-peak transverse beam motion less than a few hundred microns. We have modeled the transverse beam motion, including the beam breakup instability, corkscrew motion, transverse resistive wall instability and beam induced transverse deflection in the kicker system, from the DARHT-II injector exit to the x-ray converter target. Simulations show that the transverse motion at the x-ray converters satisfies the DARHT-II radiographic requirements.

  3. Dual Axis Radiographic Hydrodynamic Test Facility mitigation action plan. Annual report for 1997

    Energy Technology Data Exchange (ETDEWEB)

    Haagenstad, H.T.

    1998-01-15

    This Mitigation Action Plan Annual Report (MAPAR) has been prepared by the US Department of Energy (DOE) as part of implementing the Dual Axis Radiographic Hydrodynamic Test Facility (DARHT) Mitigation Action Plan (MAP). This MAPAR provides a status on specific DARHT facility design- and construction-related mitigation actions that have been initiated in order to fulfill DOE`s commitments under the DARHT MAP. The functions of the DARHT MAP are to (1) document potentially adverse environmental impacts of the Phased Containment Option delineated in the Final EIS, (2) identify commitments made in the Final EIS and ROD to mitigate those potential impacts, and (3) establish Action Plans to carry out each commitment (DOE 1996). The DARHT MAP is divided into eight sections. Sections 1--5 provide background information regarding the NEPA review of the DARHT project and an introduction to the associated MAP. Section 6 references the Mitigation Action Summary Table which summaries the potential impacts and mitigation measures; indicates whether the mitigation is design-, construction-, or operational-related; the organization responsible for the mitigation measure; and the projected or actual completion data for each mitigation measure. Sections 7 and 8 discuss the Mitigation Action Plan Annual Report and Tracking System commitment and the Potential Impacts, Commitments, and Action Plans respectively. Under Section 8, potential impacts are categorized into five areas of concern: General Environment, including impacts to air and water; Soils, especially impacts affecting soil loss and contamination; Biotic Resources, especially impacts affecting threatened and endangered species; Cultural/Paleontological Resources, especially impacts affecting the archeological site known as Nake`muu; and Human Health and Safety, especially impacts pertaining to noise and radiation. Each potential impact includes a brief statement of the nature of the impact and its cause(s). The commitment

  4. A feasibility study of stationary and dual-axis tracking grid-connected photovoltaic systems in the Upper Midwest

    Science.gov (United States)

    Warren, Ryan Duwain

    Three primary objectives were defined for this work. The first objective was to determine, assess, and compare the performance, heat transfer characteristics, economics, and feasibility of real-world stationary and dual-axis tracking grid-connected photovoltaic (PV) systems in the Upper Midwest. This objective was achieved by installing two grid-connected PV systems with different mounting schemes in central Iowa, implementing extensive data acquisition systems, monitoring operation of the PV systems for one full year, and performing detailed experimental performance and economic studies. The two PV systems that were installed, monitored, and analyzed included a 4.59 kWp roof-mounted stationary system oriented for maximum annual energy production, and a 1.02 kWp pole-mounted actively controlled dual-axis tracking system. The second objective was to demonstrate the actual use and performance of real-world stationary and dual-axis tracking grid-connected PV systems used for building energy generation applications. This objective was achieved by offering the installed PV systems to the public for demonstration purposes and through the development of three computer-based tools: a software interface that has the ability to display real-time and historical performance and meteorological data of both systems side-by-side, a software interface that shows real-time and historical video and photographs of each system, and a calculator that can predict performance and economics of stationary and dual-axis tracking grid-connected PV systems at various locations in the United States. The final objective was to disseminate this work to social, professional, scientific, and academic communities in a way that is applicable, objective, accurate, accessible, and comprehensible. This final objective will be addressed by publishing the results of this work and making the computer-based tools available on a public website (www.energy.iastate.edu/Renewable/solar). Detailed experimental

  5. Measuring physical strain during ambulation with accelerometry

    NARCIS (Netherlands)

    Bussmann, J B; Hartgerink, I; van der Woude, L H; Stam, H J

    2000-01-01

    PURPOSE: To study the feasibility of ambulatory accelerometry in the evaluation of physical strain in walking at different speeds and different levels of economy. METHODS: Twelve able-bodied subjects performed a walking test on a treadmill with increasing walking speed. After a 6-wk period, these me

  6. Comparison of Efficiencies of Solar Tracker systems with static panel Single- Axis Tracking System and Dual-Axis Tracking System with Fixed Mount

    Directory of Open Access Journals (Sweden)

    Dhanabal.R

    2013-04-01

    Full Text Available Electricity plays a key role now in our daily lives but the energy sources to electric power has been used in abundance and so researchers were compelled to find an alternate source of power leading to the discovery of solar energy. Solar energy is inexhaustible and eco-friendly and can be converted into electricityusing photovoltaic panels. These panels can be used in a fixed form or used in a solar tracking system for single axis as well as for dual axis. In a fixed form their efficiency is low since the panels will be tilted in a particular angle whereas in a tracking system the panel is made to move either in single axis or dual axis. In a single axis system the panel is moved in an east to west direction with respect to the sun and it has better efficiency than panels in fixed form. But in a dual axis system the panel is made to rotate in all four directions in accordance with the sun. And dual axis has proved to have more efficiency than both fixed panels and single axis system.

  7. Feeding and Swallowing Disorders (Dysphagia) in Children

    Science.gov (United States)

    ... for the Public / Speech, Language and Swallowing / Swallowing Feeding and Swallowing Disorders (Dysphagia) in Children What are ... children with feeding and swallowing disorders ? What are feeding and swallowing disorders? Feeding disorders include problems gathering ...

  8. Bessel-beam illumination in dual-axis confocal microscopy mitigates resolution degradation caused by refractive heterogeneities.

    Science.gov (United States)

    Chen, Ye; Glaser, Adam; Liu, Jonathan T C

    2017-01-01

    One of the main challenges for laser-scanning microscopy of biological tissues with refractive heterogeneities is the degradation in spatial resolution that occurs as a result of beam steering and distortion. This challenge is particularly significant for dual-axis confocal (DAC) microscopy, which achieves improved spatial-filtering and optical-sectioning performance over traditional confocal microscopy through off-axis illumination and collection of light with low-numerical aperture (NA) beams that must intersect precisely at their foci within tissues. DAC microscope image quality is sensitive to positional changes and distortions of these illumination- and collection-beam foci. Previous studies have shown that Bessel beams display improved positional stability and beam quality than Gaussian beams when propagating through tissues with refractive heterogeneities, which suggests that Bessel-beam illumination may enhance DAC microscopy of such tissues. Here, we utilize both Gaussian and Bessel illumination in a point-scanned DAC microscope and quantify the resultant degradation in resolution when imaging within heterogeneous optical phantoms and fresh tissues. Results indicate that DAC microscopy with Bessel illumination exhibits reduced resolution degradation from microscopic tissue heterogeneities compared to DAC microscopy with conventional Gaussian illumination. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. High precision dual-axis tracking solar wireless charging system based on the four quadrant photoelectric sensor

    Science.gov (United States)

    Liu, Zhilong; Wang, Biao; Tong, Weichao

    2015-08-01

    This paper designs a solar automatic tracking wireless charging system based on the four quadrant photoelectric sensor. The system track the sun's rays automatically in real time to received the maximum energy and wireless charging to the load through electromagnetic coupling. Four quadrant photoelectric sensor responsive to the solar spectrum, the system could get the current azimuth and elevation angle of the light by calculating the solar energy incident on the sensor profile. System driver the solar panels by the biaxial movement mechanism to rotate and tilt movement until the battery plate and light perpendicular to each other. Maximize the use of solar energy, and does not require external power supply to achieve energy self-sufficiency. Solar energy can be collected for portable devices and load wireless charging by close electromagnetic field coupling. Experimental data show that: Four quadrant photoelectric sensor more sensitive to light angle measurement. when track positioning solar light, Azimuth deviation is less than 0.8°, Elevation angle deviation is less than 0.6°. Use efficiency of a conventional solar cell is only 10% -20%.The system uses a Four quadrant dual-axis tracking to raise the utilization rate of 25% -35%.Wireless charging electromagnetic coupling efficiency reached 60%.

  10. Radionuclides in Small Mammals Collected at the Dual-Axis Radiographic Hydrodynamic Test (DARHT) Facility during 2001-- 2003

    Energy Technology Data Exchange (ETDEWEB)

    P.R. Fresquez

    2005-01-20

    Rodents are effective indicators of environmental contamination and the Dual-Axis Radiographic Hydrodynamic Test (DARHT) Facility Mitigation Action Plan specifies the (radionuclide) comparison of small mammals to baseline levels to determine if there are any impacts as a result of operations. Consequently, samples of (whole body) field mice (Peromyscus spp.) were collected from within the grounds of the DARHT facility at Los Alamos National Laboratory, Technical Area 15, from 2001 through 2003. Samples were analyzed for {sup 3}H, {sup 137}Cs, {sup 90}Sr, {sup 241}Am, {sup 238}Pu, {sup 239,240}Pu, {sup 234}U, {sup 235}U, and {sup 238}U. Results, which represent three years since the start of operations in 2000, were compared with baseline statistical reference level (BSRL) data established over a four-year-long preoperational period. Most radionuclides in mice were either at nondetectable levels or within BSRLs. The few radionuclides that were above BSRLs included U isotopes; and the ratios of some samples indicated depleted U sources. Although the amounts of U in some samples were just above BSRLs, and since depleted U is less soluble and less toxic (chemical and radioactive) than naturally occurring U, the very small levels in the mice collected around the DARHT facility grounds are unlikely to pose a threat to predators that feed upon them.

  11. Performance of Dual-Axis Solar Tracker versus Static Solar System by Segmented Clearness Index in Malaysia

    Directory of Open Access Journals (Sweden)

    Jhee Fhong Lee

    2013-01-01

    Full Text Available The performance of Dual-Axis Solar Tracker (DAST and Static Solar System (SSS with respect to clearness index in Malaysia is presented. An attempt to investigate the correlation between clearness index with energy gain and efficiency of DAST over SSS is being done experimentally. A good correlation could not be found out from the daily clearness index. It is due to the more profound advantage of DAST in the morning and evening compared to midday as it is able to follow the sun’s position. Hence, the daily clearness index is divided into three segments which are morning, midday, and evening to interpret the energy gain and efficiency better. A clearer correlation with low standard deviation can be observed on the segmented clearness index analysis. The energy gain and efficiency of seven cities in Malaysia is being estimated with the segmented clearness index and compared to the result generated from anisotropic radiation model. A similar trend is obtained and it has shown that the segmented clearness index could be utilized as a graphical method for estimation of energy gain and efficiency of DAST over SSS.

  12. [Dysphagia and swallowing rehabilitation].

    Science.gov (United States)

    Shigematsu, Takashi; Fujishima, Ichiro

    2015-02-01

    Dysphagia is a life-threatening disorder caused by many medical conditions such as stroke, neurological disorders, tumors, etc. The symptoms of dysphagia are quite variable and diagnosed by observation or through screening involving instrumental swallowing examinations such as video-fluoroscopy and video-endoscopy, to determine functional severity and treatment-prognosis. Direct- and indirect-therapy is used with and without food, respectively. Swallowing rehabilitation is very effective, and could be used in conjunction with compensatory techniques. Here we present an overview of dysphagia and swallowing rehabilitation.

  13. The Videofluorographic Swallowing Study

    Science.gov (United States)

    Martin-Harris, Bonnie; Jones, Bronwyn

    2008-01-01

    SYNOPSIS The evidence for the physiologic foundation and interpretation of the videofluorographic swallowing study (VFSS) is described. The purpose and clinical utility of VFSS are explained. Standardization of the VFSS procedure, protocol, interpretation and reporting is highlighted as a critical step in future clinical practice and in clinical research. Individualized, evidenced –based rehabilitation strategies are presented as key components that are systematically applied during the VFSS procedure and integrated into the swallowing management plan. A new tool that has been developed and tested for the quantification of swallowing impairment is introduced. PMID:18940640

  14. Videofluoroscopic Swallowing Study (VFSS)

    Science.gov (United States)

    ... More Than One Language Adult Speech and Language Child Speech and Language Swallowing and Feeding Self-Help Groups Find a Professional Advertising Disclaimer Advertise with us The ASHA Leader  Speech- ...

  15. Randomized study on the safety and efficacy of dual-axis rotational versus standard coronary angiography in the Chinese population

    Institute of Scientific and Technical Information of China (English)

    LIU Hui-liang; JIN Zhi-geng; YANG Sheng-li; LUO Jian-ping; MA Dong-xing; LIU Ying; HAN Wei

    2012-01-01

    Background Dual-axis rotational coronary angiography (DARCA) was developed as an innovative adaptation of rotational angiography (RA),but it requires a longer coronary injection compared to standard coronary angiography (SA).As the body of the average Chinese patient is smaller than that of most western patients,with the same contrast injection time,the risk of complications from the contrast agent is increased in this population.The purpose of this study was to assess the clinical safety and efficacy of DARCA in the diagnosis of coronary artery disease (CAD) in the Chinese population by directly comparing it to SA.Methods Two hundred Chinese patients were randomized to either the SA group (n=100) or DARCA group (n=100).Contrast utilization,radiation exposure and procedure time were recorded for each modalities.Blood pressure (BP),heart rate (HR) pre and post injection symptoms and any arrhythmias were recorded.Results Compared to the SA group,there was a 42% reduction in contrast utilization,55% reduction in radiation exposure and a 31% shorter procedure time in the DARCA group.In both groups,there were slight declines in the systolic BP values in the left coronary artery (LCA) post injection (P <0.01).Moreover,post injection HRs for the LCA were also reduced in the DARCA group (P <0.01).But all of these changes were small,transient and without clinical importance.Only one patient (1%) in the DARCA group had an attack of ventricular tachycardia immediately post injection and it resolved by itself during LCA angiography.No arrhythmias occurred in the SA group.Conclusion DARCA is a safe,efficient,and clinically comparable altemative to SA in the diagnosis of coronary artery disease in the Chinese population with less contrast utilized,which is less radiation exposure and a shorter procedure time than SA.

  16. Coordination of the cortisol and testosterone responses: A dual axis approach to understanding the response to social status threats.

    Science.gov (United States)

    Turan, Bulent; Tackett, Jennifer L; Lechtreck, Maria T; Browning, Wesley R

    2015-12-01

    facilitate performance. These findings have implications for developing a dual axis understanding of physiological responses during social threats and competition and their function.

  17. Youth Physical Activity Resource Use and Activity Measured by Accelerometry

    Science.gov (United States)

    Maslow, Andra L.; Colabianchi, Natalie

    2011-01-01

    Objectives: To examine whether use of physical activity resources (e.g., parks) was associated with daily physical activity measured by accelerometry. Methods: One hundred eleven adolescents completed a travel diary with concurrent accelerometry. The main exposure was self-reported use of a physical activity resource (none /1 resources). The main…

  18. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...

  19. [Arrhythmias from swallowing].

    Science.gov (United States)

    Palazzuoli, V; Mondillo, S; Faglia, S; D'Aprile, N; De Luca, G; Kristodhullu, A; Corba, E

    1992-01-01

    We describe the case of a 51-year old, non cardiopathic patient, with recurrent attacks of supraventricular tachycardia induced by swallowing. In the existing literature we found several descriptions of hypokinetic arrhythmias, easily explained by a mechanism of vagal inhibition. The cases of predominantly hyperkinetic arrhythmias, however, are much less common. In these patients the origin of the disease seems to be due to sympathetic oesophageal fibers and superior and medium cardiac nerves. In the present case, as in the others reported in the literature, the drug of choice seems to be Amiodarone which appears to be the most effective in preventing tachyarrhythmias caused by swallowing.

  20. Comparison of Efficiencies of Solar Tracker systems with static panel Single- Axis Tracking System and Dual-Axis Tracking System with Fixed Mount

    OpenAIRE

    Dhanabal R; Bharathi.V; Ranjitha.R; Ponni.A; Deepthi S; Mageshkannan.P

    2013-01-01

    Electricity plays a key role now in our daily lives but the energy sources to electric power has been used in abundance and so researchers were compelled to find an alternate source of power leading to the discovery of solar energy. Solar energy is inexhaustible and eco-friendly and can be converted into electricityusing photovoltaic panels. These panels can be used in a fixed form or used in a solar tracking system for single axis as well as for dual axis. In a fixed form their efficiency is...

  1. Design and implementation of a Sun tracker with a dual-axis single motor for an optical sensor-based photovoltaic system.

    Science.gov (United States)

    Wang, Jing-Min; Lu, Chia-Liang

    2013-03-06

    The dual threats of energy depletion and global warming place the development of methods for harnessing renewable energy resources at the center of public interest. Solar energy is one of the most promising renewable energy resources. Sun trackers can substantially improve the electricity production of a photovoltaic (PV) system. This paper proposes a novel design of a dual-axis solar tracking PV system which utilizes the feedback control theory along with a four-quadrant light dependent resistor (LDR) sensor and simple electronic circuits to provide robust system performance. The proposed system uses a unique dual-axis AC motor and a stand-alone PV inverter to accomplish solar tracking. The control implementation is a technical innovation that is a simple and effective design. In addition, a scaled-down laboratory prototype is constructed to verify the feasibility of the scheme. The effectiveness of the Sun tracker is confirmed experimentally. To conclude, the results of this study may serve as valuable references for future solar energy applications.

  2. Design and Implementation of a Sun Tracker with a Dual-Axis Single Motor for an Optical Sensor-Based Photovoltaic System

    Directory of Open Access Journals (Sweden)

    Chia-Liang Lu

    2013-03-01

    Full Text Available The dual threats of energy depletion and global warming place the development of methods for harnessing renewable energy resources at the center of public interest. Solar energy is one of the most promising renewable energy resources. Sun trackers can substantially improve the electricity production of a photovoltaic (PV system. This paper proposes a novel design of a dual-axis solar tracking PV system which utilizes the feedback control theory along with a four-quadrant light dependent resistor (LDR sensor and simple electronic circuits to provide robust system performance. The proposed system uses a unique dual-axis AC motor and a stand-alone PV inverter to accomplish solar tracking. The control implementation is a technical innovation that is a simple and effective design. In addition, a scaled-down laboratory prototype is constructed to verify the feasibility of the scheme. The effectiveness of the Sun tracker is confirmed experimentally. To conclude, the results of this study may serve as valuable references for future solar energy applications.

  3. Comparison of accelerometry and oxymetry for measuring daily physical activity.

    Science.gov (United States)

    Yokoyama, Yumiko; Kawamura, Takashi; Tamakoshi, Akiko; Noda, Akiko; Hirai, Makoto; Saito, Hidehiko; Ohno, Yoshiyuki

    2002-08-01

    To assess the validity of accelerometry in measuring daily physical activity, the energy consumption calculated by accelerometry, with respiratory gas analysis as a reference, was evaluated in 45 non-athletes during various exercise tests. Subjects were required to (1) walk on a treadmill ergometer at various speeds, (2) walk on a treadmill ergometer at a fixed speed and with a stride of 20% more or 20% less than that when walking freely, (3) walk on a treadmill ergometer at a fixed speed wearing either sneakers or leather-soled shoes, and (4) cycle on a bicycle ergometer. There were strong linear relationships between the measurements during the progressively graded treadmill test, with an overall Pearson correlation coefficient of 0.97. The mean estimated difference ranged from -0.77 to 0.27 kcal/min and the coefficients of variation from 13.2% to 22.2%. However, the difference between the methods was not negligible for individual subjects. Accelerometry overestimated energy expenditure during short-step walking, and underestimated it during long-step walking. No significant difference in energy expenditure was found according to the type of shoes worn. Cycling activity was not recorded by accelerometry. Accelerometry is a reasonably accurate and feasible method for evaluating the physical activities of non-athletes, and could be a common tool for epidemiological research and health promotion despite its limitations.

  4. A handheld MEMS-based line-scanned dual-axis confocal microscope for early cancer detection and surgical guidance (Conference Presentation)

    Science.gov (United States)

    Chen, Ye; Yin, Chengbo; Wei, Linpeng; Glaser, Adam K.; Abeytunge, Sanjee; Peterson, Gary; Mandella, Michael J.; Sanai, Nader; Rajadhyaksha, Milind; Liu, Jonathan T.

    2017-02-01

    Considerable efforts have been recently undertaken to develop miniature optical-sectioning microscopes for in vivo microendoscopy and point-of-care pathology. These devices enable in vivo interrogation of disease as a real-time and noninvasive alternative to gold-standard histopathology, and therefore could have a transformative impact for the early detection of cancer as well as for guiding tumor-resection procedures. Regardless of the specific modality, various trade-offs in size, speed, field of view, resolution, contrast, and sensitivity are necessary to optimize a device for a particular application. Here, a miniature MEMS-based line-scanned dual-axis confocal (LS-DAC) microscope, with a 12-mm diameter distal tip, has been developed for point-of-care pathology. The dual-axis architecture has demonstrated superior rejection of out-of-focus and multiply scattered photons compared to a conventional single-axis confocal configuration. The use of line scanning enables fast frame rates (≥15 frames/sec), which mitigates motion artifacts of a handheld device during clinical use. We have developed a method to actively align the illumination and collection beams in this miniature LS-DAC microscope through the use of a pair of rotatable alignment mirrors. Incorporation of a custom objective lens, with a small form factor for in vivo application, enables the device to achieve an axial and lateral resolution of 2.0 and 1.1 microns, respectively. Validation measurements with reflective targets, as well as in vivo and ex vivo images of tissues, demonstrate that this high-speed LS-DAC microscope can achieve high-contrast imaging of fluorescently labeled tissues with sufficient sensitivity for applications such as oral cancer detection and guiding brain-tumor resections.

  5. Multisite accelerometry for sleep and wake classification in children.

    Science.gov (United States)

    Lamprecht, Marnie L; Bradley, Andrew P; Tran, Tommy; Boynton, Alison; Terrill, Philip I

    2015-01-01

    Actigraphy is a useful alternative to the gold standard polysomnogram for non-invasively measuring sleep and wakefulness. However, it is unable to accurately assess sleep fragmentation due to its inability to differentiate restless sleep from wakefulness and quiet wake from sleep. This presents significant limitations in the assessment of sleep-related breathing disorders where sleep fragmentation is a common symptom. We propose that this limitation may be caused by hardware constraints and movement representation techniques. Our objective was to determine if multisite tri-axial accelerometry improves sleep and wake classification. Twenty-four patients aged 6-15 years (median: 8 years, 16 male) underwent a diagnostic polysomnogram while simultaneously recording motion from the left wrist and index fingertip, upper thorax and left ankle and great toe using a custom accelerometry system. Movement was quantified using several features and two feature selection techniques were employed to select optimal features for restricted feature set sizes. A heuristic was also applied to identify movements during restless sleep. The sleep and wake classification performance was then assessed and validated against the manually scored polysomnogram using discriminant analysis. Tri-axial accelerometry measured at the wrist significantly improved the wake detection when compared to uni-axial accelerometry (specificity at 85% sensitivity: 71.3(14.2)% versus 55.2(24.7)%, p wrist placement (specificity at 85% sensitivity: 82.1(12.5)% versus 71.3(14.2)%, p < 0.05). Our results indicate that multisite accelerometry offers a significant performance benefit which could be further improved by analysing movement in raw multisite accelerometry data.

  6. Youth physical activity resource use and activity measured by accelerometry.

    Science.gov (United States)

    Maslow, Andréa L; Colabianchi, Natalie

    2011-01-01

    To examine whether use of physical activity resources (eg, parks) was associated with daily physical activity measured by accelerometry. One hundred eleven adolescents completed a travel diary with concurrent accelerometry. The main exposure was self-reported use of a physical activity resource (none /1+ resources). The main outcomes were total minutes spent in daily (1) moderate-vigorous physical activity and (2) vigorous physical activity. Using a physical activity resource was significantly associated with total minutes in moderate-vigorous physical activity. African Americans and males had significantly greater moderate-vigorous physical activity. Results from this study support the development and use of physical activity resources.

  7. Youth Physical Activity Resources Use and Activity Measured by Accelerometry

    Science.gov (United States)

    Maslow, Andréa L.; Colabianchi, Natalie

    2014-01-01

    Objectives To examine whether utilization of physical activity resources (eg, parks) was associated with daily physical activity measured by accelerometry. Methods 111 adolescents completed a travel diary with concurrent accelerometry. The main exposure was self-reported utilization of a physical activity resource (none/1+ resources). The main outcomes were total minutes spent in daily 1) moderate-vigorous physical activity and 2) vigorous physical activity. Results Utilizing a physical activity resource was significantly associated with total minutes in moderate-vigorous physical activity. African-Americans and males had significantly greater moderate-vigorous physical activity. Conclusions Results from this study support the development and use of physical activity resources. PMID:21204684

  8. Gait analysis using accelerometry in dystrophin-deficient dogs.

    Science.gov (United States)

    Barthélémy, Inès; Barrey, Eric; Thibaud, Jean-Laurent; Uriarte, Ane; Voit, Thomas; Blot, Stéphane; Hogrel, Jean-Yves

    2009-11-01

    Dogs affected with Golden Retriever Muscular Dystrophy (GRMD) exhibit striking clinical similarities with patients suffering from Duchenne muscular dystrophy (DMD), particularly gait impairments. The purpose of this study was to describe the use and reliability of accelerometry in gait assessment of dogs with muscular dystrophy. Eight healthy and 11 GRMD adult dogs underwent three gait assessment sessions, using accelerometry. Three-axial recordings of accelerations were performed, and gait variables calculated. Total power, force and regularity of accelerations, stride length and speed, normalized by height at withers, stride frequency, and cranio-caudal power were significantly decreased, whereas medio-lateral power was significantly increased in GRMD dogs. Moreover, these variables were repeatable within and between sessions. Accelerometry provides reliable variables which highlight specific gait patterns of GRMD dogs, describing objectively and quantitatively their slow, short-stepped, and swaying gait. As it is easy to set-up, quick to perform and inexpensive, accelerometry represents a useful tool, to assess locomotion during pre-clinical trials.

  9. Endoscopic Evaluation of Swallowing (Endoscopy)

    Science.gov (United States)

    ... More Than One Language Adult Speech and Language Child Speech and Language Swallowing and Feeding Self-Help Groups Find a Professional Advertising Disclaimer Advertise with us The ASHA Leader  Speech- ...

  10. Vertical and dual-axis vibration of the seated human body: Nonlinearity, cross-axis coupling, and associations between resonances in transmissibility and apparent mass

    Science.gov (United States)

    Zheng, Guangtai; Qiu, Yi; Griffin, Michael J.

    2012-12-01

    The vertical apparent mass of the human body exhibits nonlinearity, with the principal resonance frequency reducing as the vibration magnitude increases. Measures of the transmission of vibration to the spine and the pelvis have suggested complex modes are responsible for the dominant resonance during vertical excitation, but the modes present with dual-axis excitation have not been investigated. This study was designed to examine how the apparent mass and transmissibility of the human body depend on the magnitude of vertical excitation and the addition of fore-and-aft excitation, and the relation between the apparent mass and the transmissibility of the body. The movement of the body (over the first, fifth and twelfth thoracic vertebrae, the third lumbar vertebra, and the pelvis) in the fore-and-aft and vertical directions (and in pitch at the pelvis) was measured in 12 male subjects sitting with their hands on their laps during random vertical vibration excitation (over the range 0.25-20 Hz) at three vibration magnitudes (0.25, 0.5 and 1.0 m s-2 rms). At the highest magnitude of vertical excitation (1.0 m s-2 rms) the effect of adding fore-aft vibration (at 0.25, 0.5, and 1.0 m s-2 rms) was investigated. The forces in the vertical and fore-and-aft directions on the seat surface were also measured so as to calculate apparent masses. Resonances in the apparent mass and transmissibility to the spine and pelvis in the fore-and-aft and vertical directions, and pitch transmissibility to the pelvis, shifted to lower frequencies as the magnitude of vertical excitation increased and as the magnitude of the additional fore-and-aft excitation increased. The nonlinear resonant behaviour of the apparent mass and transmissibility during dual-axis vibration excitation suggests coupling between the principal mode associated with vertical excitation and the cross-axis influence of fore-and-aft excitation. The transmissibility measures are consistent with complex modes

  11. Assessing delivery and quantifying efficacy of small interfering ribonucleic acid therapeutics in the skin using a dual-axis confocal microscope.

    Science.gov (United States)

    Ra, Hyejun; Gonzalez-Gonzalez, Emilio; Smith, Bryan R; Gambhir, Sanjiv S; Kino, Gordon S; Solgaard, Olav; Kaspar, Roger L; Contag, Christopher H

    2010-01-01

    Transgenic reporter mice and advances in imaging instrumentation are enabling real-time visualization of cellular mechanisms in living subjects and accelerating the development of novel therapies. Innovative confocal microscope designs are improving their utility for microscopic imaging of fluorescent reporters in living animals. We develop dual-axis confocal (DAC) microscopes for such in vivo studies and create mouse models where fluorescent proteins are expressed in the skin for the purpose of advancing skin therapeutics and transdermal delivery tools. Three-dimensional image volumes, through the different skin compartments of the epidermis and dermis, can be acquired in several seconds with the DAC microscope in living mice, and are comparable to histologic analyses of reporter protein expression patterns in skin sections. Intravital imaging with the DAC microscope further enables visualization of green fluorescent protein (GFP) reporter gene expression in the skin over time, and quantification of transdermal delivery of small interfering RNA (siRNA) and therapeutic efficacy. Visualization of transdermal delivery of nucleic acids will play an important role in the development of innovative strategies for treating skin pathologies.

  12. Assessing delivery and quantifying efficacy of small interfering ribonucleic acid therapeutics in the skin using a dual-axis confocal microscope

    Science.gov (United States)

    Ra, Hyejun; Gonzalez-Gonzalez, Emilio; Smith, Bryan R.; Gambhir, Sanjiv S.; Kino, Gordon S.; Solgaard, Olav; Kaspar, Roger L.; Contag, Christopher H.

    2010-05-01

    Transgenic reporter mice and advances in imaging instrumentation are enabling real-time visualization of cellular mechanisms in living subjects and accelerating the development of novel therapies. Innovative confocal microscope designs are improving their utility for microscopic imaging of fluorescent reporters in living animals. We develop dual-axis confocal (DAC) microscopes for such in vivo studies and create mouse models where fluorescent proteins are expressed in the skin for the purpose of advancing skin therapeutics and transdermal delivery tools. Three-dimensional image volumes, through the different skin compartments of the epidermis and dermis, can be acquired in several seconds with the DAC microscope in living mice, and are comparable to histologic analyses of reporter protein expression patterns in skin sections. Intravital imaging with the DAC microscope further enables visualization of green fluorescent protein (GFP) reporter gene expression in the skin over time, and quantification of transdermal delivery of small interfering RNA (siRNA) and therapeutic efficacy. Visualization of transdermal delivery of nucleic acids will play an important role in the development of innovative strategies for treating skin pathologies.

  13. 双轴伺服太阳能跟踪器控制系统设计%Design of Dual-Axis Servo Solar Energy Tracker Control System

    Institute of Scientific and Technical Information of China (English)

    郑春娇; 石玉峰

    2013-01-01

    This paper designed a dual-axis servo solar tracker based on single chip micyoco (SCM). The whole system consisted of minimum system of SCM, position detection circuit, irradiance comparison circuit, clock circuit, keyboard circuit, motor speed regu-lation circuit and angular position sensor. The software included the calculation of solar altitude and azimuth angle, the main program and each functional module subprograms. The results from debugging and running show that the system is stable, precisely tracking the sun in real time.%设计了基于单片机的双轴伺服太阳能跟踪器。整个系统由单片机最小系统、四路方位检测电路、辐照度比较电路、时钟电路、键盘电路、电机调速电路和角度传感器等组成,软件部分包括太阳高度角和方位角计算、主程序及各个功能模块子程序。经实物模型调试运行结果表明,系统工作稳定、实时性好,能够正确完成对太阳的跟踪。

  14. Swallowing disorders after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Gabriela Camargo Remesso

    2011-10-01

    Full Text Available OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7 (p<0.001. Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001 and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001. CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

  15. Hierarchy of individual calibration levels for heart rate and accelerometry to measure physical activity

    DEFF Research Database (Denmark)

    Brage, Søren; Ekelund, Ulf; Brage, Niels

    2007-01-01

    Combining accelerometry with heart rate (HR) monitoring may improve precision of physical activity measurement. Considerable variation exists in the relationships between physical activity intensity (PAI) and HR and accelerometry, which may be reduced by individual calibration. However, individual......, submaximal step and walk tests with and without calorimetry, and nonexercise calibration using sleeping HR and gender. Reference accelerometry and HR models explained >95% of the between-individual variance in PAI (P

  16. Swallowing disorders in Parkinson's disease.

    Science.gov (United States)

    Mamolar Andrés, Sandra; Santamarina Rabanal, María Liliana; Granda Membiela, Carla María; Fernández Gutiérrez, María José; Sirgo Rodríguez, Paloma; Álvarez Marcos, César

    Parkinson's disease is a type of chronic neurodegenerative pathology with a typical movement pattern, as well as different, less studied symptoms such as dysphagia. Disease-related disorders in efficacy or safety in the process of swallowing usually lead to malnutrition, dehydration or pneumonias. The aim of this study was identifying and analyzing swallowing disorders in Parkinson's disease. The initial sample consisted of 52 subjects with Parkinson's disease to whom the specific test for dysphagia SDQ was applied. Nineteen participants (36.5%) with some degree of dysphagia in the SDQ test were selected to be evaluated by volume-viscosity clinical exploration method and fiberoptic endoscopic evaluation of swallowing. Disorders in swallowing efficiency and safety were detected in 94.7% of the selected sample. With regards to efficiency, disorders were found in food transport (89.5%), insufficient labial closing (68.4%) and oral residues (47.4%), relating to duration of ingestion. Alterations in security were also observed: pharynx residues (52.7%), coughing (47.4%), penetration (31.64%), aspiration and decrease of SaO2 (5.3%), relating to the diagnosis of respiratory pathology in the previous year. The SDQ test detected swallowing disorders in 36.5% of the subjects with Parkinson's disease. Disorders in swallowing efficiency and safety were demonstrated in 94.7% of this subset. Disorders of efficiency were more frequent than those of safety, establishing a relationship with greater time in ingestion and the appearance of respiratory pathology and pneumonias. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  17. A contrasting study: cliff and bank swallows

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the project was to contrast as population of Cliff Swallows and a population of Bank Swallows. Both populations had nests located in a gravel pit near...

  18. A Kind of Dual-axis Automatic Tracking Solar Energy Device%一种基于双轴的太阳能自动跟踪装置

    Institute of Scientific and Technical Information of China (English)

    张新亮

    2015-01-01

    为了提高太阳能电池的转换效率,设计了一种以M sp430F149单片机为核心,基于双轴的太阳能自动跟踪装置。该装置能精确跟踪太阳运动轨迹,使太阳能电池组件在晴天时始终垂直接收太阳光;在阴天时自动切换至时钟式跟踪,其转换效率高、成本低。实验结果表明,对比固定安装的太阳能电池板,在相同条件下,采用太阳能自动跟踪装置的太阳能电池板的接收率提高了约40%。%A novel automatic dual-axis tracking solar energy device with the core of Msp430F149 is designed to improve conversion efficiency of the solar panel .The solar energy device can make solar panel always vertical to the sunlight at sunny day .Otherwise , the clock model will be used .The device is of high conversion efficiency and low cost .The experiment indicates that compared with the device that the solar panel is fixed ,the new device can improve the efficiency by 40% in a day under the same condition .

  19. 双轴伺服太阳能跟踪系统的设计%Design of the Dual-axis Servo Solar Energy Tracking System

    Institute of Scientific and Technical Information of China (English)

    汤世松; 舒志兵

    2011-01-01

    In order to fully utilize solar energy with high efficiency, the dual-axis servo solar tracking system based on PLC has been designed.By adopting sun motion trajectory tracking strategy, the position of the sun in daytime is calctdated by controller in accordance with related formula and parameters, then the altitude and azimuth are converted into corresponding pulses to be sended to servo driver; and the servo motor tracks the sun in real time.Therefore, the solar energy panel is always tilting towards the sun when the system tracks the sun from east to west,thus maximum solar energy is obtained.The theoretical analysis indicates that by adopting this tracking technology, the efficiency of receiving solar energy can be increased.%为了更充分、高效地利用太阳能,设计了基于PLC的双轴伺服太阳能跟踪系统.该系统采用视日运动轨迹跟踪方案,控制器根据相关的公式和参数计算出白天太阳的位置,再将高度角和方位角转化成相应的脉冲发送给伺服驱动器,驱动伺服电机实时跟踪太阳.同时,系统使太阳能板随着太阳的高度变化而倾斜,从而获得最大的太阳能.理论分析表明,采用该跟踪技术可以有效地提高能量接收率.

  20. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools, prevalen

  1. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  2. Coordination of mastication, swallowing and breathing

    Directory of Open Access Journals (Sweden)

    Koichiro Matsuo

    2009-05-01

    Full Text Available The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth; it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx and larynx serve multiple functions in breathing, speaking, mastication and swallowing. Thus, the fine temporal coordination of feeding among breathing, mastication and swallowing is essential to provide proper food nutrition and to prevent pulmonary aspiration. This review paper will review the temporo-spatial coordination of the movements of oral, pharyngeal, and laryngeal structures during mastication and swallowing, and temporal coordination between breathing, mastication, and swallowing.

  3. Coordination of Mastication, Swallowing and Breathing.

    Science.gov (United States)

    Matsuo, Koichiro; Palmer, Jeffrey B

    2009-05-01

    The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth, it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx and larynx serve multiple functions in breathing, speaking, mastication and swallowing. Thus, the fine temporal coordination of feeding among breathing, mastication and swallowing is essential to provide proper food nutrition and to prevent pulmonary aspiration. This review paper will review the temporo-spatial coordination of the movements of oral, pharyngeal, and laryngeal structures during mastication and swallowing, and temporal coordination between breathing, mastication, and swallowing.

  4. Concentrations of Radionuclides and Trace Elements in Environmantal Media arond te Dual-Axis Radiographic Hydrodynamic Test Facilit at Los Alamos National Laboratory during 2005

    Energy Technology Data Exchange (ETDEWEB)

    G.J.Gonzales; P.R. Fresquez; C.D.Hathcock; D.C. Keller

    2006-05-15

    The Mitigation Action Plan (MAP) for the Dual-Axis Radiographic Hydrodynamic Test (DARHT) facility at Los Alamos National Laboratory requires that samples of biotic and abiotic media be collected after operations began to determine if there are any human health or environmental impacts. The DARHT facility is the Laboratory's principal explosive test facility. To this end, samples of soil and sediment, vegetation, bees, and birds were collected around the facility in 2005 and analyzed for concentrations of {sup 3}H, {sup 137}Cs, {sup 90}Sr, {sup 238}Pu, {sup 239,240}Pu, {sup 241}Am, {sup 234}U, {sup 235}U, {sup 238}U, Ag, As, Ba, Be, Cd, Cr, Cu, Hg, Ni, Pb, Sb, Se, and Tl. Bird populations have also been monitored. Contaminant results, which represent up to six sample years since the start of operations, were compared with (1) baseline statistical reference levels (BSRLs) established over a four-year preoperational period before DARHT facility operations, (2) screening levels (SLs), and (3) regulatory standards. Most radionuclides and trace elements were below BSRLs and those few samples that contained radionuclides and trace elements above BSRLs were below SLs. Concentrations of radionuclides and nonradionuclides in biotic and abiotic media around the DARHT facility do not pose a significant human health hazard. The total number of birds captured and number of species represented were similar in 2003 and 2004, but both of these parameters increased substantially in 2005. Periodic interruption of the scope and schedule identified in the MAP generally should have no impact on meeting the intent of the MAP. The risk of not sampling one of the five media in any given year is that if a significant impact to contaminant levels were to occur there would exist a less complete understanding of the extent of the change to the baseline for these media and to the ecosystem as a whole. Since the MAP is a requirement that was established under the regulatory framework of

  5. Surface electromyography pattern of human swallowing

    Directory of Open Access Journals (Sweden)

    Spadaro Alessandro

    2008-03-01

    Full Text Available Abstract Background The physiology of swallowing is characterized by a complex and coordinated activation of many stomatognathic, pharyngeal, and laryngeal muscles. Kinetics and electromyographic studies have widely investigated the pharyngeal and laryngeal pattern of deglutition in order to point out the differences between normal and dysphagic people. In the dental field, muscular activation during swallowing is believed to be the cause of malocclusion. Despite the clinical importance given to spontaneous swallowing, few physiologic works have studied stomatognathic muscular activation and mandibular movement during spontaneous saliva swallowing. The aim of our study was to investigate the activity patterns of the mandibular elevator muscles (masseter and anterior temporalis muscles, the submental muscles, and the neck muscles (sternocleidomastoid muscles in healthy people during spontaneous swallowing of saliva and to relate the muscular activities to mandibular movement. Methods The spontaneous swallowing of saliva of 111 healthy individuals was analyzed using surface electromyography (SEMG and a computerized kinesiography of mandibular movement. Results Fifty-seven of 111 patients swallowed without occlusal contact (SNOC and 54 individuals had occlusal contact (SOC. The sternocleidomastoid muscles showed a slight, but constant activation during swallowing. The SEMG of the submental and sternocleidomastoid muscles showed no differences between the two groups. The SEMG of the anterior temporalis and masseter muscles showed significant differences (p Conclusion The data suggest that there is not a single "normal" or "typical" pattern for spontaneous saliva swallowing. The polygraph seemed a valuable, simple, non-invasive and reliable tool to study the physiology of swallowing.

  6. 空间太阳电池阵双轴驱动机构设计及热分析%Design and Thermal Analysis of Space Dual-axis Solar Array Drive Assembly

    Institute of Scientific and Technical Information of China (English)

    李建辉; 李瑞祥; 钱志源

    2011-01-01

    This paper introduced a lightweight Dual-axis solar array drive assembly (SADA), aiming at two key technologies of lightweight and long life.The Dual-axis SADA consists of A-axis which provides 360° of rotation and power transfer through the use of a slip ring device and B-axis which provides ±90° of travel and incorporates a simple flex loop for power transfer.The accelerated life test of key moving parts of SADA including the slip ring and the harmonic reducer were preformed and passed.The designed principle prototype of SADA has some merits, such as compact structure, good stiffness and light weight.The thermal analysis of the Dual-axis SADA had been preformed.The measures of thermal control are presented by comparing temperature distribution under different schemes.%针对空间太阳电池阵驱动机构的轻量化和长寿命两大关键技术,研制了一种轻小型双轴驱动机构,该机构由连续转动轴(A轴)和有限角度转动轴(B轴)组成,连续转动轴利用导电滑环传输电能,机构具有结构紧凑、刚度好以及重量轻等优点.并通过了包括导电滑环和谐波减速器在内的关键活动部件加速寿命试验考核.利用热分析软件对双轴驱动机构进行了热分析仿真,通过比较不同热控方案下的温度场分布,确定了可以采用的热控措施.

  7. Two techniques to make swallowing pills easier.

    Science.gov (United States)

    Schiele, Julia T; Schneider, Hendrik; Quinzler, Renate; Reich, Gabriele; Haefeli, Walter E

    2014-01-01

    To evaluate whether 2 techniques (the pop-bottle method for tablets and the lean-forward technique for capsules) ease swallowing of tablets and capsules, we conducted a cross-sectional study including 151 adults of the general German population. Participants swallowed 16 differently shaped placebos, rated their ease of swallowing on an 8-point Likert scale, and swallowed the 2 dosage forms that they had rated most difficult again using the appropriate technique. The pop-bottle method substantially improved swallowing of tablets in 59.7% (169/283) and the lean-forward technique for capsules in 88.6% (31/35). Both techniques were remarkably effective in participants with and without reported difficulties swallowing pills and should be recommended regularly.

  8. Surface Electromyographic Assessment of Swallowing Function

    Directory of Open Access Journals (Sweden)

    Marziyeh Poorjavad

    2017-03-01

    Full Text Available The reliability of surface electromyographic (sEMG variables during swallowing determines the potential usefulness of these measures in swallowing assessment and treatment. This study aimed to establish the reliability of the sEMG measures of the swallowing function of muscles during different swallowing conditions in healthy young and old volunteers. Two groups of volunteers (24 older adults, 10 younger adults participated in this cross-sectional study during 2014. The activity of masseter, submental, and infrahyoid groups were measured using sEMG during three repetitions of different swallowing tasks. Both the relative and absolute reliability (characterized respectively by ICC, SEM%, and SRD% were calculated for the sEMG indices of muscle activity during swallowing events. Statistical analyses were performed by the SPSS 19.0 and Microsoft Excel 2007 software packages. Statistical significance was set at P≤0.05. The relative reliability calculations showed significant agreements between repetitions for the mean and peak amplitude and the average of median frequency (MDF of the studied muscles function during most swallowing types in both groups. However, the duration and particularly the time to peak of muscle activity showed significant agreements during fewer swallowing conditions. Excluding MDF, we found high SEM% and SRD% for the studied measures (particularly timing measures of muscles function during most swallowing types in both groups. The reliability of sEMG measures was influenced by the age and swallowing types. Our findings suggest that the MDF of muscle function during almost all studied swallowing types can be a reliable measure for the sEMG assessment of swallowing function in both younger and older adults.

  9. Surface Electromyographic Assessment of Swallowing Function.

    Science.gov (United States)

    Poorjavad, Marziyeh; Talebian, Saeed; Ansari, Noureddin Nakhostin; Soleymani, Zahra

    2017-03-01

    The reliability of surface electromyographic (sEMG) variables during swallowing determines the potential usefulness of these measures in swallowing assessment and treatment. This study aimed to establish the reliability of the sEMG measures of the swallowing function of muscles during different swallowing conditions in healthy young and old volunteers. Two groups of volunteers (24 older adults, 10 younger adults) participated in this cross-sectional study during 2014. The activity of masseter, submental, and infrahyoid groups were measured using sEMG during three repetitions of different swallowing tasks. Both the relative and absolute reliability (characterized respectively by ICC, SEM%, and SRD%) were calculated for the sEMG indices of muscle activity during swallowing events. Statistical analyses were performed by the SPSS 19.0 and Microsoft Excel 2007 software packages. Statistical significance was set at P≤0.05. The relative reliability calculations showed significant agreements between repetitions for the mean and peak amplitude and the average of median frequency (MDF) of the studied muscles function during most swallowing types in both groups. However, the duration and particularly the time to peak of muscle activity showed significant agreements during fewer swallowing conditions. Excluding MDF, we found high SEM% and SRD% for the studied measures (particularly timing measures) of muscles function during most swallowing types in both groups. The reliability of sEMG measures was influenced by the age and swallowing types. Our findings suggest that the MDF of muscle function during almost all studied swallowing types can be a reliable measure for the sEMG assessment of swallowing function in both younger and older adults.

  10. Coordination of mastication, swallowing and breathing

    OpenAIRE

    Koichiro Matsuo; Palmer, Jeffrey B.

    2009-01-01

    The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth, it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx an...

  11. Lung Volume during Swallowing: Single Bolus Swallows in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen M. Wheeler; Huber, Jessica E.; Pitts, Teresa; Sapienza, Christine M.

    2009-01-01

    Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed. Method: Nine men and 11 women between the ages of 19 and 28 years…

  12. Lung Volume during Swallowing: Single Bolus Swallows in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen M. Wheeler; Huber, Jessica E.; Pitts, Teresa; Sapienza, Christine M.

    2009-01-01

    Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed. Method: Nine men and 11 women between the ages of 19 and 28 years…

  13. Surface electromyography pattern of human swallowing.

    Science.gov (United States)

    Monaco, Annalisa; Cattaneo, Ruggero; Spadaro, Alessandro; Giannoni, Mario

    2008-03-26

    The physiology of swallowing is characterized by a complex and coordinated activation of many stomatognathic, pharyngeal, and laryngeal muscles. Kinetics and electromyographic studies have widely investigated the pharyngeal and laryngeal pattern of deglutition in order to point out the differences between normal and dysphagic people. In the dental field, muscular activation during swallowing is believed to be the cause of malocclusion.Despite the clinical importance given to spontaneous swallowing, few physiologic works have studied stomatognathic muscular activation and mandibular movement during spontaneous saliva swallowing.The aim of our study was to investigate the activity patterns of the mandibular elevator muscles (masseter and anterior temporalis muscles), the submental muscles, and the neck muscles (sternocleidomastoid muscles) in healthy people during spontaneous swallowing of saliva and to relate the muscular activities to mandibular movement. The spontaneous swallowing of saliva of 111 healthy individuals was analyzed using surface electromyography (SEMG) and a computerized kinesiography of mandibular movement. Fifty-seven of 111 patients swallowed without occlusal contact (SNOC) and 54 individuals had occlusal contact (SOC). The sternocleidomastoid muscles showed a slight, but constant activation during swallowing. The SEMG of the submental and sternocleidomastoid muscles showed no differences between the two groups. The SEMG of the anterior temporalis and masseter muscles showed significant differences (p swallowing was significantly higher in the SNOC subjects. Gender and age were not related to electromyographic activation. Healthy SOC and SNOC behaved in different ways. The data suggest that there is not a single "normal" or "typical" pattern for spontaneous saliva swallowing. The polygraph seemed a valuable, simple, non-invasive and reliable tool to study the physiology of swallowing.

  14. Assessing volume of accelerometry data for reliability in preschool children.

    Science.gov (United States)

    Hinkley, Trina; O'Connell, Eoin; Okely, Anthony D; Crawford, David; Hesketh, Kylie; Salmon, Jo

    2012-12-01

    This study examines what volume of accelerometry data (h·d) is required to reliably estimate preschool children's physical activity and whether it is necessary to include weekday and weekend data. Accelerometry data from 493 to 799 (depending on wear time) preschool children from the Melbourne-based Healthy Active Preschool Years study were used. The percentage of wear time each child spent in total (light-vigorous) physical activity was the main outcome. Hourly increments of daily data were analyzed. t-tests, controlling for age and clustering by center of recruitment, assessed the differences between weekday and weekend physical activity. Intraclass correlation coefficients estimated reliability for an individual day. Spearman-Brown prophecy formula estimated the number of days required to reach reliability estimates of 0.7, 0.8, and 0.9. The children spent a significantly greater percentage of time being physically active on weekend compared with weekdays regardless of the minimum number of hours included (t = 12.49-16.76, P 8 d of data were required to reach a reliability estimate of 0.7 with 10 or more hours of data per day; 3.3-3.4 d were required to meet the same reliability estimate for days with 7 h of data. Future studies should ensure they include the minimum amount of data (hours per day and number of days) as identified in this study to meet at least a 0.7 reliability level and should report the level of reliability for their study. In addition to weekdays, at least one weekend day should be included in analyses to reliably estimate physical activity levels for preschool children.

  15. Swallowing: A Professional and Parental Perspective

    Science.gov (United States)

    Roche, William J.; Petronchak, JoAnn; Eicher, Peggy S.

    2008-01-01

    For humans, successful drinking is a necessity early in life. In fact, swallowing can be observed with ultrasound at approximately the 16th week of pregnancy. The fetus "drinks" amniotic fluid as a way to filter fetal debris and to help maintain the amniotic fluid level for its mother. All this "swallowing practice" in utero enables the fetus to…

  16. Unique contributions of ISCOLE to the advancement of accelerometry in large studies.

    Science.gov (United States)

    Tudor-Locke, C; Barreira, T V; Schuna, J M; Katzmarzyk, P T

    2015-12-01

    Accelerometry has become a mainstay approach for objectively monitoring children's physical activity and sedentary time in epidemiological studies. The magnitude of effort underlying successful data collection, management and treatment is prodigious and its complexity has been associated with increasingly diverse methodological choices that, while defensible relative to specific research questions, conspire to undermine the ability to compare results between studies. Although respecting widespread calls for best practices, it is also important to openly share tools and resources supporting potential improvements to research practice and study design, thus allowing others to replicate, further improve, and/or otherwise build on this foundation. The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is a large multinational study that included accelerometer-based measures of physical activity, sedentary time and sleep. This review summarizes the unique contributions of ISCOLE to the advancement of accelerometry in large studies of children's behavior, and in particular: (1) open-access publication of the ISCOLE accelerometry Manual of Operations; (2) 24-h waist-worn accelerometry protocol; (3) identification and extraction of nocturnal total sleep episode time (with open access to editable SAS syntax); (4) development of the first interpretive infrastructure for identifying and defining an evolved list of sleep-related variables from 24-h waist-worn accelerometry; (5) provision of a detailed model for reporting accelerometer paradata (administrative data related to accelerometry); and (6) cataloging the most detailed and defensible list of accelerometry-derived physical activity and sedentary time variables to date. The novel tools and resources associated with these innovations are shared openly in an effort to support methodological harmonization and overall advancement of accelerometry in large epidemiological studies.

  17. Coordination of suck-swallow and swallow respiration in preterm infants.

    Science.gov (United States)

    Lau, C; Smith, E O; Schanler, R J

    2003-06-01

    Safe oral feeding of infants necessitates the coordination of suck-swallow-breathe. Healthy full-term infants demonstrate such skills at birth. But, preterm infants are known to have difficulty in the transition from tube to oral feeding. To examine the relationship between suck and swallow and between swallow and breathe. It is hypothesized that greater milk transfer results from an increase in bolus size and/or swallowing frequency, and an improved swallow-breathe interaction. Twelve healthy preterm (swallowing, and respiration were recorded simultaneously when the preterm infants began oral feeding (i.e. taking 1-2 oral feedings/d) and at 6-8 oral feedings/d. The full-term infants were similarly monitored during their first and 2nd to 4th weeks. Rate of milk transfer (ml/min) was used as an index of oral feeding performance. Sucking and swallowing frequencies (#/min), average bolus size (ml), and suction amplitude (mmHg) were measured. The rate of milk transfer in the preterm infants increased over time and was correlated with average bolus size and swallowing frequency. Average bolus size was not correlated with swallowing frequency. Bolus size was correlated with suction amplitude, whereas the frequency of swallowing was correlated with sucking frequency. Preterm infants swallowed preferentially at different phases of respiration than those of their full-term counterparts. As feeding performance improved, sucking and swallowing frequency, bolus size, and suction amplitude increased. It is speculated that feeding difficulties in preterm infants are more likely to result from inappropriate swallow-respiration interfacing than suck-swallow interaction.

  18. Pill swallowing by adults with dysphagia.

    Science.gov (United States)

    Carnaby-Mann, Giselle; Crary, Michael

    2005-11-01

    To evaluate differences in swallowing physiology and safety in patients with dysphagia between conventional tablets and a new method of tablet transportation, orally disintegrating technology (ODT) (RapiTab; Schwarz Pharma Inc, Milwaukee, Wis). The study observed a single group, crossover design. Outpatient clinic within an academic teaching hospital. A total of 36 adult dysphagic patients referred to the clinic. All subjects underwent simultaneous nasopharyngeal endoscopic evaluation, surface electromyographic (sEMG) measurement, and respiratory monitoring during swallowing. Subjects were evaluated swallowing the ODT and a conventional tablet formulation. Tablets were randomly and blindly presented to each subject. Subjects completed a preference survey subsequent to swallowing both tablets. Significant differences included greater sEMG amplitude and longer apneic duration when swallowing a conventional tablet compared with the ODT (Pswallow durations (Pswallows per tablet (Pswallow. On a postevaluation survey, patients reported that they preferred the ODT preparation for most of the parameters assessed. Patients with dysphagia frequently complain of trouble swallowing medication. In this study, an ODT formulation provided a method of delivery that required less effort to swallow, did not result in increased levels of airway compromise, and was preferred by dysphagic patients. The ODT medication delivery technology may provide benefit to adults with dysphagia in convenience, compliance, and accuracy of dosing.

  19. Accelerometry cut points for physical activity in underserved African Americans

    Directory of Open Access Journals (Sweden)

    Trumpeter Nevelyn N

    2012-06-01

    Full Text Available Abstract Background Despite their increased use, no studies have examined the validity of Actical accelerometry cut points for moderate physical activity (PA in underserved (low-income, high-crime, minority populations. The high rates of chronic disease and physical inactivity in these populations likely impact the measurement of PA. There is growing concern that traditionally defined cut points may be too high for older or inactive adults. The present study aimed to determine the self-selected pace associated with instructions to “walk for exercise” and the corresponding accelerometry estimates (e.g., Actical counts/minute for underserved, African American adults. Method Fifty one participants (61% women had a mean age of 60.1 (SD = 9.9 and a mean body mass index of 30.5 kg/m2 (SD = 6.0. They performed one seated task, one standing task, and three walking tasks: “strolling”; “walking for exercise”; and “walking in an emergency.” Results The average pace for strolling, walking for exercise, and walking in an emergency were 1.62 miles per hour (mph; SD = .51, 2.51 mph (SD = .53, and 2.86 mph (SD = .58, respectively. The average Actical counts/minute for the five activities were: 4 (SD = 15, 16 (SD = 29, 751 (SD = 591, 2006 (SD = 1095, and 2617 (SD = 1169, respectively. Regression analyses showed that the predicted counts/minute for a pace of 2.0 mph (which is used as the criterion for moderate exercise in this study was 1075 counts/minute (SEM = 73. Conclusions The cut point associated with subjectively determined moderate PA is similar to those previously published for older adults and extends the use of adjusted cut points to African American populations. These results indicate that accurate cut points can be obtained using this innovative methodology.

  20. Lung Volume Measured during Sequential Swallowing in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen Wheeler; Huber, Jessica E.; Pitts, Teresa; Davenport, Paul W.; Sapienza, Christine M.

    2011-01-01

    Purpose: Outcomes from studying the coordinative relationship between respiratory and swallow subsystems are inconsistent for sequential swallows, and the lung volume at the initiation of sequential swallowing remains undefined. The first goal of this study was to quantify the lung volume at initiation of sequential swallowing ingestion cycles and…

  1. [Videofluoroscopy study of swallowing in neurogenic dysphagia].

    Science.gov (United States)

    Avdiunina, I A; Popova, L M; Dokuchaeva, N V; Bragina, L K; Dokuchaeva, N F

    2000-01-01

    Videofluoroscopy (VFS) was for the first time used for examining swallowing in 49 patients with nervous diseases. Disturbances in each phase of swallowing act are analyzed with evaluation of the time parameters and defects, causes of aspiration in neurogenic dysphagia are discussed, and cricopharyngeal insufficiency is described. Neurogenic dysphagia is characterized by a combination of disorders which determine the degree of dysphagia. The most severe swallowing disorders were observed in patients with multiple foci in the brain stem and in diphtheritic polyneuropathies. The authors conclude that VFS is the optimal method for the diagnosis of neurogenic dysphagia.

  2. Stuttered swallowing: Electric stimulation of the right insula interferes with water swallowing. A case report

    Directory of Open Access Journals (Sweden)

    Shoemaker J

    2011-02-01

    Full Text Available Abstract Background Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear. Case presentation Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity. Conclusions These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing.

  3. Comparison of Accelerometry Methods for Estimating Physical Activity.

    Science.gov (United States)

    Kerr, Jacqueline; Marinac, Catherine R; Ellis, Katherine; Godbole, Suneeta; Hipp, Aaron; Glanz, Karen; Mitchell, Jonathan; Laden, Francine; James, Peter; Berrigan, David

    2017-03-01

    This study aimed to compare physical activity estimates across different accelerometer wear locations, wear time protocols, and data processing techniques. A convenience sample of middle-age to older women wore a GT3X+ accelerometer at the wrist and hip for 7 d. Physical activity estimates were calculated using three data processing techniques: single-axis cut points, raw vector magnitude thresholds, and machine learning algorithms applied to the raw data from the three axes. Daily estimates were compared for the 321 women using generalized estimating equations. A total of 1420 d were analyzed. Compliance rates for the hip versus wrist location only varied by 2.7%. All differences between techniques, wear locations, and wear time protocols were statistically different (P machine-learned algorithm found 74% of participants with 150 min of walking/running per week. The wrist algorithms found 59% and 60% of participants with 150 min of physical activity per week using the raw vector magnitude and machine-learned techniques, respectively. When the wrist device was worn overnight, up to 4% more participants met guidelines. Estimates varied by 52% across techniques and by as much as 41% across wear locations. Findings suggest that researchers should be cautious when comparing physical activity estimates from different studies. Efforts to standardize accelerometry-based estimates of physical activity are needed. A first step might be to report on multiple procedures until a consensus is achieved.

  4. Accelerometry-based berg balance scale score estimation.

    Science.gov (United States)

    Simila, Heidi; Mantyjarvi, Jani; Merilahti, Juho; Lindholm, Mikko; Ermes, Miikka

    2014-07-01

    The objective of the study was to investigate the validity of 3-D-accelerometry-based Berg balance scale (BBS) score estimation. In particular, acceleration patterns of BBS tasks and gait were the targets of analysis. Accelerations of the lower back were measured during execution of the BBS test and corridor walking for 54 subjects, consisting of neurological patients, older adults, and healthy young persons. The BBS score was estimated from one to three BBS tasks and from gait-related data, separately, through assessment of the similarity of acceleration patterns between subjects. The work also validated both approaches' ability to classify subjects into high- and low-fall-risk groups. The gait-based method yielded the best BBS score estimates and the most accurate BBS-task-based estimates were produced with the stand to sit, reaching, and picking object tasks. The proposed gait-based method can identify subjects with high or low risk of falling with an accuracy of 77.8% and 96.6%, respectively, and the BBS-task based method with corresponding accuracy of 89.5% and 62.1%.

  5. Hard to swallow: dysphagia in Parkinson's disease

    National Research Council Canada - National Science Library

    Miller, Nick; Noble, Emma; Jones, Diana; Burn, David

    2006-01-01

    .... a total of 23 men and 14 women and their carers. participants were purposively sampled to give a mix of men, women, family circumstances, stage and duration of PD and severity of swallowing symptoms...

  6. Huntington's Disease: Speech, Language and Swallowing

    Science.gov (United States)

    ... Disease Society of America Huntington's Disease Youth Organization Movement Disorder Society National Institute of Neurological Disorders and Stroke Typical Speech and Language Development Learning More Than One Language Adult Speech and Language Child Speech and Language Swallowing ...

  7. Stuttered swallowing: Electric stimulation of the right insula interferes with water swallowing. A case report

    OpenAIRE

    Shoemaker J; Wong Savio WH; Al-Otaibi Faisal; Sörös Peter; Mirsattari Seyed M; Hachinski Vladimir; Martin Ruth E

    2011-01-01

    Abstract Background Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear. Case presentation Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimula...

  8. Swallowing assessment in myotonic dystrophy type 1 using fiberoptic endoscopic evaluation of swallowing (FEES).

    Science.gov (United States)

    Pilz, Walmari; Baijens, Laura W J; Passos, Valéria Lima; Verdonschot, Rob; Wesseling, Frederik; Roodenburg, Nel; Faber, Catharina G; Kremer, Bernd

    2014-12-01

    This study describes the swallowing function of patients with myotonic dystrophy type 1 (DM1) and the effect of bolus consistency on swallowing in this group. The aim of the study is twofold: (a) to identify which (and to what extent) swallowing variables change for DM1 patients relative to healthy control subjects and (b) to examine whether the degree of oropharyngeal dysphagia is associated with disease severity. Forty-five consecutive DM1 patients and ten healthy subjects underwent a swallowing assessment, at Maastricht University medical Center in the Netherlands. The assessment included a standardized fiberoptic endoscopic evaluation of swallowing (FEES) protocol using different bolus consistencies. Clinical severity of the disease was assessed using the muscular impairment rating scale (MIRS). Significant differences were found between patients and controls for all FEES variables. The magnitude of these differences depended on the bolus consistency. The odds of a more pathological swallowing outcome increased significantly with higher MIRS levels. In conclusion, swallowing function is found to be significantly altered in DM1 patients. The results emphasize the importance of conducting a detailed swallowing assessment in all patients, even those with mild muscle weakness.

  9. A Review of Accelerometry-Based Wearable Motion Detectors for Physical Activity Monitoring

    Directory of Open Access Journals (Sweden)

    Che-Chang Yang

    2010-08-01

    Full Text Available Characteristics of physical activity are indicative of one’s mobility level, latent chronic diseases and aging process. Accelerometers have been widely accepted as useful and practical sensors for wearable devices to measure and assess physical activity. This paper reviews the development of wearable accelerometry-based motion detectors. The principle of accelerometry measurement, sensor properties and sensor placements are first introduced. Various research using accelerometry-based wearable motion detectors for physical activity monitoring and assessment, including posture and movement classification, estimation of energy expenditure, fall detection and balance control evaluation, are also reviewed. Finally this paper reviews and compares existing commercial products to provide a comprehensive outlook of current development status and possible emerging technologies.

  10. Seed germination behavior of swallow wort

    Directory of Open Access Journals (Sweden)

    amir hosein pahlavani

    2009-06-01

    Full Text Available The exotic plant, Swallow- wort, a twining perennial of the Milkweed family, has become increasingly invasive in some place of Iran, especially orchards. Increased knowledge of wort germination biology would facilitate development of an optimum control program. Germination of Swallow wort seeds as affected by environmental factors was studied under controlled-environment growth chamber conditions. The following studies were conducted in plant Pests & Diseases Research Institute during the years 2003-4: 1- Effect of constant temperature on germination that including 10, 15, 18, 20, 25, 30, 35 and 40˚C; 2- Effect of light on constant germination; 3- Effect of temperature fluctuations on seed germination: 15/7, 20/12, 25/17 and 30/22˚C. All experiments were conducted with 8 replications. Swallow wort seeds showed no dormancy when detachment from mother plant. Seed germination was strongly influenced by temperature. Light did not play a crucial role on seed germination of this weed. Therefore Swallow wort seeds were not photoblastic and temperature fluctuations did not increase seed germination of Swallow wort. The above characteristics are very important in making swallowwort an invasive weed. Having precise information of these traits enables us to a better management and control of this troublesome weed.

  11. The interaction between breathing and swallowing in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Erdem, Nazan Simsek; Karaali, Kamil; Ünal, Ali; Kızılay, Ferah; Öğüş, Candan; Uysal, Hilmi

    2016-12-01

    The aim of the study is to determine the association between respiratory swallow patterns in amyotrophic lateral sclerosis (ALS) patients. Furthermore, it aims to clarify the role of the dysphagia limit in defining the relationship between swallowing disorders and respiratory disorders. Functional rating scales were used to describe swallowing and respiratory function. Swallowing was observed using the dysphagia limit. Dysphagia limit is the volume at which a second or more swallows are required to swallow the whole bolus. Laryngeal and chest movement sensors, pulmonary function tests, submental, and diaphragm electromyography activity were used to evaluate the relationship between swallowing and respiratory phase. Of the 27 patients included in the study, 14 were dysphagic and 13 were non-dysphagic. Tests showed normal respiratory function in 11 of the non-dysphagic patients and 3 of the dysphagic patients. There was a high correlation between the dysphagia limit and Amyotrophic Lateral Sclerosis Functional Rating Scale swallowing parameters. Non-dysphagic patients were able to swallow during inspiration but only six patients in the dysphagic group were able to swallow during inspiration. The occurrence of dysphagia in ALS is related to piecemeal deglutition and respiration consistency during swallowing. Detecting the timing of disturbances in the relationship between swallowing and respiration may be a way of identifying dysphagia. Dysphagia limit may be a useful, complementary test for assessing swallowing disturbances in amyotrophic lateral sclerosis.

  12. EFFECT OF GUM CHEWING ON AIR SWALLOWING, SALIVA SWALLOWING AND BELCHING

    Directory of Open Access Journals (Sweden)

    Ana Cristina Viana da SILVA

    2015-09-01

    Full Text Available BackgroundEructation is a physiologic event which allows gastric venting of swallowed air and most of the time is not perceived as a symptom. This is called gastric belching. Supragastric belching occurs when swallowed air does not reach the stomach and returns by mouth a short time after swallowing. This situation may cause discomfort, life limitations and problems in daily life.ObjectiveOur objective in this investigation was to evaluate if gum chewing increases the frequency of gastric and/or supragastric belches.MethodsEsophageal transit of liquid and gas was evaluated by impedance measurement in 16 patients with complaint of troublesome belching and in 15 controls. The Rome III criteria were used in the diagnosis of troublesome belching. The esophageal transit of liquid and gas was measured at 5 cm, 10 cm, 15 cm and 20 cm from the lower esophageal sphincter. The subjects were evaluated for 1 hour which was divided into three 20-minute periods: (1 while sitting for a 20-minute base period; (2 after the ingestion of yogurt (200 mL, 190 kcal, in which the subjects were evaluated while chewing or not chewing gum; (3 final 20-minute period in which the subjects then inverted the task of chewing or not chewing gum. In gastric belch, the air flowed from the stomach through the esophagus in oral direction and in supragastric belch the air entered the esophagus rapidly from proximal and was expulsed almost immediately in oral direction. Air swallows were characterized by an increase of at least 50% of basal impedance and saliva swallow by a decrease of at least 50% of basal impedance, that progress from proximal to distal esophagus.ResultsIn base period, air swallowing was more frequent in patients than in controls and saliva swallowing was more frequent in controls than in patients. There was no difference between the medians of controls and patients in the number of gastric belches and supragastric belches. In six patients, supragastric belches

  13. Tongue pressure patterns during water swallowing.

    Science.gov (United States)

    Kennedy, Daniel; Kieser, Jules; Bolter, Chris; Swain, Michael; Singh, Bhavia; Waddell, J Neil

    2010-03-01

    Bolus propulsion during the normal oral phase of swallowing is thought to be characterised by the sequential elevation of the front, middle, and posterior regions of the dorsum of the tongue. However, the coordinated orchestration of lingual movement is still poorly understood. This study examined how pressures generated by the tongue against the hard palate differed between three points along the midline of the tongue. Specifically, we tested three hypotheses: (1) that there are defined individual patterns of pressure change within the mouth during liquid swallowing; (2) that there are significant negative pressures generated at defined moments during normal swallowing; and, (3) that liquid swallowing is governed by the interplay of pressures generated in an anteroposterior direction in the mouth. Using a metal appliance described previously, we measured absolute pressures during water swallows in six healthy volunteers (4 male, 2 female) with an age range of 25-35 years. Participants performed three 10-ml water swallows from a small cup on five separate days, thus providing data for a total of 15 separate water swallows. There was a distinct pattern to the each of the pressure signals, and this pattern was preserved in the mean obtained when the data were pooled. Furthermore, raw signals from the same subjects presented consistent patterns at each of the five testing sessions. In all subjects, pressure at the anterior and hind palate tended to be negative relative to the preswallow value; at mid-palate, however, pressure changes were less consistent between individuals. When the pressure differences between the sites were calculated, we found that during the swallow a net negative pressure difference developed between anterior and mid-palate and a net positive pressure difference developed between mid-palate and hind palate. Large, rapid fluctuations in pressure occurred at all sites and these varied several-fold between subjects. When the brief sharp reduction

  14. Clinical practice: swallowing problems in cerebral palsy.

    Science.gov (United States)

    Erasmus, Corrie E; van Hulst, Karen; Rotteveel, Jan J; Willemsen, Michel A A P; Jongerius, Peter H

    2012-03-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Early attention should be given to dysphagia and excessive drooling and their substantial contribution to the burden of a child with CP and his/her family. This review displays the important functional and anatomical issues related to swallowing problems in children with CP based on relevant literature and expert opinion. Furthermore, based on our experience, we describe a plan for approach of investigation and treatment of swallowing problems in cerebral palsy.

  15. Examining the role of carbonation and temperature on water swallowing performance: a swallowing reaction-time study.

    Science.gov (United States)

    Michou, Emilia; Mastan, Aliya; Ahmed, Saira; Mistry, Satish; Hamdy, Shaheen

    2012-11-01

    Various therapeutic approaches for dysphagia management are based on modifications of bolus properties to change swallowing biomechanics and increase swallowing safety. Limited evidence exists for the effects of carbonation and bolus temperature on swallowing behavior. Here, we investigated the effects of carbonation and temperature on swallowing behavior using a novel automated and complex swallowing reaction time task via pressure signal recordings in the hypopharynx. Healthy participants (n = 39, 27.7±5 years old) were randomized in two different experiments and asked to perform 10 normal-paced swallows, 10 fast-paced swallows, and 10 challenged swallows within a predetermined time-window of carbonated versus still water (experiment 1) and of cold (4 °C) versus hot (45 °C) versus room temperature (21 °C) water (experiment 2). Quantitative measurements of latencies and percentage of successful challenged swallows were collected and analyzed nonparametrically. An increase in successfully performed challenged swallowing task was observed with carbonated water versus still water (P = 0.021), whereas only cold water shortened the latencies of normally paced swallows compared with room (P = 0.001) and hot (P = 0.004) temperatures. Therefore, it appears that chemothermal stimulation with carbonation and cold are most effective at modulating water swallowing, which in part is likely to be driven by central swallowing afferent activity.

  16. Rehabilitation of swallowing and communication following glossectomy.

    Science.gov (United States)

    LaBlance, G R; Kraus, K; Steckol, K F

    1991-01-01

    Patients who have had surgical removal of part or all of the tongue are left with varying degrees of swallowing and speech deficiencies. The extent of resection, mobility of the residual tongue segment, and adequacy of the remaining structures determine the amount and type of deficiency. While communicative impairment and dysphagia commonly are seen in a rehabilitation setting, the problems of the glossectomy patient often are unique. This article reviews the anatomy and physiology of the oral and pharyngeal musculature, discusses the speech and swallowing of the glossectomy patient, and presents nursing considerations for successful rehabilitation.

  17. Unique contributions of ISCOLE to the advancement of accelerometry in large studies

    OpenAIRE

    Tudor-Locke, C.; Barreira, T V; Schuna, J. M.; Katzmarzyk, P. T.

    2015-01-01

    Accelerometry has become a mainstay approach for objectively monitoring children's physical activity and sedentary time in epidemiological studies. The magnitude of effort underlying successful data collection, management and treatment is prodigious and its complexity has been associated with increasingly diverse methodological choices that, while defensible relative to specific research questions, conspire to undermine the ability to compare results between studies. Although respecting wides...

  18. 基于PMAC的双轴运动控制系统的软件开发%Development of Dual-axis Motion System Control Software Based on PMAC

    Institute of Scientific and Technical Information of China (English)

    张凌悦; 李慧媛

    2015-01-01

    以双轴运动系统实验台为例,研究了PMAC控制器上位机软件的开发方法,重点分析了在VC 6.0环境下PMAC与上层Win32应用程序之间的通讯机制、主要问题和解决方法。详细介绍了PMAC双端RAM技术在数据传输中的应用。采用模块化的设计方法,构建了能实现数据实时采集、手动JOG控制和运动程序控制等功能的友好人机界面。该控制软件对于自主开发基于PMAC的开放式运动系统,具有一定的实际意义。%This paper researches the methods to develop software of PMAC control er based on dual-axis motion sys-tem.The communication mechanisms between PMAC and Win32 application program in VC 6.0,main concerns and the solu-tions are analysed.The application of Dual-ported RAM technology in data transmission is introduced.

  19. The influence of product and oral characteristics on swallowing

    NARCIS (Netherlands)

    Engelen, L; Fontijn-Tekamp, A; van der Bilt, A

    2005-01-01

    The urge to swallow food could be triggered by a threshold level in both food particle size and lubrication of the food bolus. Thus, both oral physiology and product characteristics may influence the swallowing threshold. We quantified the swallowing threshold in a group of 266 healthy adult subject

  20. The influence of product and oral characteristics on swallowing

    NARCIS (Netherlands)

    Engelen, L; Fontijn-Tekamp, A; van der Bilt, A

    2005-01-01

    The urge to swallow food could be triggered by a threshold level in both food particle size and lubrication of the food bolus. Thus, both oral physiology and product characteristics may influence the swallowing threshold. We quantified the swallowing threshold in a group of 266 healthy adult subject

  1. The electrodiagnostic examination of psychogenic swallowing disorders.

    Science.gov (United States)

    Vaiman, Michael; Shoval, Gal; Gavriel, Haim

    2008-06-01

    The article discusses the usefulness and technique of investigation of suspected psychogenic dysphagia by surface electromyography (sEMG) of deglutition. Thirty-two patients with suspected psychogenic dysphagia (Group 1) and 40 healthy individuals (Group 2) were involved in the study. The timing, amplitude and graphic patterns of activity of the masseter, submental, infrahyoid and trapezius muscles were examined during voluntary single water swallows ("normal"), and continuous drinking of 100 cc of water. The muscle activity in oral, pharyngeal and initial oesophageal stages of swallowing was measured, and graphic records were evaluated in relation to timing and voltage. Globus hystericus was found in only 14 patients of the Group 1 (43.75%). The main sEMG pattern of psychogenic dysphagia is a lack of any pathologic changes of timing, voltage and graphic patterns of deglutition. In 28% of cases tension of skeletal muscles not involved in deglutition was observed during single swallowing (vs. 0% in controls). Psychogenic/hysteria-conversion dysphagia has no pathologic sEMG patterns associated with deglutition. Skeletal muscle tension during deglutition, being observed in some cases has no connection with the act of swallowing itself. Surface EMG, being non-invasive and non-radiographic, can be used for screening purposes for patients with dysphagia thus avoiding expensive and time-consuming investigation.

  2. The Neurobiology of Swallowing and Dysphagia

    Science.gov (United States)

    Miller, Arthur J.

    2008-01-01

    The neurobiological study of swallowing and its dysfunction, defined as dysphagia, has evolved over two centuries beginning with electrical stimulation applied directly to the central nervous system, and then followed by systematic investigations that have used lesioning, transmagnetic stimulation, magnetoencephalography, and functional magnetic…

  3. Feeding and Swallowing Dysfunction in Genetic Syndromes

    Science.gov (United States)

    Cooper-Brown, Linda; Copeland, Sara; Dailey, Scott; Downey, Debora; Petersen, Mario Cesar; Stimson, Cheryl; Van Dyke, Don C.

    2008-01-01

    Children with genetic syndromes frequently have feeding problems and swallowing dysfunction as a result of the complex interactions between anatomical, medical, physiological, and behavioral factors. Feeding problems associated with genetic disorders may also cause feeding to be unpleasant, negative, or even painful because of choking, coughing,…

  4. Cortical swallowing processing in early subacute stroke

    Directory of Open Access Journals (Sweden)

    Fischer Maren

    2011-03-01

    Full Text Available Abstract Background Dysphagia is a major complication in hemispheric as well as brainstem stroke patients causing aspiration pneumonia and increased mortality. Little is known about the recovery from dysphagia after stroke. The aim of the present study was to determine the different patterns of cortical swallowing processing in patients with hemispheric and brainstem stroke with and without dysphagia in the early subacute phase. Methods We measured brain activity by mean of whole-head MEG in 37 patients with different stroke localisation 8.2 +/- 4.8 days after stroke to study changes in cortical activation during self-paced swallowing. An age matched group of healthy subjects served as controls. Data were analyzed by means of synthetic aperture magnetometry and group analyses were performed using a permutation test. Results Our results demonstrate strong bilateral reduction of cortical swallowing activation in dysphagic patients with hemispheric stroke. In hemispheric stroke without dysphagia, bilateral activation was found. In the small group of patients with brainstem stroke we observed a reduction of cortical activation and a right hemispheric lateralization. Conclusion Bulbar central pattern generators coordinate the pharyngeal swallowing phase. The observed right hemispheric lateralization in brainstem stroke can therefore be interpreted as acute cortical compensation of subcortically caused dysphagia. The reduction of activation in brainstem stroke patients and dysphagic patients with cortical stroke could be explained in terms of diaschisis.

  5. The Neurobiology of Swallowing and Dysphagia

    Science.gov (United States)

    Miller, Arthur J.

    2008-01-01

    The neurobiological study of swallowing and its dysfunction, defined as dysphagia, has evolved over two centuries beginning with electrical stimulation applied directly to the central nervous system, and then followed by systematic investigations that have used lesioning, transmagnetic stimulation, magnetoencephalography, and functional magnetic…

  6. Nonspecific effects of gap paradigm on swallowing.

    Science.gov (United States)

    Yoneda, Masaki; Saitoh, Kazuya

    2017-02-01

    Analogous to the gap paradigm in experiments for saccadic eye movements with very short reaction times, we hypothesized that the initiation of oropharyngeal swallowing movements guided by visual cues are encouraged under experimental conditions using a similar gap paradigm. A red visual cue indicating to hold a bolus in the mouth and a blue one indicating to swallow the bolus were sequentially provided on a computer display to 11 healthy participants. The gap period between these cues varied from 0 to 800ms. Swallowing kinetics and kinematics were recorded using surface electromyography and a laser displacement sensor, respectively. In comparison with the no-gap paradigm, the delay from the onset of muscle activities to initiation of movement significantly decreased with a 100- (pparadigm of 100-200ms. Wrist flexion was boosted in a similar manner. Thus, the gap effect may be a generalized warning effect. Our findings might provide insights into the contribution of the basal ganglia to volitional swallowing. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The potential benefit of swallowing sparing intensity modulated radiotherapy to reduce swallowing dysfunction : An in silico planning comparative study

    NARCIS (Netherlands)

    van der Laan, Hans Paul; Christianen, Miranda E M C; Bijl, Hendrik P; Schilstra, C; Langendijk, Johannes A

    2012-01-01

    PURPOSE: To apply recently developed predictive models for swallowing dysfunction to compare the predicted probabilities of swallowing dysfunction for standard intensity modulated radiotherapy (ST-IMRT) and swallowing sparing IMRT (SW-IMRT). MATERIALS AND METHODS: Thirty head and neck cancer patient

  8. Functional MRI of swallowing: from neurophysiology to neuroplasticity.

    Science.gov (United States)

    Malandraki, Georgia A; Johnson, Sterling; Robbins, Joanne

    2011-10-01

    Swallowing is a complex neurogenic sensorimotor process involving all levels of the neuraxis and a vast number of muscles and anatomic structures. Disruption of any of these anatomic or functional components can lead to swallowing disorders (also known as dysphagia). Understanding the neural pathways that govern swallowing is necessary in diagnosing and treating patients with dysphagia. Functional MRI (fMRI) is a prevalent and effective neuroimaging method that has been used to study the complex neurophysiologic control of swallowing in vivo. This article presents a summary of the research studies that have used fMRI to study the neural control of swallowing in normal subjects and dysphagic patients, and to investigate the effects of swallowing treatments on neuroplasticity. Methodologic challenges and caveats are discussed, and a case study of a pre-posttreatment paradigm is presented to highlight potential future directions of fMRI applications in swallowing research and clinical practice. Copyright © 2011 Wiley Periodicals, Inc.

  9. [Surface electromyographic study on swallowing in normal adults].

    Science.gov (United States)

    Zhang, Jie; Li, Jin-rang; Chen, Dong-lan

    2013-06-01

    To study the characteristics of surface electromyography (sEMG) during swallowing in normal adults. The sEMG during swallowing was carried out in 126 normal adults. There were 66 males and 60 females with their age ranged from 18 to 65 years. The recording electrodes were placed on the skin above the superior thyroid notch and the duration and amplitude of muscle activities during every deglutition were recorded. Swallowing styles were dry swallow, 20 ml water swallow and 40 ml water swallow. The durations of sEMG at dry swallow, 20 ml water swallow and 40 ml water swallow were (1.133 ± 0.209)s (x¯ ± s), (1.097 ± 0.208)s, and (1.510 ± 0.432)s, while the amplitudes were (0.332 ± 0.115)mV, (0.308 ± 0.095)mV, and (0.399 ± 0.139)mV in normal male group. The durations of sEMG at dry swallow, 20 ml water swallow and 40 ml water swallow were (1.118 ± 0.170)s, (1.085 ± 0.209)s, and (1.765 ± 0.463)s, while the amplitudes were (0.292 ± 0.100)mV, (0.261 ± 0.113)mV, and (0.342 ± 0.129)mV in normal female group. The amplitudes of sEMG in male were higher than those in female (P 0.05) in all swallow styles except that the duration of 40 ml water swallow in female was longer than that in male (P sEMG at 40 ml water swallow were longer than those at dry swallow and 20 ml water swallow, and there was no statistically significant difference between dry swallow and 20 ml water swallow. The amplitude of sEMG at 40 ml water swallow was higher than that at dry swallow. The amplitude of sEMG in dry swallow was higher than that at 20 ml water swallow. There was no statistically significant difference in durations and amplitudes of sEMG among four different age groups of male. In the female groups, there was no statistically significant difference in durations and amplitudes of sEMG among four different age groups except that the duration at 40 ml water swallow was longer in younger group (swallowing is a simple and noninvasive method for evaluating the swallowing function

  10. Epiglottis is not essential for successful swallowing in humans.

    Science.gov (United States)

    Leder, Steven B; Burrell, Morton I; Van Daele, Douglas J

    2010-12-01

    Controversy has continued for well over 100 years regarding the role of the epiglottis in deglutition. We describe the effect of isolated epiglottectomy on swallowing success in a case series of 3 adult human subjects with isolated epiglottectomy due to trauma, surgery, or cancerous erosion. The patients were 42, 51, and 70 years of age, and swallowing was analyzed objectively with videofluoroscopy. All subjects exhibited successful swallowing with all food types: thin liquid, puree, and solid food. Specifically, the patient with traumatic epiglottectomy exhibited rapid swallowing success, the patient with surgical epiglottectomy exhibited a short period of dysphagia due to postoperative edema, followed by swallowing success, and the patient with epiglottectomy due to cancerous erosion of the entire epiglottis exhibited long-term adaptation, with successful swallowing maintained. We conclude that the epiglottis is not essential for successful swallowing in humans, because individuals can readily adapt to isolated epiglottectomy and avoid tracheal aspiration.

  11. The Effect of the Cervical Orthosis on Swallowing Physiology and Cervical Spine Motion During Swallowing.

    Science.gov (United States)

    Mekata, Kojiro; Takigawa, Tomoyuki; Matsubayashi, Jun; Toda, Kazukiyo; Hasegawa, Yasuhiro; Ito, Yasuo

    2016-02-01

    Cervical orthosis is used to immobilize the neck in various disorders such as trauma and post-operation. However, it is still uncertain how cervical orthosis restricts the degree of movement of the cervical spine during swallowing and how they affect swallowing physiology. The purpose of this study was to evaluate these issues using the Philadelphia(®) Collar. We conducted videofluorography of swallowing in 39 healthy subjects (23 men, 16 women; mean age of 34.3 years) with and without cervical orthosis. To compare the two conditions regarding the cervical spine motion, we determined the angular and positional changes of the occipital bone (C0) and each cervical vertebra (C1-C7) from the oral phase to the pharyngeal phase. Similarly, to compare swallowing physiology, we assessed the start and end times and the durations of soft palate elevation, rapid hyoid anterosuperior movement, epiglottis inversion, closure of the laryngeal vestibule, and pharyngoesophageal segment (PES) opening. Finally, we compared the transit times of contrast agent in the two conditions. The respective extensions of C1, C2, and C3 were 0.31°, 0.07°, and 0.05° (mean) with cervical orthosis, and the respective flexions of C1, C2, and C3 were 0.98°, 1.42°, and 0.85° (mean) without. These results suggested that cervical orthosis restricted the flexion of C1-C3. Analysis of swallowing physiology revealed that the average durations of hyoid anterosuperior elevation, epiglottic inversion, and PES opening were prolonged by 0.09, 0.19, and 0.05 s, respectively. In conclusion, the cervical orthosis restricted the movement of the cervical spine during swallowing and changed swallowing physiology.

  12. Changes in physical activity measured by accelerometry following initiation of DMARD therapy in rheumatoid arthritis.

    Science.gov (United States)

    Prioreschi, Alessandra; Hodkinson, Bridget; Tikly, Mohammed; McVeigh, Joanne A

    2014-05-01

    The aim of this study was to assess changes in habitual physical activity levels in response to DMARD therapy in RA patients. Eighteen drug-naive RA patients were prospectively assessed at baseline and following 3 months of DMARD therapy for habitual physical activity by accelerometry, disease activity using the clinical disease activity index (CDAI) and functional disability using the modified HAQ (mHAQ). Baseline physical activity was also compared with an equal number of healthy control participants matched for age, sex and BMI. Following 3 months of DMARD therapy, in parallel with significant improvements in CDAI scores (P physically active than control participants in the morning (P = 0.048) and in the late afternoon (P = 0.016), but these diurnal differences were no longer significant after the DMARD intervention. These findings suggest that accelerometry may potentially be a viable objective method of assessing changes in physical disability in response to various disease-modifying drugs.

  13. Improved supervised classification of accelerometry data to distinguish behaviors of soaring birds

    Science.gov (United States)

    Sur, Maitreyi; Suffredini, Tony; Wessells, Stephen M.; Bloom, Peter H; Lanzone, Michael; Blackshire, Sheldon; Sridhar, Srisarguru; Katzner, Todd

    2017-01-01

    Soaring birds can balance the energetic costs of movement by switching between flapping, soaring and gliding flight. Accelerometers can allow quantification of flight behavior and thus a context to interpret these energetic costs. However, models to interpret accelerometry data are still being developed, rarely trained with supervised datasets, and difficult to apply. We collected accelerometry data at 140Hz from a trained golden eagle (Aquila chrysaetos) whose flight we recorded with video that we used to characterize behavior. We applied two forms of supervised classifications, random forest (RF) models and K-nearest neighbor (KNN) models. The KNN model was substantially easier to implement than the RF approach but both were highly accurate in classifying basic behaviors such as flapping (85.5% and 83.6% accurate, respectively), soaring (92.8% and 87.6%) and sitting (84.1% and 88.9%) with overall accuracies of 86.6% and 92.3% respectively. More detailed classification schemes, with specific behaviors such as banking and straight flights were well classified only by the KNN model (91.24% accurate; RF = 61.64% accurate). The RF model maintained its accuracy of classifying basic behavior classification accuracy of basic behaviors at sampling frequencies as low as 10Hz, the KNN at sampling frequencies as low as 20Hz. Classification of accelerometer data collected from free ranging birds demonstrated a strong dependence of predicted behavior on the type of classification model used. Our analyses demonstrate the consequence of different approaches to classification of accelerometry data, the potential to optimize classification algorithms with validated flight behaviors to improve classification accuracy, ideal sampling frequencies for different classification algorithms, and a number of ways to improve commonly used analytical techniques and best practices for classification of accelerometry data.

  14. Clinical swallowing assessment in intensive care unit.

    Science.gov (United States)

    Padovani, Aline Rodrigues; Moraes, Danielle Pedroni; Sassi, Fernanda Chiarion; Andrade, Claudia Regina Furquim de

    2013-01-01

    To report the results of the full clinical swallowing assessment in acute-care population in a large Brazilian teaching hospital. A prospective, descriptive clinical study was conducted during three months in a 30-bed adult clinical emergency ICU from a large Brazilian teaching hospital. Thirty-five patients consecutively referred to the Speech-Language Pathology Service according to our standard clinical practice were included. A full clinical swallowing assessment was completed and includes a Preliminary Assessment Protocol (PAP), a Dysphagia Risk Evaluation Protocol (DREP) and an Oral Feeding Transition Protocol (OFTP). In this study, the prevalence of OD in the ICU setting was of 63%, most of which were classified as moderate and moderate-severe (39%). Patients submitted to orotracheal intubation were very frequently referred to swallowing assessment (74%). The results of the statistical analyses revealed clinical indicators that could correctly classify patients as either having or not having OD on clinical tests. These include cough strength, coordination between breathing and speaking, dysphonia severity, and laryngeal elevation. Twenty six patients (74%) completed all protocols. Of these total, 38% were able to eat a regular diet. The practice with standardized protocols adds an important option for the management of oropharyngeal dysphagia in intensive care unit.

  15. Gastrointestinal damage caused by swallowing multiple magnets.

    Science.gov (United States)

    Liu, Shiqi; Li, Jianhui; Lv, Yi

    2012-09-01

    Swallowing multiple magnets is not uncommon worldwide and it frequently leads to serious consequences. However, most patients fail to receive timely and correct diagnosis and treatment. A literature search was performed to establish an algorithm for these accidents by the authors to identify relevant articles published from June 1987 to October 2010 in Google, Medline, ISI Web of Knowledge Ovid, CNKI, Korea Med and library document delivery, using search terms "magnet ingestion, " "fistula," and "perforation." A total of 149 patients with ingestion of magnetic foreign bodies from 20 countries and areas were identified. 22 of them were companioned with neurological and psychiatric disorders. Swallowing magnets occurred throughout childhood and adolescent, mostly ranging 2 to 4 years in age. Various gastrointestinal damages such as necrosis and intestinal perforation or fistula were encountered. Damage from swallowing multiple magnets carries a significant risk of morbidity and even mortality throughout childhood to adolescent worldwide. Older children and adults with neurological and psychiatric problems may be at high risk for such accidents. Early intervention is crucial.

  16. Measuring leg movements during sleep using accelerometry: comparison with EMG and piezo-electric scored events.

    Science.gov (United States)

    Terrill, Philip I; Leong, Matthew; Barton, Katrina; Freakley, Craig; Downey, Carl; Vanniekerk, Mark; Jorgensen, Greg; Douglas, James

    2013-01-01

    Periodic Limb Movements during Sleep (PLMS) can cause significant disturbance to sleep, resulting in daytime sleepiness and reduced quality of life. In conventional clinical practice, PLMS are measured using overnight electromyogram (EMG) of the tibialis anterior muscle, although historically they have also been measured using piezo-electric gauges placed over the muscle. However, PLMS counts (PLM index) do not correlate well with clinical symptomology. In this study, we propose that because EMG and piezo derived signals measure muscle activation rather than actual movement, they may count events with no appreciable movement of the limb and therefore no contribution to sleep disturbance. The aim of this study is thus to determine the percentage of clinically scored limb movements which are not associated with movement of the great toe measured using accelerometry. 9 participants were studied simultaneously with an overnight diagnostic polysomnogram (including EMG and piezo instrumentation of the right leg) and high temporal resolution accelerometry of the right great toe. Limb movements were scored, and peak acceleration during each scored movement was quantified. Across the participant population, 54.9% (range: 26.7-76.3) and 39.0% (range: 4.8-69.6) of limb movements scored using piezo and EMG instrumentation respectively, were not associated with toe movement measured with accelerometry. If sleep disturbance is the consequence of the limb movements, these results may explain why conventional piezo or EMG derived PLMI is poorly correlated with clinical symptomology.

  17. Diagnosis of spasmodic dysphonia manifested by swallowing difficulty in videofluoroscopic swallowing study.

    Science.gov (United States)

    Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun; Kim, Tae Uk

    2015-04-01

    Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS.

  18. Coordinate mapping of hyolaryngeal mechanics in swallowing.

    Science.gov (United States)

    Thompson, Thomas Z; Obeidin, Farres; Davidoff, Alisa A; Hightower, Cody L; Johnson, Christohper Z; Rice, Sonya L; Sokolove, Rebecca-Lyn; Taylor, Brandon K; Tuck, John M; Pearson, William G

    2014-05-06

    Characterizing hyolaryngeal movement is important to dysphagia research. Prior methods require multiple measurements to obtain one kinematic measurement whereas coordinate mapping of hyolaryngeal mechanics using Modified Barium Swallow (MBS) uses one set of coordinates to calculate multiple variables of interest. For demonstration purposes, ten kinematic measurements were generated from one set of coordinates to determine differences in swallowing two different bolus types. Calculations of hyoid excursion against the vertebrae and mandible are correlated to determine the importance of axes of reference. To demonstrate coordinate mapping methodology, 40 MBS studies were randomly selected from a dataset of healthy normal subjects with no known swallowing impairment. A 5 ml thin-liquid bolus and a 5 ml pudding swallows were measured from each subject. Nine coordinates, mapping the cranial base, mandible, vertebrae and elements of the hyolaryngeal complex, were recorded at the frames of minimum and maximum hyolaryngeal excursion. Coordinates were mathematically converted into ten variables of hyolaryngeal mechanics. Inter-rater reliability was evaluated by Intraclass correlation coefficients (ICC). Two-tailed t-tests were used to evaluate differences in kinematics by bolus viscosity. Hyoid excursion measurements against different axes of reference were correlated. Inter-rater reliability among six raters for the 18 coordinates ranged from ICC = 0.90 - 0.97. A slate of ten kinematic measurements was compared by subject between the six raters. One outlier was rejected, and the mean of the remaining reliability scores was ICC = 0.91, 0.84 - 0.96, 95% CI. Two-tailed t-tests with Bonferroni corrections comparing ten kinematic variables (5 ml thin-liquid vs. 5 ml pudding swallows) showed statistically significant differences in hyoid excursion, superior laryngeal movement, and pharyngeal shortening (p Pearson correlations of hyoid excursion measurements from two different

  19. Evaluation of Swallowing in Infants with Congenital Heart Defect

    OpenAIRE

    Pereira,Karine da Rosa; Firpo,Cora; Gasparin, Marisa; Teixeira,Adriane Ribeiro; Dornelles, Silvia; Bacaltchuk,Tzvi; Levy, Deborah Salle

    2015-01-01

    Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were...

  20. Importance of the swallowing atypical in them malocclusions

    OpenAIRE

    Jiménez Jiménez, Jonatan; Universidad Nacional Mayor de San Marcos, Facultad de Odontología.

    2017-01-01

    This review aims to determine the atypical swallowing malocclusions. When there are inadequate move-ments of the tongue and / or other structures during oral and pharyngolaryngeal phase of swallowing, talking about atypical swallowing, as a non-physiological habit. Its objectives may be multiple, simul-taneously acting alone or cumulatively. The size of a large tongue has been found as an impediment to correct such alternations, though this is a cause of causing malocclusion. the importance o...

  1. Energy expenditure estimation during normal ambulation using triaxial accelerometry and barometric pressure.

    Science.gov (United States)

    Wang, Jingjing; Redmond, Stephen J; Voleno, Matteo; Narayanan, Michael R; Wang, Ning; Cerutti, Sergio; Lovell, Nigel H

    2012-11-01

    Energy expenditure (EE) is an important parameter in the assessment of physical activity. Most reliable techniques for EE estimation are too impractical for deployment in unsupervised free-living environments; those which do prove practical for unsupervised use often poorly estimate EE when the subject is working to change their altitude by walking up or down stairs or inclines. This study evaluates the augmentation of a standard triaxial accelerometry waist-worn wearable sensor with a barometric pressure sensor (as a surrogate measure for altitude) to improve EE estimates, particularly when the subject is ascending or descending stairs. Using a number of features extracted from the accelerometry and barometric pressure signals, a state space model is trained for EE estimation. An activity classification algorithm is also presented, and this activity classification output is also investigated as a model input parameter when estimating EE. This EE estimation model is compared against a similar model which solely utilizes accelerometry-derived features. A protocol (comprising lying, sitting, standing, walking, walking up stairs, walking down stairs and transitioning between activities) was performed by 13 healthy volunteers (8 males and 5 females; age: 23.8 ± 3.7 years; weight: 70.5 ± 14.9 kg), whose instantaneous oxygen uptake was measured by means of an indirect calorimetry system (K4b(2), COSMED, Italy). Activity classification improves from 81.65% to 90.91% when including barometric pressure information; when analyzing walking activities alone the accuracy increases from 70.23% to 98.54%. Using features derived from both accelerometry and barometry signals, combined with features relating to the activity classification in a state space model, resulted in a VO(2) estimation bias of -0.00 095 and precision (1.96SD) of 3.54 ml min(-1) kg(-1). Using only accelerometry features gives a relatively worse performance, with a bias of -0.09 and precision (1.96SD) of 5

  2. Variability of the pharyngeal phase of swallow in the cat.

    Directory of Open Access Journals (Sweden)

    Daniel G Spearman

    Full Text Available The pharyngeal phase of swallow has been thought to be a stereotypical motor behavior.This is a prospective, preclinical, hypothesis driven, one group by three-task design.We sought to compare the effects of pharyngeal swabbing, water only, and water plus punctate mechanical stimulation on the spatiotemporal features of the pharyngeal phase of swallow in the cat. Swallow was elicited under these three conditions in six anaesthetized cats. Electromyographic activity was recorded from seven muscles used to evaluate swallow: mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus, and parasternal.Pharyngeal swabbing in comparison to the other stimulus conditions, results in decreases in post-swallow cricopharyngeus activity (upper esophageal sphincter; a significant increase in parasternal (schluckatmung; swallow breath activity; and increases in thyrohyoid (laryngeal elevator, thyroarytenoid (laryngeal adductor and parasternal muscles burst duration. Pearson correlations were found of moderate strength between 19% of burst duration comparisons and weak to moderate relationships between 29% of burst amplitude comparisons. However, there were no positive significant relationships between phase durations and electromyogram amplitudes between any of the muscles studied during swallow.The results support the concept that a stereotypical behavior, such as pharyngeal swallowing in animal models, can be modified by sensory feedback from pharyngeal mucosal mechanoreceptors. Furthermore, differences in swallow phase durations and amplitudes provide evidence that separate regulatory mechanisms exist which regulate spatial and temporal aspects of the behavior.

  3. Prophylactic Swallowing Exercises in Head and Neck Cancer Radiotherapy

    DEFF Research Database (Denmark)

    Mortensen, H R; Jensen, Kenneth; Aksglæde, K

    2015-01-01

    Many head and neck cancer (HNC) survivors experience reduced quality of life due to radiotherapy (RT)-related dysphagia. The aim of this prospective randomized trial was to evaluate the impact of prophylactic swallowing exercises on swallowing-related outcomes in HNC patients treated with curative...... of the dysphagia outcomes during and after treatment. Adherence to exercises was poor and dropouts due to especially fatigue were very frequent in both groups. Systematic swallowing exercises had no impact on swallowing outcomes within the first year after RT. Despite repeated supervised sessions, adherence...

  4. Swallowing difficulties in Duchenne muscular dystrophy: indications for feeding assessment and outcome of videofluroscopic swallow studies

    DEFF Research Database (Denmark)

    Aloysius, A.; Born, P.; Kinali, M.

    2008-01-01

    Feeding difficulties are known to occur with advancing age in Duchenne muscular dystrophy (DMD). We evaluated the role of videofluoroscopy swallow study (VFSS) in a group of 30 DMD patients with feeding difficulties. Indications for feeding assessment were: respiratory infections potentially...

  5. Assessment of Infant Oral Sensorimotor and Swallowing Function

    Science.gov (United States)

    Rogers, Brian; Arvedson, Joan

    2005-01-01

    The development of feeding and swallowing is the result of a complex interface between the developing nervous system, various physiological systems, and the environment. The purpose of this article is to review the neurobiology, development, and assessment of feeding and swallowing during early infancy. In recent years, there have been exciting…

  6. IMPLICATIONS OF MOUTH BREATHING AND ATYPICAL SWALLOWING IN BODY POSTURE

    Directory of Open Access Journals (Sweden)

    Veronique Sousa

    2017-07-01

    Conclusion: Statistically significant associations were established between the breathing pattern and the horizontal alignment of acromions, as well as the horizontal and vertical alignment of the head; between the pattern of breathing and swallowing with occlusal relationship anteroposterior and occlusal relationship vertical and also between breathing pattern and swallowing with digital sucking habits and pacifier use.

  7. Aerophagia : Excessive Air Swallowing Demonstrated by Esophageal Impedance Monitoring

    NARCIS (Netherlands)

    Hemmink, Gerrit J. M.; Weusten, Bas L. A. M.; Bredenoord, Albert J.; Timmer, Robin; Smout, Andre J. P. M.

    2009-01-01

    BACKGROUND & AIMS: Patients with aerophagia suffer from the presence of an excessive volume of intestinal gas, which is thought to result from excessive air ingestion. However, this has not been shown thus far. The aim of this study was therefore to assess swallowing and air swallowing frequencies i

  8. Swallow Characteristics in Patients with Oculopharyngeal Muscular Dystrophy

    Science.gov (United States)

    Palmer, Phyllis M.; Neel, Amy T.; Sprouls, Gwyneth; Morrison, Leslie

    2010-01-01

    Purpose: This prospective investigation evaluates oral weakness and its impact on swallow function, weight, and quality of life in patients with oculopharyngeal muscular dystrophy (OPMD). Method: Intraoral pressure, swallow pressure, and endurance were measured using an Iowa Oral Performance Instrument in participants with OPMD and matched…

  9. A case of colohepatic penetration by a swallowed toothbrush

    Institute of Scientific and Technical Information of China (English)

    Min Ro Lee; Yong Hwang; Jong Hun Kim

    2006-01-01

    Although foreign body ingestion is relatively common,toothbrush swallowing is rare. We report a case of a swallowed toothbrush which passed through the ileocecal valve and perforated the proximal transverse colon,then the liver. To our knowledge, this is the first case to be reported.

  10. A case of colohepatic penetration by a swallowed toothbrush

    OpenAIRE

    Lee, Min Ro; Hwang, Yong; Kim, Jong Hun

    2006-01-01

    Although foreign body ingestion is relatively common, toothbrush swallowing is rare. We report a case of a swallowed toothbrush which passed through the ileocecal valve and perforated the proximal transverse colon, then the liver. To our knowledge, this is the first case to be reported.

  11. Nature and evaluation of dyspnea in speaking and swallowing.

    Science.gov (United States)

    Hoit, Jeannette D; Lansing, Robert W; Dean, Kristen; Yarkosky, Molly; Lederle, Amy

    2011-02-01

    Dyspnea (breathing discomfort) is a serious and pervasive problem that can have a profound impact on quality of life. It can manifest in different qualities (air hunger, physical exertion, chest/lung tightness, and mental concentration, among others) and intensities (barely noticeable to intolerable) and can influence a person's emotional state (causing anxiety, fear, and frustration, among others). Dyspnea can make it difficult to perform daily activities, including speaking and swallowing. In fact, dyspnea can cause people to change the way they speak and swallow in their attempts to relieve their breathing discomfort; in extreme cases, it can even cause people to avoid speaking and eating/drinking. This article provides an overview of dyspnea in general, describes the effects of dyspnea on speaking and swallowing, includes data from two survey studies of speaking-related dyspnea and swallowing-related dyspnea, and outlines suggested protocols for evaluating dyspnea during speaking and swallowing.

  12. Physical activity in an indigenous Ecuadorian forager-horticulturalist population as measured using accelerometry

    Science.gov (United States)

    Madimenos, Felicia C.; Snodgrass, J. Josh; Blackwell, Aaron D.; Liebert, Melissa A.; Sugiyama, Lawrence S.

    2011-01-01

    Objective Minimal information on physical activity is available for non-Western populations undergoing the transition to a market economy. This is unfortunate given the importance of these data for understanding health issues such as the global obesity epidemic. We consider the utility of using accelerometry technology to examine activity patterns and energy use regulation among indigenous Shuar, an Ecuadorian forager-horticulturalist population undergoing economic and lifestyle change. We investigate sex differences in Shuar activity patterns and the effects of reproductive status on activity. Finally, we discuss the potential of accelerometry use in human biology research. Methods Physical activity levels were measured using Actical accelerometers in 49 indigenous Shuar adults (23 males, 26 females) from a rural Ecuadorian community. Female participants were in various reproductive states including pregnant, lactating, and non-pregnant/non-lactating. Results Activity counts (AC), activity energy expenditure (AEE), and physical activity levels (PAL) were significantly higher (P < 0.05) in males than females. Significant differences in energy expenditure were found among pregnant or lactating females and males with pregnant or lactating partners (P < 0.001). Males with pregnant or lactating partners also had significantly higher activity levels than did other men (P < 0.01). Conclusions Shuar activity levels are relatively low compared to other non-Western populations. Despite increasing market integration, pregnant and lactating females seem to be adopting a strategy noted in other subsistence populations where male participation in subsistence activities increases to compensate for their partners’ elevated reproductive costs. Despite certain limitations, use of accelerometry in human biology research shows promise. PMID:21538650

  13. Correlation of accelerometry with clinical balance tests in older fallers and non-fallers.

    LENUS (Irish Health Repository)

    O'Sullivan, Maura

    2012-02-01

    BACKGROUND: falls are a common cause of injury and decreased functional independence in the older adult. Diagnosis and treatment of fallers require tools that accurately assess physiological parameters associated with balance. Validated clinical tools include the Berg Balance Scale (BBS) and the Timed Up and Go test (TUG); however, the BBS tends to be subjective in nature, while the TUG quantifies an individuals functional impairment but requires further subjective evaluation for balance assessment. Other quantitative alternatives to date require expensive, sophisticated equipment. Measurement of the acceleration of centre of mass, with relatively inexpensive, lightweight, body-mounted accelerometers is a potential solution to this problem. OBJECTIVES: to determine (i) if accelerometry correlates with standard clinical tests (BBS and TUG), (ii) to characterise accelerometer responses to increasingly difficult challenges to balance and (iii) to characterise acceleration patterns between fallers and non-fallers. Study design and setting: torso accelerations were measured at the level of L3 using a tri-axial accelerometer under four conditions; standing unsupported with eyes open (EO), eyes closed (EC) and on a mat with eyes open (MAT EO) and closed (MAT EC). Older patients (n = 21, 8 males, 13 females) with a mean age of 78 (SD +\\/- 7.6) years who attended a day hospital were recruited for this study. Patients were identified as fallers or non-fallers based on a comprehensive falls history. MEASUREMENTS: Spearman\\'s rank correlation analysis examined the relationship between acceleration root mean square (RMS) data and the BBS while Pearson\\'s correlation was used with TUG scores. Differences in accelerometer RMS between fallers and non-fallers and between test conditions were examined using t-test and non-parametric alternatives where appropriate. RESULTS: there was a stepwise increase in accelerometer RMS with increasing task complexity, and the accelerometer

  14. Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics.

    Science.gov (United States)

    Manrique, Yady J; Sparkes, Arron M; Cichero, Julie A Y; Stokes, Jason R; Nissen, Lisa M; Steadman, Kathryn J

    2016-09-01

    Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12-50% in 30 min, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G' values compared to G'' (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method.

  15. Tactile thermal oral stimulation increases the cortical representation of swallowing

    Directory of Open Access Journals (Sweden)

    Suntrup Sonja

    2009-06-01

    Full Text Available Abstract Background Dysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. Thermal tactile oral stimulation (TTOS is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Little is known about the possible mechanisms by which this interventional therapy may work. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. Data were analyzed by means of synthetic aperture magnetometry (SAM and the group analysis of individual SAM data was performed using a permutation test. Results Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. Conclusion In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. These findings facilitate our understanding of the role of cortical reorganization in dysphagia treatment and recovery.

  16. The effect of taste and palatability on lingual swallowing pressure.

    Science.gov (United States)

    Pelletier, Cathy A; Dhanaraj, Glory E

    2006-04-01

    There is evidence that a strong, unpalatable, sour bolus improves swallowing in neurogenic dysphagia. It is not known whether other tastes may alter swallowing physiology. This study investigated the effect of moderate versus high taste concentrations (sweet, sour, salty, bitter) and barium taste samples on lingual swallowing pressure in ten healthy young adults, using a three-bulb lingual pressure array secured to the hard palate. Palatability of the samples was analyzed using the nine-point hedonic scale. Results showed that moderate sucrose, high salt, and high citric acid elicited significantly higher lingual swallowing pressures compared with the pressures generated by water. Pressures in the anterior bulb were significantly higher than those recorded from the middle or posterior bulb. There was no significant effect of palatability on lingual swallowing pressures. High salt and citric acid are known to elicit chemesthesis mediated by the trigeminal nerve. These results suggest that chemesthesis may play a crucial role in swallowing physiology. If true, dysphagia diet recommendations that include trigeminal irritants such as carbonation may be beneficial to individuals with dysphagia. However, before this recommendation more research is needed to examine how food properties and their perception affect swallowing in individuals with and without dysphagia.

  17. Risk factors for swallowing dysfunction in stroke patients

    Directory of Open Access Journals (Sweden)

    Anna Flávia Ferraz Barros Baroni

    2012-06-01

    Full Text Available CONTEXT: Stroke is a frequent cause of dysphagia. OBJECTIVE: To evaluate in a tertiary care hospital the prevalence of swallowing dysfunction in stroke patients, to analyze factors associated with the dysfunction and to relate swallowing dysfunction to mortality 3 months after the stroke. METHODS: Clinical evaluation of deglutition was performed in 212 consecutive patients with a medical and radiologic diagnosis of stroke. The occurrence of death was determined 3 months after the stroke. RESULTS: It was observed that 63% of the patients had swallowing dysfunction. The variables gender and specific location of the lesion were not associated with the presence or absence of swallowing dysfunction. The patients with swallowing dysfunction had more frequently a previous stroke, had a stroke in the left hemisphere, motor and/or sensitivity alterations, difficulty in oral comprehension, alteration of oral expression, alteration of the level of consciousness, complications such as fever and pneumonia, high indexes on the Rankin scale, and low indexes on the Barthel scale. These patients had a higher mortality rate. CONCLUSIONS: Swallowing evaluation should be done in all patients with stroke, since swallowing dysfunction is associated with complications and an increased risk of death.

  18. Fabrication of Artificial Food Bolus for Evaluation of Swallowing

    Science.gov (United States)

    Hosotsubo, Miyu; Magota, Tetsuro; Egusa, Masahiko; Miyawaki, Takuya; Matsumoto, Takuya

    2016-01-01

    Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy). The results indicated that Young’s modulus of bolus before swallowing was below 150 kPa. The bolus volume before swallowing was below 400 mm3. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa•s. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Thus, this artificial food bolus would be a promising tool for evaluation of swallowing. PMID:27977775

  19. Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

    Science.gov (United States)

    Hirata, Ayumu; Funato, Hiroki; Nakai, Megumi; Iizuka, Michiro; Abe, Noriaki; Yagi, Yusuke; Shiraishi, Hisashi; Jobu, Kohei; Yokota, Junko; Hirose, Kahori; Hyodo, Masamitsu; Miyamura, Mitsuhiko

    2016-01-01

    We previously prepared and pharmaceutically evaluated ginger orally disintegrating (OD) tablets, optimized the base formulation, and carried out a clinical trial in healthy adults in their 20 s and 50s to measure their effect on salivary substance P (SP) level and improved swallowing function. In this study, we conducted clinical trials using the ginger OD tablets in older people to clinically evaluate the improvements in swallowing function resulting from the functional components of the tablet. The ginger OD tablets were prepared by mixing the excipients with the same amount of mannitol and sucrose to a concentration of 1% ginger. Eighteen healthy older adult volunteers aged 63 to 90 were included in the swallowing function test. Saliva was collected before and 15 min after administration of the placebo and ginger OD tablets. Swallowing endoscopy was performed by an otolaryngologist before administration and 15 min after administration of the ginger OD tablets. A scoring method was used to evaluate the endoscopic swallowing. Fifteen minutes after taking the ginger OD tablets, the salivary SP amount was significantly higher than prior to ingestion or after taking the placebo (pginger OD tablets. Our findings showed that the ginger OD tablets increased the salivary SP amount and improved swallowing function in older people with appreciably reduced swallowing function.

  20. Imaginary particle tracking accelerometry based on time-resolved velocity fields

    Science.gov (United States)

    Wang, Zhongyi; Gao, Qi; Pan, Chong; Feng, Lihao; Wang, Jinjun

    2017-09-01

    An accurate calculation of material acceleration is important for particle image velocimetry-based pressure reconstruction. Therefore, an imaginary particle tracking accelerometry (IPTA) approach based on time-resolved velocity fields is described in this paper for a better determination of acceleration. Multi-velocity fields and a least squares polynomial fitting of the velocity along imaginary particle trajectories are introduced to improve the acceleration accuracy. The process of imaginary particle tracking is operated iteratively until a convergence condition is satisfied. Then the Lagrangian acceleration (or the material acceleration in the Eulerian coordinates) is acquired by the first-order time derivation of the fitting polynomial. In addition, the sensitivity of the IPTA approach to different levels of noise and parameters that affect its performance is investigated. A criterion is proposed to determine these parameters when using IPTA to calculate the acceleration. Performance of the IPTA method is compared with other velocity-based accelerometry methods, including both Eulerian and Lagrangian methods. Assessments are conducted in a synthetic solid body rotation flow, a synthetic flow of a vortex ring, and an experimental jet flow. The results show that IPTA is a robust method for experimental acceleration determination that can both improve the accuracy of acceleration and provide better physical characteristics of the flow field.

  1. Activity patterns of free-ranging koalas (Phascolarctos cinereus revealed by accelerometry.

    Directory of Open Access Journals (Sweden)

    Michelle A Ryan

    Full Text Available An understanding of koala activity patterns is important for measuring the behavioral response of this species to environmental change, but to date has been limited by the logistical challenges of traditional field methodologies. We addressed this knowledge gap by using tri-axial accelerometer data loggers attached to VHF radio collars to examine activity patterns of adult male and female koalas in a high-density population at Cape Otway, Victoria, Australia. Data were obtained from 27 adult koalas over two 7-d periods during the breeding season: 12 in the early-breeding season in November 2010, and 15 in the late-breeding season in January 2011. Multiple 15 minute observation blocks on each animal were used for validation of activity patterns determined from the accelerometer data loggers. Accelerometry was effective in distinguishing between inactive (sleeping, resting and active (grooming, feeding and moving behaviors. Koalas were more active during the early-breeding season with a higher index of movement (overall dynamic body acceleration [ODBA] for both males and females. Koalas showed a distinct temporal pattern of behavior, with most activity occurring from mid-afternoon to early morning. Accelerometry has potential for examining fine-scale behavior of a wide range of arboreal and terrestrial species.

  2. Validation of activity questionnaires in patients with cystic fibrosis by accelerometry and cycle ergometry

    Directory of Open Access Journals (Sweden)

    Ruf Katharina C

    2012-04-01

    Full Text Available Abstract Background The objective of this study was to validate physical activity questionnaires for cystic fibrosis (CF against accelerometry and cycle ergometry. Methods 41 patients with CF (12-42 years completed the Habitual Activity Estimation Scale (HAES, the 7-Day Physical Activity Recall questionnaire (7D-PAR and the Lipid Research Clinics questionnaire (LRC and performed an incremental exercise test according to the Godfrey protocol up to volitional fatigue. Time spent in moderate and vigorous physical activity (MVPA assessed objectively by accelerometry was related to the time spent in the respective activity categories by correlation analyses and calculating intraclass correlation coefficients (ICC. Furthermore, the results of the exercise test were correlated with the results of the questionnaires. Results Time spent in the categories 'hard','very hard' and 'hard & very hard' of the 7D-PAR (0.41 p = 0.002; VO2peak: r = 0.32, p = 0.041. Conclusions In conclusion, the activity categories 'hard' and 'very hard' of the 7D-PAR best reflected objectively measured MVPA. Since the association was at most moderate, the 7D-PAR may be selected to describe physical activity within a population. None of the evaluated questionnaires was able to generate valid physical activity data exercise performance data at the individual level. Neither did any of the questionnaires provide a valid assessment of aerobic fitness on an invidual level.

  3. Sport Engagement by Accelerometry under Field Conditions in German Adolescents: Results from GINIPlus.

    Science.gov (United States)

    Smith, Maia; Berdel, Dietrich; Nowak, Dennis; Heinrich, Joachim; Schulz, Holger

    2015-01-01

    Sporting activities differ in their ability to promote moderate-to-vigorous physical activity (MVPA). To assess adolescents' engagement in sport under field conditions we used accelerometers to measure their MVPA levels during sport. We pay special attention to differences between team and individual sport and between common sports. Diary data and 7-day accelerometry from 1054 Germans ages 15-17 were combined to measure physical activity. 1373 diaried episodes of more than 40 common sports were identified from 626 participants and grouped into team and individual sport. We modeled the effect of team and individual sport, and described levels of MVPA and episodes of no MVPA for all recorded sports. German boys and girls averaged 43 (SD 21) and 37 (SD 24) minutes MVPA per day. Boys got 2.2 times as much MVPA per minute during team compared to individual sport (psport ranged from 6% for weight training to 74% for jogging, with individual sports averaging 10-30% and team sports 30-50%. 11% of sport episodes had no MVPA: half of episodes of cycling, 5% of jogging, and none for tennis or badminton. An episode of individual sport was 17 times more likely to have no MVPA than an episode of team sport (psporting time. As measured by accelerometry, individual sport often produced no MVPA. Characteristics of the sport, such as team vs. individual, were more predictive of MVPA than were characteristics of the participant, such as background activity levels.

  4. Improvement of walking speed prediction by accelerometry and altimetry, validated by satellite positioning.

    Science.gov (United States)

    Perrin, O; Terrier, P; Ladetto, Q; Merminod, B; Schutz, Y

    2000-03-01

    Activity monitors based on accelerometry are used to predict the speed and energy cost of walking at 0% slope, but not at other inclinations. Parallel measurements of body accelerations and altitude variation were studied to determine whether walking speed prediction could be improved. Fourteen subjects walked twice along a 1.3 km circuit with substantial slope variations (-17% to +17%). The parameters recorded were body acceleration using a uni-axial accelerometer, altitude variation using differential barometry, and walking speed using satellite positioning (DGPS). Linear regressions were calculated between acceleration and walking speed, and between acceleration/altitude and walking speed. These predictive models, calculated using the data from the first circuit run, were used to predict speed during the second circuit. Finally the predicted velocity was compared with the measured one. The result was that acceleration alone failed to predict speed (mean r = 0.4). Adding altitude variation improved the prediction (mean r = 0.7). With regard to the altitude/acceleration-speed relationship, substantial inter-individual variation was found. It is concluded that accelerometry, combined with altitude measurement, can assess position variations of humans provided inter-individual variation is taken into account. It is also confirmed that DGPS can be used for outdoor walking speed measurements, opening up new perspectives in the field of biomechanics.

  5. Activity Patterns of Free-Ranging Koalas (Phascolarctos cinereus) Revealed by Accelerometry

    Science.gov (United States)

    Ryan, Michelle A.; Whisson, Desley A.; Holland, Greg J.; Arnould, John P. Y.

    2013-01-01

    An understanding of koala activity patterns is important for measuring the behavioral response of this species to environmental change, but to date has been limited by the logistical challenges of traditional field methodologies. We addressed this knowledge gap by using tri-axial accelerometer data loggers attached to VHF radio collars to examine activity patterns of adult male and female koalas in a high-density population at Cape Otway, Victoria, Australia. Data were obtained from 27 adult koalas over two 7-d periods during the breeding season: 12 in the early-breeding season in November 2010, and 15 in the late-breeding season in January 2011. Multiple 15 minute observation blocks on each animal were used for validation of activity patterns determined from the accelerometer data loggers. Accelerometry was effective in distinguishing between inactive (sleeping, resting) and active (grooming, feeding and moving) behaviors. Koalas were more active during the early-breeding season with a higher index of movement (overall dynamic body acceleration [ODBA]) for both males and females. Koalas showed a distinct temporal pattern of behavior, with most activity occurring from mid-afternoon to early morning. Accelerometry has potential for examining fine-scale behavior of a wide range of arboreal and terrestrial species. PMID:24224050

  6. Activity patterns of free-ranging koalas (Phascolarctos cinereus) revealed by accelerometry.

    Science.gov (United States)

    Ryan, Michelle A; Whisson, Desley A; Holland, Greg J; Arnould, John P Y

    2013-01-01

    An understanding of koala activity patterns is important for measuring the behavioral response of this species to environmental change, but to date has been limited by the logistical challenges of traditional field methodologies. We addressed this knowledge gap by using tri-axial accelerometer data loggers attached to VHF radio collars to examine activity patterns of adult male and female koalas in a high-density population at Cape Otway, Victoria, Australia. Data were obtained from 27 adult koalas over two 7-d periods during the breeding season: 12 in the early-breeding season in November 2010, and 15 in the late-breeding season in January 2011. Multiple 15 minute observation blocks on each animal were used for validation of activity patterns determined from the accelerometer data loggers. Accelerometry was effective in distinguishing between inactive (sleeping, resting) and active (grooming, feeding and moving) behaviors. Koalas were more active during the early-breeding season with a higher index of movement (overall dynamic body acceleration [ODBA]) for both males and females. Koalas showed a distinct temporal pattern of behavior, with most activity occurring from mid-afternoon to early morning. Accelerometry has potential for examining fine-scale behavior of a wide range of arboreal and terrestrial species.

  7. Characterization of Swallowing Sound: Preliminary Investigation of Normal Subjects.

    Science.gov (United States)

    Honda, Tsuyoshi; Baba, Takuro; Fujimoto, Keiko; Goto, Takaharu; Nagao, Kan; Harada, Masafumi; Honda, Eiichi; Ichikawa, Tetsuo

    2016-01-01

    The purpose of this study was to characterize the swallowing sound and identify the process of sound generation during swallowing in young healthy adults. Thirty-three healthy volunteers were enrolled and allocated into three experimental groups. In experiment 1, a microphone was attached to one of eight cervical sites in 20 subjects, participants swallowed 5 ml water, and the sound waveform was recorded. In experiment 2, 10 subjects swallowed either 0, 5, 10, or 15 ml water during audio recording. In addition, participants consumed the 5 ml bolus in two different cervical postures. In experiment 3, the sound waveform and videofluoroscopy were simultaneously recorded while the three participants consumed 5 ml iopamidol solution. The duration and peak intensity ratio of the waveform were analyzed in all experimental groups. The acoustic analysis of the waveforms and videofluoroscopy suggested that the swallowing sound could be divided into three periods, each associated with a stage of the swallowing movement: the oral phase comprising posterior tongue and hyoid bone movement; the pharyngeal phase comprising larynx movement, hyoid bone elevation, epiglottis closure, and passage of the bolus through the esophagus orifice; and the repositioning phase comprising the return of the hyoid bone and larynx to their resting positions, and reopening of the epiglottis. Acoustic analysis of swallowing sounds and videofluoroscopy suggests that the swallowing sound could be divided into three periods associated with each process of the swallowing movement: the oral phase comprising the posterior movement of the tongue and hyoid bone; the pharyngeal phase comprising the laryngeal movement, hyoid bone elevation, epiglottis closure, and the bolus passage to the esophagus orifice; and the repositioning phase comprising the repositioning of the hyoid bone and larynx, and reopening of the epiglottis.

  8. Characterization of Swallowing Sound: Preliminary Investigation of Normal Subjects

    Science.gov (United States)

    Honda, Tsuyoshi; Baba, Takuro; Fujimoto, Keiko; Goto, Takaharu; Nagao, Kan; Harada, Masafumi; Honda, Eiichi; Ichikawa, Tetsuo

    2016-01-01

    Objective The purpose of this study was to characterize the swallowing sound and identify the process of sound generation during swallowing in young healthy adults. Methods Thirty-three healthy volunteers were enrolled and allocated into three experimental groups. In experiment 1, a microphone was attached to one of eight cervical sites in 20 subjects, participants swallowed 5 ml water, and the sound waveform was recorded. In experiment 2, 10 subjects swallowed either 0, 5, 10, or 15 ml water during audio recording. In addition, participants consumed the 5 ml bolus in two different cervical postures. In experiment 3, the sound waveform and videofluoroscopy were simultaneously recorded while the three participants consumed 5 ml iopamidol solution. The duration and peak intensity ratio of the waveform were analyzed in all experimental groups. Results The acoustic analysis of the waveforms and videofluoroscopy suggested that the swallowing sound could be divided into three periods, each associated with a stage of the swallowing movement: the oral phase comprising posterior tongue and hyoid bone movement; the pharyngeal phase comprising larynx movement, hyoid bone elevation, epiglottis closure, and passage of the bolus through the esophagus orifice; and the repositioning phase comprising the return of the hyoid bone and larynx to their resting positions, and reopening of the epiglottis. Conclusion Acoustic analysis of swallowing sounds and videofluoroscopy suggests that the swallowing sound could be divided into three periods associated with each process of the swallowing movement: the oral phase comprising the posterior movement of the tongue and hyoid bone; the pharyngeal phase comprising the laryngeal movement, hyoid bone elevation, epiglottis closure, and the bolus passage to the esophagus orifice; and the repositioning phase comprising the repositioning of the hyoid bone and larynx, and reopening of the epiglottis. PMID:27959902

  9. Decoding human swallowing via electroencephalography: a state-of-the-art review

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L.; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  10. Mis-swallowing of cleaning naphtha: report of three cases.

    Science.gov (United States)

    Kuo, C Y; Lee, C Y

    1990-01-01

    Cleaning naphtha, a product of Chinese Petroleum Corporation, is a complex hydrocarbon mixture which contains mainly aliphatic hydrocarbons. It is used as a cleaning fluid and solvent. Three toddlers mis-swallowed a mouth of cleaning naphtha accidentally. One developed multiple organ failure before death, another completely recovered without sequelae, and the other died very soon after mis-swallowing. Two fatal cases were both induced vomiting with aspiration immediately after mis-swallowing by their parents. Therefore, inducing vomiting should not be encouraged especially at home, and prevention of aspiration is very important in the management of such cases.

  11. Metal detector and swallowed metal foreign bodies in children.

    OpenAIRE

    Doraiswamy, N V; Baig, H; Hallam, L

    1999-01-01

    OBJECTIVE: To evaluate a metal detector to diagnose swallowed radio-opaque metal foreign bodies (MFBs) in children, and whether they can detect non-radio-opaque MFBs. METHODS: In a prospective study, 231 children, who presented to the accident and emergency department with a history of swallowing MFBs, were evaluated by the metal detector as well as radiography to confirm and locate the presence or absence of MFBs. RESULTS: A definite history of swallowing a MFB by the child was given by 186 ...

  12. Central swallowing in normal adults using functional magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Shasha Li; Cheng Luo; Chengqi He; Qiyong Gong; Dong Zhou

    2009-01-01

    BACKGROUND: While brain-imaging studies in healthy adults have indicated that multiple cortical regions are involved in swallowing, these functional imaging techniques have not been extensively applied to the complete understand neurophysiology of swallowing in China. A full understanding of normal swallowing neurophysiology is important for improving functional outcomes for dysphagia due to neurologic disorders or damage with increasing age. Thus the interpretations of the functional contributions of various brain areas in swallowing should be scientifically researched.OBJECTIVE: To identify the activation and characteristic of swallowing center in healthy adults using functional magnetic resonance imaging.DESIGN, TIME AND SETTING: An uncontrolled neuroimaging study was performed at the Outpatient Clinic, Department of Radiology, West China Hospital of Sichuan University between March and November 2008.PARTICIPANTS: Ten healthy right-handed volunteers, aged over 20 years with a mean age of (34.2 ±8.1) years, a range of 25-45 years and including five males and five females participated. A medical history was obtained from all potential subjects and all subjects were free of systemic diseases and neurological disorders.METHODS: The healthy volunteers were examined with event-related functional magnetic resonance imaging of blood oxygenation level-dependent while laryngeal swallow-related movements were recorded. Subjects were scanned during voluntary saliva swallowing and water bolus swallowing activation tasks. Data was processed using the General Linear Model. A voxel by voxel group comparison was performed using random effect analysis. Any cluster with a corrected P < 0.05 for spatial extent was considered significant.MAIN OUTCOME MEASURES: The cerebral cortical activation maps of voluntary swallowing of saliva and swallowing of water bolus in healthy adults were observed.RESULTS: A multifocal cortical representation of swallowing was in the precentral gyrus

  13. IMPLICATIONS OF MOUTH BREATHING AND ATYPICAL SWALLOWING IN BODY POSTURE

    National Research Council Canada - National Science Library

    Veronique Sousa; Maria Paço; Teresa Pinho

    2017-01-01

    .... Changes in any of the parts may lead to a general postural imbalance. Purpose: To verify if there is a relation between breathing pattern and swallowing with posture, dental occlusion and harmful oral habits of the sample under study...

  14. Swallowed foreign body: Is interventional management always required?

    Directory of Open Access Journals (Sweden)

    Al Shehri Gharamah

    2000-01-01

    Full Text Available A retrospective study of 20 cases diagnosed as "swallowed foreign body" seen over a five-year period (July 1993-June 1998 at Asir Central Hospital was performed. Six (30% were children and 14 (70% adults. In the children, five were boys and one was a girl. Objects swallowed included metal nails. coins, hair pins and a chain pendant. In the adult group, eight (57% were males and six (43% females. Objects swallowed included sewing needles, sharp blades, pieces of glass, paper clips and gravel. The swallowed foreign body in all the patients passed innocuously through the gastrointestinal tract in two to ten (average 4.7 days. Our method of treatment consisted of giving high fiber diet, Metamucil or lactulose and liquid paraffin. There was no mortality.

  15. Cliff swallow populations in the southern Askinuk Mountains, Alaska

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — During breeding season, cliff swallows are widely distributed throughout Alaska and North America south to Mexico, and they are locally common in western and...

  16. Swallowed magnets and batteries: a dangerous but not unexpected attraction.

    Science.gov (United States)

    Teague, Warwick Jonathan; Vaughan, Elizabeth Mary; McHoney, Merrill; McCabe, Amanda Jayne

    2013-04-10

    An 18-month-old boy was witnessed swallowing a cluster of five magnetic toy balls. He was coincidentally noted on plain x-rays to have also recently swallowed a watch battery and a small screw. Initial outpatient management with serial review and x-rays was unsuccessful, and delayed inpatient surgical care by 9 days. Although the child never manifested features of systemic or gastrointestinal upset, emergency laparotomy confirmed a resultant jejunocolic fistula. This case demonstrates how clinical assessment of children who have swallowed magnets separately from each other can be falsely reassuring, and highlights the potential dangers of outpatient management. We recommend children who have swallowed separately >1 magnetic objects (or >1 objects capable of magnetic attraction) be managed as inpatients with active observation and timely foreign body removal.

  17. Weather-related Tree Swallow Mortality and Reduced Nesting Effort

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report documents the spring 2007 die-off of 216 Tree Swallows in western New York due to a period of unseasonably warm temperatures followed immediately by a...

  18. Automated Detection and Evaluation of Swallowing Using a Combined EMG/Bioimpedance Measurement System

    Directory of Open Access Journals (Sweden)

    Corinna Schultheiss

    2014-01-01

    Full Text Available Introduction. Developing an automated diagnostic and therapeutic instrument for treating swallowing disorders requires procedures able to reliably detect and evaluate a swallow. We tested a two-stage detection procedure based on a combined electromyography/bioimpedance (EMBI measurement system. EMBI is able to detect swallows and distinguish them from similar movements in healthy test subjects. Study Design. The study was planned and conducted as a case-control study (EA 1/019/10, and EA1/160/09, EA1/161/09. Method. The study looked at differences in swallowing parameters in general and in the event of penetration during swallows in healthy subjects and in patients with an oropharyngeal swallowing disorder. A two-stage automated swallow detection procedure which used electromyography (EMG and bioimpedance (BI to reliably detect swallows was developed. Results. Statistically significant differences between healthy subjects and patients with a swallowing disorder were found in swallowing parameters previously used to distinguish between swallowing and head movements. Our two-stage algorithm was able to reliably detect swallows (sensitivity = 96.1%, specificity = 97.1% on the basis of these differences. Discussion. Using a two-stage detection procedure, the EMBI measurement procedure is able to detect and evaluate swallows automatically and reliably. The two procedures (EMBI + swallow detection could in future form the basis for automated diagnosis and treatment (stimulation of swallowing disorders.

  19. Skill training for swallowing rehabilitation in patients with Parkinson's disease.

    Science.gov (United States)

    Athukorala, Ruvini P; Jones, Richard D; Sella, Oshrat; Huckabee, Maggie-Lee

    2014-07-01

    To examine the effects of skill training on swallowing in individuals with dysphagia secondary to Parkinson's disease (PD) and to explore skill retention after treatment termination. Within-subject pilot study with follow-up after 2 weeks of treatment and after a 2-week nontreatment period. Clinic in a research institute. Patients (N=10; mean age, 67.4y) included 3 women (mean Hoehn and Yahr score, 2.6) and 7 men (mean Hoehn and Yahr score, 2.4). Patients underwent 10 daily sessions of skill training therapy focused on increasing precision in muscle contraction during swallowing using visual feedback. Data from the timed water swallow test, Test of Mastication and Swallowing Solids, surface electromyography (sEMG) of submental muscles, and swallowing-related quality of life questionnaire were collected at 2 baseline sessions (conducted 2wk apart) at the end of treatment and after 2 nontreatment weeks to assess skill retention. Immediately after posttreatment, the swallowing rate for liquids (P=.034), sEMG durational parameters of premotor time (P=.003), and preswallow time (Pswallows (P=.009). Additionally, swallowing-related quality of life improved (P=.018). Reassessment at 2 weeks after treatment termination revealed short-term retention of treatment effects. A skill-based training approach produced functional, biomechanical, and swallowing-related quality of life improvements in this cohort indicating compelling evidence for the effectiveness of this novel approach for dysphagia rehabilitation in PD. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. "Lock in accelerometry" to follow sink dynamics in shaken granular matter

    Science.gov (United States)

    Clement, Cecile; Sanchez-Colina, Gustavo; Alonso-Llanes, Laciel; Martinez-Roman, Etien; Batitsta-Leyva, Alfo-Jose; Toussaint, Renaud; Altshuler, Ernesto

    2015-04-01

    Understanding the penetration dynamics of intruders in granular beds is relevant not only for fundamental Physics, but also for geophysical processes and construction on granular soils in earthquake areas. Indeed a phenomenon named soil liquefaction can cause buildings to sink or tilt in areas separated of 1000 km from the epicentre in the worst cases. The damages on the constructions, the pipes and the roads may be huge. There is a conventional understanding of liquefaction from which scientists made theoretical and empirical laws for geotechnical use and building construction, but the dynamical penetration of buildings into the soil is still not well understood. While the penetration of intruders in 2D laboratory granular beds can be followed using video recording, it is useless in 3D beds of non-transparent materials such as common sand. Wireless accelerometry constitutes a natural alternative that has been used in very few occasions, however, it has never been used to quantify the penetration into horizontally shaken granular beds. Here we propose a method to quantify the sink dynamics of an intruder into laterally shaken, fluidized granular bed. We developped an embarked accelerometer small enough to fit into a modelized building. This sensor allows us to follow the intruder in realistic conditions namely buried in a 3D box of sand. Our method is based on the temporal correlations between the signals from a reference accelerometer fixed to the shaken granular bed, and the accelerometer deployed inside the intruder. We demonstrate that our method is able to determine the time interval of sinking of an intruder into shaken granular beds for both quasi-2D and 3D systems [1]. Due to its analogy with the working principle of a lock in amplifier, we call this technique Lock in accelerometry (LIA). In the experiments the intruder stops at a depth that we assume to be the beginning of the "jammed" granular phase. We are now developing numerical simulations based on a

  1. A Targeted Swallow Screen for the Detection of Postoperative Dysphagia.

    Science.gov (United States)

    Gee, Erica; Lancaster, Elizabeth; Meltzer, Jospeh; Mendelsohn, Abie H; Benharash, Peyman

    2015-10-01

    Postoperative dysphagia leads to aspiration pneumonia, prolonged hospital stay, and is associated with increased mortality. A simple and sensitive screening test to identify patients requiring objective dysphagia evaluation is presently lacking. In this study, we evaluated the efficacy of a novel targeted swallow screen evaluation. This was a prospective trial involving all adult patients who underwent elective cardiac surgery with cardiopulmonary bypass at our institution over an 8-week period. Within 24 hours of extubation and before the initiation of oral intake, all postsurgical patients were evaluated using the targeted swallow screen. A fiberoptic endoscopic evaluation of swallowing was requested for failed screenings. During the study, 50 postcardiac surgery patients were screened. Fifteen (30%) failed the targeted swallow screen, and ten of the fifteen (66%) failed the subsequent fiberoptic endoscopic evaluation of swallowing exam and were confirmed to have dysphagia. The screening test had 100 per cent sensitivity for detecting dysphagia in our patient population, and a specificity of 87.5 per cent. The overall incidence of dysphagia was 20 per cent. We have shown that a targeted swallow evaluation can efficiently screen patients during the postcardiac surgery period. Furthermore, we have shown that the true incidence of dysphagia after cardiac surgery is significantly higher than previously recognized in literature.

  2. Human hyolaryngeal movements show adaptive motor learning during swallowing.

    Science.gov (United States)

    Humbert, Ianessa A; Christopherson, Heather; Lokhande, Akshay; German, Rebecca; Gonzalez-Fernandez, Marlis; Celnik, Pablo

    2013-06-01

    The hyoid bone and larynx elevate to protect the airway during swallowing. However, it is unknown whether hyolaryngeal movements during swallowing can adjust and adapt to predict the presence of a persistent perturbation in a feed-forward manner (adaptive motor learning). We investigated adaptive motor learning in nine healthy adults. Electrical stimulation was administered to the anterior neck to reduce hyolaryngeal elevation, requiring more strength to swallow during the perturbation period of this study. We assessed peak hyoid bone and laryngeal movements using videofluoroscopy across thirty-five 5-ml water swallows. Evidence of adaptive motor learning of hyolaryngeal movements was found when (1) participants showed systematic gradual increases in elevation against the force of electrical stimulation and (2) hyolaryngeal elevation overshot the baseline (preperturbation) range of motion, showing behavioral aftereffects, when the perturbation was unexpectedly removed. Hyolaryngeal kinematics demonstrates adaptive, error-reducing movements in the presence of changing and unexpected demands. This is significant because individuals with dysphagia often aspirate due to disordered hyolaryngeal movements. Thus, if rapid motor learning is accessible during swallowing in healthy adults, patients may be taught to predict the presence of perturbations and reduce errors in swallowing before they occur.

  3. Quality of life related to swallowing in Parkinson's disease.

    Science.gov (United States)

    Carneiro, Danielle; das Graças Wanderley de Sales Coriolano, Maria; Belo, Luciana Rodrigues; de Marcos Rabelo, Aneide Rocha; Asano, Amdore Guescel; Lins, Otávio Gomes

    2014-10-01

    Swallowing difficulties in Parkinson's disease can result in decreased quality of life. The swallowing quality of life questionnaire (SWAL-QOL) is an instrument for specifically assessing quality of life with respect to swallowing, which has been little explored in patients with Parkinson's disease (PD). The goal of this study was to evaluate the quality of life with respect to swallowing in persons with PD compared to controls and at several stages of the disease using the SWAL-QOL. The experimental group was composed of 62 persons with PD at stages 1-4. Forty-one age-matched healthy subjects constituted the control group. The SWAL-QOL scores were significantly lower for the patients with PD than for the controls in all SWAL-QOL domains. Eating duration had the largest difference in score between persons with PD and the controls and the lowest mean score, followed by communication, fatigue, fear, sleep, and food selection. The scores of most domains were lower at later stages of the disease. The scores for eating duration, symptom frequency, and sleep were significantly lower at stage 4 than stages 1 and 2. In conclusion, patients with PD have significantly lower scores in all domains of the SWAL-QOL than normal controls. This means swallowing difficulties occurring in patients with PD negatively affect their QOL. Progression of the disease worsens swallowing QOL, more specifically in the domains of eating duration, symptom frequency, and sleep. This occurs mostly at later stages of the disease.

  4. Functional magnetic resonance and swallowing: critical literature review,

    Directory of Open Access Journals (Sweden)

    Maíra Santilli de Lima

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Aspects of the neuroanatomical representation of swallowing have been investigated in humans through brain mapping techniques, such as functional magnetic resonance imaging (fMRI. OBJECTIVE: This critical qualitative review of the literature analyzed international scientific publications in the PubMed database that investigated the activation of the central nervous system in humans during the act of swallowing. METHODS: This investigation was limited to articles that investigated adults older than 18 years, published in English or Portuguese, between January 2002 and December 2013. Publications that did not have access to the full text, that were repeated by overlapping keywords, case studies, literature reviews, letters to the editor, and those not directly related to the topic of the investigation were excluded. RESULTS: A total of 649 articles were identified, of which 21 matched the inclusion criteria. CONCLUSION: The main purpose of the manuscripts that investigate the swallowing process through fMRI were: to characterize swallowing in different pathologies; to compare swallowing in different age groups; to describe brain activation in different stimulation conditions. These studies indicate multiple cortical regions involved in swallowing control. Overall, the studies indicate that fMRI is a non-invasive and quantitative method that allows the investigation of characteristics that are quite often not clinically visible.

  5. Accelerometry-based monitoring of daily physical activity in children with juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Nørgaard, M; Twilt, M; Andersen, L B

    2015-01-01

    Objectives: Juvenile idiopathic arthritis (JIA) may cause functional impairment, reduced participation in physical activity (PA) and, over time, physical deconditioning. The aim of this study was to objectively monitor daily free-living PA in 10-16-year-old children with JIA using accelerometry...... with regard to disease activity and physical variables and to compare the data with those from healthy age- and gender-matched controls.Method: Patients underwent an evaluation of disease activity, functional ability, physical capacity, and pain. Accelerometer monitoring was assessed using the GT1M Acti...... range of motion (ROM). No correlation was found between PA and pain scores, functional ability, and hypermobility. Patients with involvement of ankles or hips demonstrated significantly lower levels of PA.Conclusions: Children with JIA are less physically active and have lower physical capacity...

  6. Sport Engagement by Accelerometry under Field Conditions in German Adolescents: Results from GINIPlus.

    Directory of Open Access Journals (Sweden)

    Maia Smith

    Full Text Available Sporting activities differ in their ability to promote moderate-to-vigorous physical activity (MVPA. To assess adolescents' engagement in sport under field conditions we used accelerometers to measure their MVPA levels during sport. We pay special attention to differences between team and individual sport and between common sports.Diary data and 7-day accelerometry from 1054 Germans ages 15-17 were combined to measure physical activity. 1373 diaried episodes of more than 40 common sports were identified from 626 participants and grouped into team and individual sport. We modeled the effect of team and individual sport, and described levels of MVPA and episodes of no MVPA for all recorded sports.German boys and girls averaged 43 (SD 21 and 37 (SD 24 minutes MVPA per day. Boys got 2.2 times as much MVPA per minute during team compared to individual sport (p<0.0001 but there was no significant difference for girls. Percent of time spent in MVPA during sport ranged from 6% for weight training to 74% for jogging, with individual sports averaging 10-30% and team sports 30-50%. 11% of sport episodes had no MVPA: half of episodes of cycling, 5% of jogging, and none for tennis or badminton. An episode of individual sport was 17 times more likely to have no MVPA than an episode of team sport (p<0.0001.Under field condition, adolescents were active for only a fraction of diaried sporting time. As measured by accelerometry, individual sport often produced no MVPA. Characteristics of the sport, such as team vs. individual, were more predictive of MVPA than were characteristics of the participant, such as background activity levels.

  7. An accelerometry-based methodology for assessment of real-world bilateral upper extremity activity.

    Directory of Open Access Journals (Sweden)

    Ryan R Bailey

    Full Text Available The use of both upper extremities (UE is necessary for the completion of many everyday tasks. Few clinical assessments measure the abilities of the UEs to work together; rather, they assess unilateral function and compare it between affected and unaffected UEs. Furthermore, clinical assessments are unable to measure function that occurs in the real-world, outside the clinic. This study examines the validity of an innovative approach to assess real-world bilateral UE activity using accelerometry.Seventy-four neurologically intact adults completed ten tasks (donning/doffing shoes, grooming, stacking boxes, cutting playdough, folding towels, writing, unilateral sorting, bilateral sorting, unilateral typing, and bilateral typing while wearing accelerometers on both wrists. Two variables, the Bilateral Magnitude and Magnitude Ratio, were derived from accelerometry data to distinguish between high- and low-intensity tasks, and between bilateral and unilateral tasks. Estimated energy expenditure and time spent in simultaneous UE activity for each task were also calculated.The Bilateral Magnitude distinguished between high- and low-intensity tasks, and the Magnitude Ratio distinguished between unilateral and bilateral UE tasks. The Bilateral Magnitude was strongly correlated with estimated energy expenditure (ρ = 0.74, p<0.02, and the Magnitude Ratio was strongly correlated with time spent in simultaneous UE activity (ρ = 0.93, p<0.01 across tasks.These results demonstrate face validity and construct validity of this methodology to quantify bilateral UE activity during the performance of everyday tasks performed in a laboratory setting, and can now be used to assess bilateral UE activity in real-world environments.

  8. Supervised accelerometry analysis can identify prey capture by penguins at sea.

    Science.gov (United States)

    Carroll, Gemma; Slip, David; Jonsen, Ian; Harcourt, Rob

    2014-12-15

    Determining where, when and how much animals eat is fundamental to understanding their ecology. We developed a technique to identify a prey capture signature for little penguins from accelerometry, in order to quantify food intake remotely. We categorised behaviour of captive penguins from HD video and matched this to time-series data from back-mounted accelerometers. We then trained a support vector machine (SVM) to classify the penguins' behaviour at 0.3 s intervals as either 'prey handling' or 'swimming'. We applied this model to accelerometer data collected from foraging wild penguins to identify prey capture events. We compared prey capture and non-prey capture dives to test the model predictions against foraging theory. The SVM had an accuracy of 84.95±0.26% (mean ± s.e.) and a false positive rate of 9.82±0.24% when tested on unseen captive data. For wild data, we defined three independent, consecutive prey handling observations as representing true prey capture, with a false positive rate of 0.09%. Dives with prey captures had longer duration and bottom times, were deeper, had faster ascent rates, and had more 'wiggles' and 'dashes' (proxies for prey encounter used in other studies). The mean (±s.e.) number of prey captures per foraging trip was 446.6±66.28. By recording the behaviour of captive animals on HD video and using a supervised machine learning approach, we show that accelerometry signatures can classify the behaviour of wild animals at unprecedentedly fine scales.

  9. Do more active children sleep more? A repeated cross-sectional analysis using accelerometry.

    Directory of Open Access Journals (Sweden)

    Sheila M Williams

    Full Text Available AIM: To determine whether levels of daytime physical activity are associated with sleep duration and night waking in children assessed using accelerometry, and if these associations change over time. METHODS: 24-hour accelerometry data were obtained from 234 children at 3, 5 and 7 years of age for at least 5 days at each time. Sleep duration was estimated using the Sadeh algorithm. Time spent in sedentary, light and moderate-vigorous (MVPA activity was established using published cut-points. Appropriate statistical techniques were utilised to account for the closed nature of the data (24-hour periods. RESULTS: Time spent asleep was related more to sedentary or light activity and not to MVPA. The most active (95th percentile children spent 55-84 fewer minutes asleep and 16-19 more minutes awake at night compared to the least active (5th percentile children. Children with later bedtimes slept less at night (30-40 minutes and undertook more sedentary (10-15 minutes but also more light (18-23 minutes activity during the day. However, no differences in MVPA were apparent according to bedtime. Children slept slightly less on weekend nights (11 minutes compared with week-nights, but only at 3 years of age. Most relationships were broadly similar at 3, 5 and 7 years of age. CONCLUSION: Children who are more physically active during the day have shorter total sleep time and are more awake at night than less active children. The protective effect of sleep on obesity does not appear to be mediated by increased physical activity.

  10. Measuring energy expenditure in sub-adult and hatchling sea turtles via accelerometry.

    Science.gov (United States)

    Halsey, Lewis G; Jones, T Todd; Jones, David R; Liebsch, Nikolai; Booth, David T

    2011-01-01

    Measuring the metabolic of sea turtles is fundamental to understanding their ecology yet the presently available methods are limited. Accelerometry is a relatively new technique for estimating metabolic rate that has shown promise with a number of species but its utility with air-breathing divers is not yet established. The present study undertakes laboratory experiments to investigate whether rate of oxygen uptake (VO2) at the surface in active sub-adult green turtles Chelonia mydas and hatchling loggerhead turtles Caretta caretta correlates with overall dynamic body acceleration (ODBA), a derivative of acceleration used as a proxy for metabolic rate. Six green turtles (25-44 kg) and two loggerhead turtles (20 g) were instrumented with tri-axial acceleration logging devices and placed singly into a respirometry chamber. The green turtles were able to submerge freely within a 1.5 m deep tank and the loggerhead turtles were tethered in water 16 cm deep so that they swam at the surface. A significant prediction equation for mean VO2 over an hour in a green turtle from measures of ODBA and mean flipper length (R(2) = 0.56) returned a mean estimate error across turtles of 8.0%. The range of temperatures used in the green turtle experiments (22-30 °C) had only a small effect on Vo₂. A VO2-ODBA equation for the loggerhead hatchling data was also significant (R(2) = 0.67). Together these data indicate the potential of the accelerometry technique for estimating energy expenditure in sea turtles, which may have important applications in sea turtle diving ecology, and also in conservation such as assessing turtle survival times when trapped underwater in fishing nets.

  11. Measuring energy expenditure in sub-adult and hatchling sea turtles via accelerometry.

    Directory of Open Access Journals (Sweden)

    Lewis G Halsey

    Full Text Available Measuring the metabolic of sea turtles is fundamental to understanding their ecology yet the presently available methods are limited. Accelerometry is a relatively new technique for estimating metabolic rate that has shown promise with a number of species but its utility with air-breathing divers is not yet established. The present study undertakes laboratory experiments to investigate whether rate of oxygen uptake (VO2 at the surface in active sub-adult green turtles Chelonia mydas and hatchling loggerhead turtles Caretta caretta correlates with overall dynamic body acceleration (ODBA, a derivative of acceleration used as a proxy for metabolic rate. Six green turtles (25-44 kg and two loggerhead turtles (20 g were instrumented with tri-axial acceleration logging devices and placed singly into a respirometry chamber. The green turtles were able to submerge freely within a 1.5 m deep tank and the loggerhead turtles were tethered in water 16 cm deep so that they swam at the surface. A significant prediction equation for mean VO2 over an hour in a green turtle from measures of ODBA and mean flipper length (R(2 = 0.56 returned a mean estimate error across turtles of 8.0%. The range of temperatures used in the green turtle experiments (22-30 °C had only a small effect on Vo₂. A VO2-ODBA equation for the loggerhead hatchling data was also significant (R(2 = 0.67. Together these data indicate the potential of the accelerometry technique for estimating energy expenditure in sea turtles, which may have important applications in sea turtle diving ecology, and also in conservation such as assessing turtle survival times when trapped underwater in fishing nets.

  12. Effect of occlusal vertical dimension on swallowing patterns and perioral electromyographic activity.

    Science.gov (United States)

    MacAvoy, S K; Jack, H C; Kieser, J; Farella, M

    2016-07-01

    Abnormal swallow patterns have been associated with specific dentofacial traits, such as an anterior open bite, but the cause-effect relationship between swallowing and malocclusion remains highly controversial. The aim of this research was to determine the effects of acute change in occlusal vertical dimension (OVD) on intraoral pressure swallow patterns and perioral electromyographic activity (EMG) during swallowing. Ten volunteers (five female, five male; 27-32 years) repeated standardised swallowing tasks as the OVD was progressively increased using mandibular trays of different heights. Standardised swallowing tasks were performed repetitively with each tray in place. Individual swallowing waveforms were quantitatively and qualitatively analysed. Peak pressure, swallow duration, time to peak pressure and lip EMG peak activity were assessed for each swallow. Data were analysed using mixed-model analysis. As OVD increased, lip peak pressure during swallowing increased almost threefold (+2·1 kPa; P ≤ 0·001), whereas swallow duration increased by 12·7 per cent (+160 ms; P = 0·01) at lip level and by 26·4 per cent (+270 ms; P < 0·001) at tongue level. Perioral muscle activity during swallows increased by 43·7 per cent (P ≤ 0·01) up to the OVD where resting lip seal was not attainable. Swallowing waveforms varied markedly between individuals, but interindividual waveforms were only minimally affected. The adaptive response and the waveform similarities associated with OVD variation supports the existence of a central control mechanism for swallowing, which may be modified by peripheral inputs.

  13. The Relationship Between Pharyngeal Constriction and Post-swallow Residue.

    Science.gov (United States)

    Stokely, Shauna L; Peladeau-Pigeon, Melanie; Leigh, Chelsea; Molfenter, Sonja M; Steele, Catriona M

    2015-06-01

    Pharyngeal constriction has been proposed as a parameter that may distinguish functional from impaired swallows. We employed anatomically normalized pixel-based measures of pharyngeal area at maximum constriction, and the ratio of this measure to area at rest, and explored the association between these measures and post-swallow residue using the normalized residue ratio scale (NRRS). Videofluoroscopy data for 5 ml boluses of 22 % (w/v) liquid barium were analyzed from 20 healthy young adults and 40 patients with suspected neurogenic dysphagia. The frames of maximum pharyngeal constriction and post-swallow hyoid rest were extracted. Pixel-based measures of pharyngeal area were made using ImageJ and size-normalized using the squared C2-C4 vertebral distance as a reference scalar. Post-swallow residue and the areas of the vallecular and pyriform sinus spaces were measured on the hyoid rest frame to calculate the NRRSv and NRRSp. The dataset was divided into swallows with residue within or exceeding the upper confidence interval boundary seen in the healthy participants. Mixed model repeated measures ANOVAs were used to compare pharyngeal area (rest, constriction) and the pharyngeal constriction ratio, between individuals with and without residue. Measures of pharyngeal area at maximum constriction were significantly larger (i.e., less constricted, p = 0.000) in individuals with post-swallow residue in either the valleculae or the pyriform sinus. These results support the idea that interventions targeted toward improving pharyngeal constriction have the potential to be effective in reducing post-swallow residue.

  14. Gamma radiation effects on nestling Tree Swallows

    Energy Technology Data Exchange (ETDEWEB)

    Zach, R.; Mayoh, K.R.

    1984-10-01

    The sensitivity of Tree Swallows (Tachycineta bicolor) to the stress of ionizing radiation was investigated with growth analysis. Freshly hatched nestlings were temporarily removed from nests, taken to the laboratory and acutely exposed to 0.9, 2.7, or 4.5 Gy gamma radiation. Some of the unirradiated control nestlings were also taken to the laboratory whereas others were left in the nests. Growth of all the nestlings was measured daily and analyzed by fitting growth models. There was no detectable radiation-induced mortality up to fledgling, approx. = 20 d after irradiation. Radiation exposure did not affect the basic growth pattern; the logistic growth model was most suitable for body mass and foot length, and the von Bertalanffy model for primary-feather length, irrespective of treatment. Parameter values from these models indicated pronounced growth depression in the 2.7-Gy and 4.5-Gy groups, particularly for body mass. Radiation also affected the timing of development. The growth depression of the 2.7-Gy group was similar to that caused by hatching asynchrony in unirradiated nestlings. The 4.5-Cy nestlings grew as well as unexposed nestlings that died from natural causes. Chronic irradiation at approx. = 1.0 Cy/d caused more severe growth effects than acute exposure to 4.5 Gy and may have caused permanent stunting. Growth analysis is a potent tool for assessing man-made environmental stresses. Observed body-mass statistics and model parameters seem to be most sensitive to environmental stresses, but coefficients of variation are not necessarily correlated with sensitivity. 34 references, 2 figures, 4 tables.

  15. Application of Kinesio Taping method for newborn swallowing difficultly

    Science.gov (United States)

    Lin, Chien-Lin; Wu, Wei-Ting; Chang, Ke-Vin; Lin, Hong-Yi; Chou, Li-Wei

    2016-01-01

    Abstract Background: Preterm infants are at an increased risk of sucking problems, swallowing difficulty, and poor nourishment. During the neonatal period, the neurobehavioral organization of a preterm baby is poor compared with that of appropriate gestational age infants. Kinesio Taping has been widely used for edema control, joint protection, and proprioception training. With the help of augmentation of the sensory input for muscle facilitation and inhibition through tapping, the coordination of the target muscle groups can be improved. Until now, no research is available on the use of Kinesio Taping for the swallowing difficulty of infant. Methods: We reported a preterm infant suffering from brain edema at birth and swallowing difficultly until 40 weeks. The swallowing reflex was delayed. Moreover, lip closure and rooting reflex combined with the dysfunction grade of jaw movement were poor. We performed KT methods on the baby under the theory of the direction of the tape for facilitate or inhibit the muscle. Result: After the Kinesio Taping treatment, the sucking function was improved with good lip closure.One week later, the baby was discharged without the use of an oral gastric tube. Conclusion: Kinesio Taping contributed significantly to the improvement of impaired sucking and swallowing and could be implemented as a regular rehabilitative approach for infants suffering from these difficulties. PMID:27495080

  16. Hard to Swallow: Developmental Biological Insights into Pediatric Dysphagia

    Science.gov (United States)

    LaMantia, Anthony-Samuel; Moody, Sally A.; Maynard, Thomas M.; Karpinski, Beverly A.; Zohn, Irene E.; Mendelowitz, David; Lee, Norman H.; Popratiloff, Anastas

    2015-01-01

    Pediatric dysphagia—feeding and swallowing difficulties that begin at birth, last throughout childhood, and continue into maturity—is one of the most common, least understood complications in children with developmental disorders. We argue that a major cause of pediatric dysphagia is altered hindbrain patterning during pre-natal development. Such changes can compromise craniofacial structures including oropharyngeal muscles and skeletal elements as well as motor and sensory circuits necessary for normal feeding and swallowing. Animal models of developmental disorders that include pediatric dysphagia in their phenotypic spectrum can provide mechanistic insight into pathogenesis of feeding and swallowing difficulties. A fairly common human genetic developmental disorder, DiGeorge/22q11.2 Deletion Syndrome (22q11DS) includes a substantial incidence of pediatric dysphagia in its phenotypic spectrum. Infant mice carrying a parallel deletion to 22q11DS patients have feeding and swallowing difficulties. Altered hindbrain patterning, neural crest migration, craniofacial malformations, and changes in cranial nerve growth prefigure these difficulties. Thus, in addition to craniofacial and pharyngeal anomalies that arise independently of altered neural development, pediatric dysphagia may reflect disrupted hindbrain patterning and its impact on neural circuit development critical for feeding and swallowing. The mechanisms that disrupt hindbrain patterning and circuitry may provide a foundation to develop novel therapeutic approaches for improved clinical management of pediatric dysphagia. PMID:26554723

  17. Effects of tongue pressing effortful swallow in older healthy individuals.

    Science.gov (United States)

    Park, Taeok; Kim, Youngsun

    2016-01-01

    The risk of swallowing disorders is increased for older individuals due to weak tongue and pharyngeal muscle strength. This study was appraised the value of a preventative approach by developing the tongue pressing effortful swallow (TPES) applied using a home-based and self-administered procedure. The TPES was developed by combining two swallowing exercises: tongue strengthening exercise and the effortful swallow. The purpose of this study was to examine the effects of the TPES on maximum tongue pressure and peak amplitude of submental muscle activity in older individuals. 27 older individuals (mean 73 years) performed a 4-week TPES. The exercise program was adapted to a home-based and self-administered procedure. The maximum tongue pressure was measured by the Iowa Oral Performance Instrument and peak amplitude of submental muscle activity by surface electromyography (sEMG). Statistical comparisons were made by a matched pairs t-test (psEMG did not differ between before and after exercises. The TPES had a positive impact in older individuals. The TPES, a combining exercise, was possible because two exercises had common physiological events. The TPES was a more innovative and efficient approach than the tongue strengthening exercise alone. In addition, older individuals were able to perform the swallowing exercise at home and by themselves with little assistance. Future research needs to refine the TPES and apply it to patients with dysphagia. Published by Elsevier Ireland Ltd.

  18. Swallowing in patients with Parkinson's disease: a surface electromyography study.

    Science.gov (United States)

    Ws Coriolano, Maria das Graças; R Belo, Luciana; Carneiro, Danielle; G Asano, Amdore; Al Oliveira, Paulo José; da Silva, Douglas Monteiro; G Lins, Otávio

    2012-12-01

    Our goal was to study deglutition of Parkinson's disease (PD) patients and normal controls (NC) using surface electromyography (sEMG). The study included 15 patients with idiopathic PD and 15 age-matched normal controls. Surface electromyography was collected over the suprahyoid muscle group. Conditions were the following: swallow at once 10 and 20 ml of water and 5 and 10 ml of yogurt of firm consistency, and freely drink 100 ml of water. During swallowing, durations of sEMG were significantly longer in PD patients than in normal controls but no significant differences of amplitudes were found. Eighty percent of the PD patients and 20 % of the NC needed more than one swallow to consume 20 ml of water, while 70 % of the PD patients and none of the NC needed more than one swallow to consume 5 ml of yogurt. PD patients took significantly more time and needed significantly more swallows to drink 100 ml of water than normal controls. We conclude that sEMG might be a simple and useful tool to study and monitor deglutition in PD patients.

  19. A swallowed sewing needle migrating to the liver

    Directory of Open Access Journals (Sweden)

    Serhat Avcu

    2009-01-01

    Full Text Available Context: Swallowing foreign bodies is a common problem in children. Although most objects pass through the gastrointestinal tract with no untoward effect; long, sharppointed, or slender objects can perforate the gut. Migration of a swallowed object to the liver is extremely rare and very few cases have been reported in the literature up to now. The aim of this study is to draw attention to this subject once again by contributing a case report of a child with hepatic migration of a swallowed sewing needle. Case Report: A 16-year-old girl presented to the emergency room of pediatrics department in our hospital with complaints of abdominal pain, nausea and vomiting. Physical examination revealed tenderness on the right upper quadrant of the abdomen. Laboratory examination revealed increased hepatic enzymes as well as increased white blood cell count. Abdominal ultrasonography and computed tomography examinations revealed foreign body in the liver accompanied by surrounding abscess formation. The foreign body (sewing needle was removed surgically after two operations. Conclusion : The children may not be able to remember the swallowing of the foreign body or they may try to hide such a condition. The radiological diagnosis in such cases which can be achieved by X-rays, ultrasonography or computed tomography is of critical importance, as well as getting detailed patient history for foreign body swallowing.

  20. A swallowed sewing needle migrating to the liver

    Directory of Open Access Journals (Sweden)

    Serhat Avcu

    2009-09-01

    Full Text Available Context: Swallowing foreign bodies is a common problem in children. Although most objects pass through the gastrointestinal tract with no untoward effect; long, sharppointed, or slender objects can perforate the gut. Migration of a swallowed object to the liver is extremely rare and very few cases have been reported in the literature up to now. The aim of this study is to draw attention to this subject once again by contributing a case report of a child with hepatic migration of a swallowed sewing needle. Case Report: A 16-year-old girl presented to the emergency room of pediatrics department in our hospital with complaints of abdominal pain, nausea and vomiting. Physical examination revealed tenderness on the right upper quadrant of the abdomen. Laboratory examination revealed increased hepatic enzymes as well as increased white blood cell count. Abdominal ultrasonography and computed tomography examinations revealed foreign body in the liver accompanied by surrounding abscess formation. The foreign body (sewing needle was removed surgically after two operations. Conclusion: The children may not be able to remember the swallowing of the foreign body or they may try to hide such a condition. The radiological diagnosis in such cases which can be achieved by X-rays, ultrasonography or computed tomography is of critical importance, as well as getting detailed patient history for foreign body swallowing.

  1. Effects of strengthening exercises on swallowing musculature and function in senior healthy subjects; a prospective effectiveness and feasibility study

    NARCIS (Netherlands)

    Kraaijenga, S.A.C.; van der Molen, L.; Stuiver, M.M.; Teertstra, H.J.; Hilgers, F.J.M.; van den Brekel, M.

    2015-01-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise

  2. The feasibility and acceptability of questionnaires and accelerometry for measuring physical activity and sedentary behaviour in adults with mental illness.

    Science.gov (United States)

    Chapman, Justin J; Fraser, Sarah J; Brown, Wendy J; Burton, Nicola W

    2015-01-01

    Adults with mental illness may have difficulties with data collection methods such as questionnaires and accelerometry. To assess the utility of questionnaires and accelerometry for assessing physical activity (PA) and sedentary behaviour (SB) in non-institutionalised adults with mental illness. Participants were recruited from outpatient clinics and community organisations. Participants completed PA and SB questionnaires, wore accelerometers for 7 d, and rated the ease/difficulty of completing study components. Recruitment numbers, adherence, and ease/difficulty ratings were examined. Ease/difficulty ratings were compared between study components, and between participants by distress level. One hundred forty-two participants completed the questionnaires; they found it easier to report PA than reclining time (p = 0.017), and reclining time than sitting time (p questionnaires (p questionnaires. Questionnaires were feasible for assessing PA, but less acceptable for people experiencing high distress.

  3. Effect of carbonated beverages on pharyngeal swallowing in young individuals and elderly inpatients.

    Science.gov (United States)

    Morishita, Motoyoshi; Mori, Sanae; Yamagami, Shota; Mizutani, Masatoshi

    2014-04-01

    Gustatory and chemical stimulations of the oral cavity and pharyngeal mucosa by carbonated water improve pharyngeal swallowing. We compared changes in pharyngeal swallowing and sensory aspects induced by a carbonated beverage preferred by Japanese with those induced by carbonated water, a sports drink, and tap water in healthy young subjects and elderly inpatients with no swallowing problems. The duration of laryngeal elevation (DOLE) for swallowing the carbonated beverage and water in the second session was shorter compared to that for water in the first session in the elderly subjects. The DOLE and the duration of suprahyoid muscle activity for swallowing were longer in the elderly subjects than in the young subjects for all beverages. Beverages that the subjects subjectively felt were easy to swallow were the sports drink and carbonated beverage, whereas they stated that carbonated water was less easy to swallow. In the elderly subjects, swallowing ability latently decreased, even though they had no problem swallowing in their daily lives, and it was assumed that the carbonated beverage improved pharyngeal swallowing. In addition, the carbonated beverage also influenced the subsequent swallowing of water, showing a persistent effect. It was suggested that carbonated beverages are easy to swallow and effective for improving pharyngeal swallowing.

  4. Wireless Tri-Axial Trunk Accelerometry Detects Deviations in Dynamic Center of Mass Motion Due to Running-Induced Fatigue.

    Directory of Open Access Journals (Sweden)

    Kurt H Schütte

    Full Text Available Small wireless trunk accelerometers have become a popular approach to unobtrusively quantify human locomotion and provide insights into both gait rehabilitation and sports performance. However, limited evidence exists as to which trunk accelerometry measures are suitable for the purpose of detecting movement compensations while running, and specifically in response to fatigue. The aim of this study was therefore to detect deviations in the dynamic center of mass (CoM motion due to running-induced fatigue using tri-axial trunk accelerometry. Twenty runners aged 18-25 years completed an indoor treadmill running protocol to volitional exhaustion at speeds equivalent to their 3.2 km time trial performance. The following dependent measures were extracted from tri-axial trunk accelerations of 20 running steps before and after the treadmill fatigue protocol: the tri-axial ratio of acceleration root mean square (RMS to the resultant vector RMS, step and stride regularity (autocorrelation procedure, and sample entropy. Running-induced fatigue increased mediolateral and anteroposterior ratios of acceleration RMS (p < .05, decreased the anteroposterior step regularity (p < .05, and increased the anteroposterior sample entropy (p < .05 of trunk accelerometry patterns. Our findings indicate that treadmill running-induced fatigue might reveal itself in a greater contribution of variability in horizontal plane trunk accelerations, with anteroposterior trunk accelerations that are less regular from step-to-step and are less predictable. It appears that trunk accelerometry parameters can be used to detect deviations in dynamic CoM motion induced by treadmill running fatigue, yet it is unknown how robust or generalizable these parameters are to outdoor running environments.

  5. Cortical recovery of swallowing function in wound botulism

    Directory of Open Access Journals (Sweden)

    Ringelstein Erich B

    2008-05-01

    Full Text Available Abstract Background Botulism is a rare disease caused by intoxication leading to muscle weakness and rapidly progressive dysphagia. With adequate therapy signs of recovery can be observed within several days. In the last few years, brain imaging studies carried out in healthy subjects showed activation of the sensorimotor cortex and the insula during volitional swallowing. However, little is known about cortical changes and compensation mechanisms accompanying swallowing pathology. Methods In this study, we applied whole-head magnetoencephalography (MEG in order to study changes in cortical activation in a 27-year-old patient suffering from wound botulism during recovery from dysphagia. An age-matched group of healthy subjects served as control group. A self-paced swallowing paradigm was performed and data were analyzed using synthetic aperture magnetometry (SAM. Results The first MEG measurement, carried out when the patient still demonstrated severe dysphagia, revealed strongly decreased activation of the somatosensory cortex but a strong activation of the right insula and marked recruitment of the left posterior parietal cortex (PPC. In the second measurement performed five days later after clinical recovery from dysphagia we found a decreased activation in these two areas and a bilateral cortical activation of the primary and secondary sensorimotor cortex comparable to the results seen in a healthy control group. Conclusion These findings indicate parallel development to normalization of swallowing related cortical activation and clinical recovery from dysphagia and highlight the importance of the insula and the PPC for the central coordination of swallowing. The results suggest that MEG examination of swallowing can reflect short-term changes in patients suffering from neurogenic dysphagia.

  6. Cortical recovery of swallowing function in wound botulism.

    Science.gov (United States)

    Teismann, Inga K; Steinstraeter, Olaf; Warnecke, Tobias; Zimmermann, Julian; Ringelstein, Erich B; Pantev, Christo; Dziewas, Rainer

    2008-05-07

    Botulism is a rare disease caused by intoxication leading to muscle weakness and rapidly progressive dysphagia. With adequate therapy signs of recovery can be observed within several days. In the last few years, brain imaging studies carried out in healthy subjects showed activation of the sensorimotor cortex and the insula during volitional swallowing. However, little is known about cortical changes and compensation mechanisms accompanying swallowing pathology. In this study, we applied whole-head magnetoencephalography (MEG) in order to study changes in cortical activation in a 27-year-old patient suffering from wound botulism during recovery from dysphagia. An age-matched group of healthy subjects served as control group. A self-paced swallowing paradigm was performed and data were analyzed using synthetic aperture magnetometry (SAM). The first MEG measurement, carried out when the patient still demonstrated severe dysphagia, revealed strongly decreased activation of the somatosensory cortex but a strong activation of the right insula and marked recruitment of the left posterior parietal cortex (PPC). In the second measurement performed five days later after clinical recovery from dysphagia we found a decreased activation in these two areas and a bilateral cortical activation of the primary and secondary sensorimotor cortex comparable to the results seen in a healthy control group. These findings indicate parallel development to normalization of swallowing related cortical activation and clinical recovery from dysphagia and highlight the importance of the insula and the PPC for the central coordination of swallowing. The results suggest that MEG examination of swallowing can reflect short-term changes in patients suffering from neurogenic dysphagia.

  7. VIDEOFLUOROSCOPIC SWALLOWING STUDY: esophageal alterations in patients with dysphagia

    Directory of Open Access Journals (Sweden)

    Betina SCHEEREN

    2014-09-01

    Full Text Available Context Videofluoroscopic swallowing study is a dynamic exam and allows the evaluation of the complete swallowing process. However, most published studies have only reported alterations in the oropharynx and pharyngoesophageal transition, leaving the analysis of the esophagus as a secondary goal. Objectives The goal of this study was to investigate the prevalence of alterations in the esophageal phase thorough videofluoroscopic swallowing study in patients with dysphagia. Methods Consecutive patients with dysphagia who underwent videofluoroscopic swallowing study including esophageal analysis between May 2010 and May 2012 had their exams retrospectively reviewed. Patients were classified into two groups: Group I - without a pre-established etiological diagnosis and Group II - with neurological disease. During the exam, the patients ingested three different consistencies of food (liquid, pasty and solid contrasted with barium sulfate and 19 items were analyzed according to a protocol. The esophageal phase was considered abnormal when one of the evaluated items was compromised. Results Three hundred and thirty-three (n = 333 consecutive patients were studied - 213 (64% in Group I and 120 (36% in Group II. Esophageal alterations were found in 104 (31% patients, with a higher prevalence in Group I (36.2%, especially on the items esophageal clearance (16.9% and tertiary contractions (16.4%. It was observed that 12% of individuals in Group I only presented alterations on the esophageal phase. Conclusion Evaluation of the esophageal phase of swallowing during videofluoroscopic swallowing study detects abnormalities in patients with cervical dysphagia, especially in the group without pre-established etiological diagnosis.

  8. Subsurface Structure in the Martian Polar Layered Deposits: The Deep Space 2 Impact Accelerometry Experiment

    Science.gov (United States)

    Moersch, J. E.; Lorenz, R. D.

    1998-01-01

    While primarily a technology demonstration mission, the New Millenium Mars Microprobes (also known as Deep Space 2, or simply DS2)will also provide the first in situ science measurements of the martian subsurface. The DS2 impact accelerometry experiment will provide both engineering data about the depth of probe emplacement and science data about the physical nature of the subsurface at the probes' landing sites. Little is known about the detailed physical properties or small-scale vertical structure of the subsurface at the DS2 landing site in the southern martian polar layered deposits. Imaging data from the Viking Orbiters and Mars Global Surveyor reveal alternating bands of light and dark material in this region with thicknesses at least as small as the limit of resolution, about 10 m. The overall composition of these layers is poorly constrained, but generally thought to be a mixture of dust and ice with the layers being caused by variations in the dust/ice ratio, or perhaps by dust deposits of different densities. Low thermal inertias in the region suggest that the top few centimeters of the surface are composed of a mantling of fine-grained dust. However, 3.5-cm radar returns indicate that the maximum depth of this dust is not greater than a few tens of centimeters. Thermal models generally agree that, while the layered deposits do provide a potential near-surface reservoir for ice, the uppermost few centimeters to meters in these regions are likely to be ice-free because of sublimation losses. Finally, while it is generally agreed that the layered deposits are the product of variations in the martian climate, no direct correlation has been made between band sequences and specific climate changes. Our intention is to shed light on some of these questions about the martian polar layered deposits by using the DS2 accelerometry experiment to determine the physical nature of the layered deposits, and to detect the presence of any subsurface layering of dust, ice

  9. Examining user perceptions of SwallowIT: A pilot study of a new telepractice application for delivering intensive swallowing therapy to head and neck cancer patients.

    Science.gov (United States)

    Wall, Laurelie R; Ward, Elizabeth C; Cartmill, Bena; Hill, Anne J; Porceddu, Sandro V

    2017-01-01

    Consumer feedback and end-user perceptions provide important information regarding the clinical acceptability of new telepractice systems. This pilot investigation aimed to evaluate end-user perceptions of a new asynchronous telepractice application, ' SwallowIT', designed to support patients to remotely complete intensive swallowing therapy during curative chemoradiotherapy (CRT) treatment for head and neck cancer (HNC). Insights were sought from 15 patients with oropharyngeal cancer who used SwallowIT to complete supported home swallowing therapy. Perceptions were evaluated via structured questionnaires, completed following initial orientation to SwallowIT and on completion of CRT. Semi-structured phone interviews were conducted ≥3 months post-treatment. The majority of patients reported positive initial perceptions towards SwallowIT for comfort (87%), confidence (87%), motivation (73%) and support (87%). No statistically significant change in perceptions was observed from baseline to end of CRT ( p > 0.05). Thematic analysis of interviews revealed four main themes: the ease of use of SwallowIT, motivating factors, circumstances which made therapy difficult, and personal preferences for service-delivery models. These preliminary findings demonstrate that SwallowIT was well-perceived by the current group of HNC consumers and suggest that SwallowIT may be well-accepted as an alternate service-delivery model for delivering intensive swallowing therapy during CRT.

  10. Fiber-optic endoscopic evaluation of swallowing to assess swallowing outcomes as a function of head position in a normal population

    Science.gov (United States)

    2014-01-01

    Background Head position practice has been shown to influence pill-swallowing ability, but the impact of head position on measures of swallowing outcomes has not yet been studied with fiber-optic endoscopic evaluation of swallowing (FEES). The primary purpose of this study was to determine whether head position impacts penetration-aspiration scale scores and/or post-swallow pharyngeal residue as assessed by FEES. Documenting the incidence of pharyngeal residue and laryngeal penetration and aspiration in a normal population was a secondary goal. Methods Adults without swallowing difficulties (N = 84) were taught a pill swallowing technique based on learning five head positions and were asked to practice with small, hard candies (e.g., TicTacs) for two weeks. Then they demonstrated swallowing in each of the head positions for two conditions, liquid and purée, while undergoing FEES. Results Out of 840 examined swallows, one event of aspiration and 5 events of penetration occurred. During practice >50% participants found positions they preferred over the center position for swallowing but head position was not associated with penetration-aspiration scores assessed by FEES. Significant associations and non-significant trends were found between pharyngeal residue and three variables: age, most preferred head position, and least preferred head position. Conclusion Head position during swallowing (head up) and age greater than 40 years may result in increased pharyngeal residue but not laryngeal penetration or aspiration. PMID:24755159

  11. Treatment of post-stroke dysphagia by vitalstim therapy coupled with conventional swallowing training.

    Science.gov (United States)

    Xia, Wenguang; Zheng, Chanjuan; Lei, Qingtao; Tang, Zhouping; Hua, Qiang; Zhang, Yangpu; Zhu, Suiqiang

    2011-02-01

    To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia, a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups: conventional swallowing therapy group, VitalStim therapy group, and VitalStim therapy plus conventional swallowing therapy group. Prior to and after the treatment, signals of surface electromyography (sEMG) of swallowing muscles were detected, swallowing function was evaluated by using the Standardized Swallowing Assessment (SSA) and Videofluoroscopic Swallowing Study (VFSS) tests, and swallowing-related quality of life (SWAL-QOL) was evaluated using the SWAL-QOL questionnaire. There were significant differences in sEMG value, SSA, VFSS, and SWAL-QOL scores in each group between prior to and after treatment. After 4-week treatment, sEMG value, SSA, VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group, but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group. It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.

  12. Use of a metal detector in the location of a swallowed razor blade in the oesophagus.

    Science.gov (United States)

    Kessler, A; Yellin, A; Kessler, A; Kronenberg, J

    1990-05-01

    A case describing the use of a metal detector to locate a metallic foreign body swallowed by a prisoner. Initial work up included plain thoracic X-rays and a gastrografin swallow which were negative. A metal detector was used to confirm the presence of a metal body in the oesophagus which was verified by a barium swallow.

  13. Tongue Movements during Water Swallowing in Healthy Young and Older Adults

    Science.gov (United States)

    Steele, Catriona M.; Van Lieshout, Pascal

    2009-01-01

    Purpose: The purpose of this study was to explore the nature and extent of variability in tongue movement during healthy swallowing as a function of aging and gender. In addition, changes were quantified in healthy tongue movements in response to specific differences in the nature of the swallowing task (discrete vs. sequential swallows). Method:…

  14. Acoustic analysis of swallowing sounds: a new technique for assessing dysphagia.

    Science.gov (United States)

    Santamato, Andrea; Panza, Francesco; Solfrizzi, Vincenzo; Russo, Anna; Frisardi, Vincenza; Megna, Marisa; Ranieri, Maurizio; Fiore, Pietro

    2009-07-01

    To perform acoustic analysis of swallowing sounds, using a microphone and a notebook computer system, in healthy subjects and patients with dysphagia affected by neurological diseases, testing the positive/negative predictive value of a pathological pattern of swallowing sounds for penetration/aspiration. Diagnostic test study, prospective, not blinded, with the penetration/aspiration evaluated by fibreoptic endoscopy of swallowing as criterion standard. Data from a previously recorded database of normal swallowing sounds for 60 healthy subjects according to gender, age, and bolus consistency was compared with those of 15 patients with dysphagia from a university hospital referral centre who were affected by various neurological diseases. Mean duration of the swallowing sounds and post-swallowing apnoea were recorded. Penetration/aspiration was verified by fibreoptic endoscopy of swallowing in all patients with dysphagia. The mean duration of swallowing sounds for a liquid bolus of 10 ml water was significantly different between patients with dysphagia and healthy patients. We also described patterns of swallowing sounds and tested the negative/positive predictive values of post-swallowing apnoea for penetration/aspiration verified by fibreoptic endoscopy of swallowing (sensitivity 0.67 (95% confidence interval 0.24-0.94); specificity 1.00 (95% confidence interval 0.56-1.00)). The proposed technique for recording and measuring swallowing sounds could be incorporated into the bedside evaluation, but it should not replace the use of more diagnostic and valuable measures.

  15. Swallowing transit times and valleculae residue in stable chronic obstructive pulmonary disease

    OpenAIRE

    CHAVES, Rosane de Deus; Sassi,Fernanda Chiarion; Mangilli,Laura Davison; Jayanthi, Shri Krishna; Cukier,Alberto; Zilberstein,Bruno; Andrade,Claudia Regina Furquim de

    2014-01-01

    Abstract Background Breathing and swallowing are physiologically linked to ensure effortless gas exchange during oronasal breathing and to prevent aspiration during swallowing. Studies have indicated consistent aspiration in chronic obstructive pulmonary disease, mainly related to delayed swallowing reflex and problems with lingual propulsion and pharyngeal peristalsis as a result of bilateral weakness and incoordination of the related m...

  16. Quantification of free-living activity patterns using accelerometry in adults with mental illness

    Science.gov (United States)

    Chapman, Justin J.; Roberts, James A.; Nguyen, Vinh T.; Breakspear, Michael

    2017-01-01

    Physical activity is disrupted in many psychiatric disorders. Advances in everyday technologies – such as accelerometers in smart phones – opens exciting possibilities for non-intrusive acquisition of activity data. Successful exploitation of this opportunity requires the validation of analytical methods that can capture the full movement spectrum. The study aim was to demonstrate an analytical approach to characterise accelerometer-derived activity patterns. Here, we use statistical methods to characterize accelerometer-derived activity patterns from a heterogeneous sample of 99 community-based adults with mental illnesses. Diagnoses were screened using the Mini International Neuropsychiatric Interview, and participants wore accelerometers for one week. We studied the relative ability of simple (exponential), complex (heavy-tailed), and composite models to explain patterns of activity and inactivity. Activity during wakefulness was a composite of brief random (exponential) movements and complex (heavy-tailed) processes, whereas movement during sleep lacked the heavy-tailed component. In contrast, inactivity followed a heavy-tailed process, lacking the random component. Activity patterns differed in nature between those with a diagnosis of bipolar disorder and a primary psychotic disorder. These results show the potential of complex models to quantify the rich nature of human movement captured by accelerometry during wake and sleep, and the interaction with diagnosis and health. PMID:28266563

  17. "Spatial Energetics": Integrating Data From GPS, Accelerometry, and GIS to Address Obesity and Inactivity.

    Science.gov (United States)

    James, Peter; Jankowska, Marta; Marx, Christine; Hart, Jaime E; Berrigan, David; Kerr, Jacqueline; Hurvitz, Philip M; Hipp, J Aaron; Laden, Francine

    2016-11-01

    To address the current obesity and inactivity epidemics, public health researchers have attempted to identify spatial factors that influence physical inactivity and obesity. Technologic and methodologic developments have led to a revolutionary ability to examine dynamic, high-resolution measures of temporally matched location and behavior data through GPS, accelerometry, and GIS. These advances allow the investigation of spatial energetics, high-spatiotemporal resolution data on location and time-matched energetics, to examine how environmental characteristics, space, and time are linked to activity-related health behaviors with far more robust and detailed data than in previous work. Although the transdisciplinary field of spatial energetics demonstrates promise to provide novel insights on how individuals and populations interact with their environment, there remain significant conceptual, technical, analytical, and ethical challenges stemming from the complex data streams that spatial energetics research generates. First, it is essential to better understand what spatial energetics data represent, the relevant spatial context of analysis for these data, and if spatial energetics can establish causality for development of spatially relevant interventions. Second, there are significant technical problems for analysis of voluminous and complex data that may require development of spatially aware scalable computational infrastructures. Third, the field must come to agreement on appropriate statistical methodologies to account for multiple observations per person. Finally, these challenges must be considered within the context of maintaining participant privacy and security. This article describes gaps in current practice and understanding and suggests solutions to move this promising area of research forward.

  18. Gait analysis using 3D accelerometry in horses sedated with xylazine.

    Science.gov (United States)

    López-Sanromán, F J; Holmbak-Petersen, R; Santiago, I; Gómez de Segura, I A; Barrey, E

    2012-07-01

    The aim of the present study was to verify the efficacy and sensitivity of an accelerometric device in detecting and quantifying the degree of movement alteration produced in horses sedated with xylazine. Horses (n=6) were randomly administered either xylazine or a control by intravenous injection, with at least 1 week between each treatment. A triaxial accelerometric device was used for the accelerometric gait assessment 15 min before (baseline) and 5, 15, 30, 45, 60, 75, 90, 105 and 120 min after each treatment. Eight different accelerometric parameters were calculated, including speed, stride frequency, stride length, regularity, dorsoventral power, propulsion power, mediolateral power and total power, with the force of acceleration and the dorsoventral, mediolateral and craniocaudal (propulsive) parts of the power then calculated. Administration of xylazine decreased many of the parameters investigated, with significant differences for speed, stride frequency, dorsoventral power, propulsion power and total power at 5, 15, 30 and 45 min after injection. There were no significant differences in stride length values at any time point. Decreases in regularity values were evident with significant differences at every time point from 5 to 120 min following xylazine injection. Force values were also significantly reduced from 5 to 30 min after treatment and a redistribution of the total power was observed 5 min after injection as the mediolateral power increased significantly, while the dorsoventral power decreased. Accelerometry offers a practical, accurate, easy to use, portable and low cost method of objectively monitoring gait abnormalities at the walk in horses after sedation with xylazine.

  19. Evaluation of swallowing in infants with congenital heart defect.

    Science.gov (United States)

    Pereira, Karine da Rosa; Firpo, Cora; Gasparin, Marisa; Teixeira, Adriane Ribeiro; Dornelles, Silvia; Bacaltchuk, Tzvi; Levy, Deborah Salle

    2015-01-01

    Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036) and between oral-motor oral feeding readiness and dysphagia (p = 0.014). Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  20. Evaluation of Swallowing in Infants with Congenital Heart Defect

    Directory of Open Access Journals (Sweden)

    Pereira, Karine da Rosa

    2014-11-01

    Full Text Available Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036 and between oral-motor oral feeding readiness and dysphagia (p = 0.014. Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  1. Evaluation of Manometric Measures during Tongue-Hold Swallows

    Science.gov (United States)

    Doeltgen, Sebastian H.; Witte, Ulrike; Gumbley, Freya; Huckabee, Maggie-Lee

    2009-01-01

    Purpose: Based on visual inspection, prior research documented increased movement of the posterior pharyngeal wall in healthy volunteers during tongue-hold swallows. This manometric study investigated the immediate effects of the tongue-hold maneuver on pharyngeal peak pressure generation, duration of pressure generation, and pressure slope…

  2. Mastication and swallowing : influence of fluid addition to foods

    NARCIS (Netherlands)

    Pereira, Luciano Jose; Duarte Gaviao, Maria Beatriz; Engelen, Lina; van der Bilt, Andries

    2007-01-01

    introduction: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. Objectives: The hypothesis examined in the present study was that adding fluids to foods will influence chew

  3. [Specialties in dentistry. Salivary flow and swallowing in Parkinson's disease

    NARCIS (Netherlands)

    Wierink, C.D.; Spijker, P.C.; Baat, C. de

    2006-01-01

    Parkinson's disease is a slowly progressive and irreversible disorder of the nervous system. Drooling is listed as a secondary symptom of Parkinson's disease. Its cause is insufficiently clear. In the literature 2 possible causes are described: hypersalivation and swallowing abnormalities. These

  4. Effects of Lingual Effort on Swallow Pressures Following Radiation Treatment

    Science.gov (United States)

    Lenius, Kerry; Stierwalt, Julie; LaPointe, Leonard L.; Bourgeois, Michelle; Carnaby, Giselle; Crary, Michael

    2015-01-01

    Purpose: This article investigated the effects of increased oral lingual pressure on pharyngeal pressures during swallowing in patients who have undergone radiotherapy for head and neck cancer. It was hypothesized that increased oral lingual pressure would result in increased pharyngeal pressures. Method: A within-subject experimental design was…

  5. Effect of posture on swallowing | Alghadir | African Health Sciences

    African Journals Online (AJOL)

    Log in or Register to get access to full text downloads. ... Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while swallowing.

  6. Mastication and swallowing : influence of fluid addition to foods

    NARCIS (Netherlands)

    Pereira, Luciano Jose; Duarte Gaviao, Maria Beatriz; Engelen, Lina; Van der Bilt, Andries

    2007-01-01

    introduction: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. Objectives: The hypothesis examined in the present study was that adding fluids to foods will influence chew

  7. Swallowing Disorders in Parkinson's Disease: Impact of Lingual Pumping

    Science.gov (United States)

    Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

    2015-01-01

    Background: Lingual pumping (LP) is a repetitive, involuntary, anteroposterior movement of the tongue on the soft palate that is executed prior to transferring the food bolus to the pharynx, but we also observed LP when multiple swallows were taken. LP may be associated with rigidity and bradykinesia in patients with Parkinson's disease (PD). This…

  8. Coordination in oro-pharyngeal biomechanics during human swallowing.

    Science.gov (United States)

    Li, Qiang; Minagi, Yoshitomo; Hori, Kazuhiro; Kondoh, Jugo; Fujiwara, Shigehiro; Tamine, Kenichi; Inoue, Makoto; Maeda, Yoshinobu; Chen, Yongjin; Ono, Takahiro

    2015-08-01

    In swallowing, the tongue contacts against the hard palate to generate pressure for propelling a bolus from the oral cavity into the pharynx. Meanwhile, the hyoid and larynx move upward and forward to facilitate the bolus from the pharynx into the esophagus. It has been well known that sequential coordination between those actions is critical for safety accomplishment of swallowing. However, the absence of noninvasive assessment for it limits the detection to the physiological symptom of dysphagia. We applied a sensor sheet on the hard palate to measure tongue contact pressure and a bend sensor on the frontal neck to monitor the laryngeal movement, which was synchronized with hyoid motion for assessing the coordination between both actions in 14 healthy male subjects when swallowing 5ml of water. The sequential order of tongue pressure and hyoid movement was successfully displayed. Tongue pressure was produced after slight movement of the hyoid and closely to the hyoid elevation, then reached a maximum when the hyoid stabilized in the most anterior-superior position, and ceased concurrently with the onset of hyoid descent. Additionally, the synchronized data from both sensors showed positive correlations between identified time points on the laryngeal signal waveform and onset, peak and offset of tongue pressure. Our sensing system successfully showed the coordination between tongue pressure production and hyoid motion, and could be a simple and noninvasive method for clinicians to evaluate the oral and pharyngeal stages of swallowing.

  9. Differential retention of emulsion components in the mouth after swallowing

    NARCIS (Netherlands)

    Jongh, de H.H.J.; Janssen, A.M.; Weenen, H.

    2006-01-01

    ATR FT-IR spectroscopy was used to investigate the coating that stays behind in the mouth after swallowing mayonnaise samples. Typically, the oil content was found to decrease to an average of 26% (range: 12-40%) of the t=0 value after 2 min, to

  10. Differences in Swallowing between High and Low Concentration Taste Stimuli

    Directory of Open Access Journals (Sweden)

    Ahmed Nagy

    2014-01-01

    Full Text Available Taste is a property that is thought to potentially modulate swallowing behavior. Whether such effects depend on taste, intensity remains unclear. This study explored differences in the amplitudes of tongue-palate pressures in swallowing as a function of taste stimulus concentration. Tongue-palate pressures were collected in 80 healthy women, in two age groups (under 40, over 60, stratified by genetic taste status (nontasters, supertasters. Liquids with different taste qualities (sweet, sour, salty, and bitter were presented in high and low concentrations. General labeled magnitude scale ratings captured perceived taste intensity and liking/disliking of the test liquids. Path analysis explored whether factors of taste, concentration, age group, and/or genetic taste status impacted: (1 perceived intensity; (2 palatability; and (3 swallowing pressures. Higher ratings of perceived intensity were found in supertasters and with higher concentrations, which were more liked/disliked than lower concentrations. Sweet stimuli were more palatable than sour, salty, or bitter stimuli. Higher concentrations elicited stronger tongue-palate pressures independently and in association with intensity ratings. The perceived intensity of a taste stimulus varies as a function of stimulus concentration, taste quality, participant age, and genetic taste status and influences swallowing pressure amplitudes. High-concentration salty and sour stimuli elicit the greatest tongue-palate pressures.

  11. Suck, swallow and breathing coordination in infants with infantile colic

    Directory of Open Access Journals (Sweden)

    Hanlie Degenaar

    2015-02-01

    Full Text Available Background: There appears to be a perception amongst parents and in popular literature that infantile colic is caused by feeding difficulties. Limited support for this perception is found in scientific literature. Whilst there is scientific evidence that suck, swallow and breathing are key components of successful feeding, these components and the coordination thereof in infants with colic have not been extensively researched.Objective: The objective of the study was to explore the suck, swallow and breathing coordination in infants with infantile colic and compare it with infants without the condition.Method: An assessment protocol for suck, swallow and breathing coordination was compiled from literature. This protocol was performed on a research group of 50 infants, independently diagnosed with infantile colic, and a control group of 28 infants without the condition. All participants were from two rural towns in the North–West province, South Africa, selected with a snowball selection method and strict selection criteria. The study followed a static comparison group design. Results: A significant difference in the key components of feeding and the presence of colic in participants of four age categories were found. The correlation between postural control and the presence of infantile colic were sustained in participants from 2–19 weeks old. Conclusion: Suck, swallow and breathing were found to be significantly associated with infantile colic. The findings should be investigated further. It appears that speech-language therapists may play an expanding role in infantile colic.[pdf to follow

  12. [The effectiveness of fiberoptic endoscopic swallow study and modified barium swallow study techniques in diagnosis of dysphagia].

    Science.gov (United States)

    Gerek, Mustafa; Atalay, Altan; Cekin, Engin; Ciyiltepe, Müzeyyen; Ozkaptan, Yalçin

    2005-01-01

    The purpose of this study was to evaluate the effectiveness of fiberoptic endoscopic evaluation of swallowing (FEES) and the modified barium swallow test (MBST) in patients with dysphagia. Eighty patients with dysphagia were evaluated in three groups consisting of 27 patients with oral, pharyngeal, or esophageal masses; 26 patients with neurogenic dysphagia; and 27 patients with no distinct pathology. All the patients underwent FEES and MBST to examine elevation of the soft palate, nasal regurgitation, pharyngeal residue, penetration, aspiration, and pooling of secretions in the pyriform sinus and vallecula. In neurogenic dysphagia, MBST was more efficacious in detecting aspiration and pooling in the vallecula (p<0.05). Evaluation of the internal anatomy, visualization of masses, and laryngopharyngeal sensory discrimination were only possible with the FEES. On the other hand, evaluation of the elevation of the larynx and the hyoid, the relaxation of the upper esophageal sphincter, and the oral phase of swallowing, and the detection of esophageal pathologies were only possible with the MBST. The leading advantages of the two evaluation techniques seem to lie in the detection of aspiration for the FEES, and dynamic evaluation of the oral and esophageal phases of swallowing for the MBST.

  13. Soft-robotic esophageal swallowing as a clinically-inspired bolus rheometry technique

    Science.gov (United States)

    Dirven, Steven; Allen, Jacqueline; (Peter Xu, Weiliang; Cheng, Leo K.

    2017-03-01

    To investigate the impact of viscosity and peristaltic transport parameters on manometric pressure signatures, a reproducible swallowing process is required. Due to inter- and intra-subject variability from swallow to swallow, the human body does not represent an optimal mechanism for such an investigation. A smooth and continuous swallowing soft-robot has been developed to produce biomimetic swallowing trajectories, and is proposed to operate as a bench-top bolus rheometric investigation method. The method compares conventional viscometry and pressure signature findings from robotic swallowing experiments. The robotic aspect of experimentation involved 450 biomimetic swallows (10 repetitions of 45 unique experiments). The method examined swallowing transport in three dimensions: bolus formulation, peristaltic wavelength, and peristaltic velocity, each of which are known to contribute to safe and effective swallowing in vivo. It is found that the pressure gradients and magnitudes are commensurate with clinical reports on biological swallowing, on the order of 100 mmHg peak, however, the relationship between viscosity and pressure signatures is less clear. Bolus transport cannot be predicted as a function of bolus viscosity alone. Traditional viscometric data at 50 s-1, as used in clinical practice, may not be a strong indicator of swallow effort, safety, or efficacy in vivo.

  14. The swallowing reflex and its significance as an airway defensive reflex

    Directory of Open Access Journals (Sweden)

    Takashi eNishino

    2013-01-01

    Full Text Available Swallowing function, in humans, is very complex. Swallowing plays, not only an important role in food digestion, but also a major role in preventing the entrance of food and/or other materials into the lower respiratory tract. To achieve this, precise coordination is necessary between breathing and swallowing since the pharynx serves as a common pathway for both respiration and digestion. The swallowing reflex consists of afferent pathways, central integration, and efferent pathways. Any defect or disorder along reflex arc can cause a potential delay or impairment in swallow function. The swallowing reflex can be modulated not only by pathological factors but also by physiological factors. Among these, timing of swallows in relation to the phase of respiration may be the most important factor that determines the occurrence of pulmonary aspiration, since phases of inspiration and the expiration-inspiration transition are the most vulnerable for pulmonary aspiration.

  15. Use of respiratory inductance plethysmography for the detection of swallowing in the elderly.

    Science.gov (United States)

    Moreau-Gaudry, Alexandre; Sabil, Abdelkebir; Benchetrit, Gila; Franco, Alain

    2005-01-01

    It is essential to have a user-friendly, noninvasive bedside procedure at our disposal in order to study swallowing and swallowing disorders in the elderly in view of the frailty of this age group. In the present work, respiratory inductance plethysmography (RIP) is proposed as an appropriate clinical tool for such studies. An automated process for the detection of swallowing is used involving the derivative of the respiratory volume signal. The accuracy of the automated detection is given by the area under the Receiver Operating Characteristic (ROC) curve and is found to be greater than 0.9. At the optimal threshold, RIP constitutes a reliable and objective bedside clinical tool for studying swallowing in the elderly, as well as being user-friendly and noninvasive. In addition, RIP can be used to monitor swallowing in order to analyze swallowing disorders and put in place medical supervision of swallowing for individuals who might aspirate.

  16. Submental sEMG and Hyoid Movement during Mendelsohn Maneuver, Effortful Swallow, and Expiratory Muscle Strength Training

    Science.gov (United States)

    Wheeler-Hegland, Karen M.; Rosenbek, John C.; Sapienza, Christine M.

    2008-01-01

    Purpose: This study investigated the concurrent biomechanical and electromyographic properties of 2 swallow-specific tasks (effortful swallow and Mendelsohn maneuver) and 1 swallow-nonspecific (expiratory muscle strength training [EMST]) swallow therapy task in order to examine the differential effects of each on hyoid motion and associated…

  17. [Comparison of swallowing surface electromyography in globus patients and healthy adults].

    Science.gov (United States)

    Zhang, Jie; Li, Jinrang

    2015-02-01

    To study the surface electromyography (sEMG) changes of globus patients during swallowing and to discuss the cause of the globus. The sEMG during swallowing was recorded in 126 healthy volunteers (control group) and 34 globus patients (globus group).Swallow included dry swallow and 20 ml water swallow. The durations and amplitudes of muscle activities during every swallow were recorded. The durations and amplitudes of the sEMG in two groups were compared using t test. The durations of sEMG at dry swallow and 20 ml water swallow were (1.128 ± 0.191)s and (1.091 ± 0.208)s, while the amplitudes were (0.313 ± 0.110) mV and (0.286 ± 0.106) mV in control group. The durations of sEMG at dry swallow and 20 ml water swallow were (1.178 ± 0.252)s and (1.127 ± 0.178)s, while the amplitudes were (0.341 ± 0.116) mV and (0.316 ± 0.094) mV in globus group. There were no significant differences between globus patients and healthy volunteers in the durations and amplitudes of sEMG at dry swallow and 20 ml water swallow (P > 0.05).Furthermore, there were also no significant differences in the durations and amplitudes of the sEMG between the two groups in the same gender (P > 0.05). The results of swallowing sEMG suggested that the swallowing function in globus patients has not been damaged and psychological intervention should be considered in the treatment.

  18. Localization of Physical Activity in Primary School Children Using Accelerometry and Global Positioning System.

    Directory of Open Access Journals (Sweden)

    Rahel Bürgi

    Full Text Available Ecological approaches have highlighted the importance of the built environment as a factor affecting physical activity. However, knowledge on children's activity patterns is still incomplete. Particularly, data on the spatial context of physical activity is limited, which limits the potential to design location-based interventions effectively. Using global positioning system (GPS and accelerometry, this study aimed to identify locations where children engage in moderate-vigorous physical activity (MVPA.Participants included 119 children (11-14 years, 57% girls from public schools in Winterthur, Switzerland. During a regular school week between February and April 2013, children wore an accelerometer and GPS sensor for seven consecutive days. Time-matched accelerometer and GPS data was mapped with a geographic information system and each data point was assigned to one of seven defined activity settings. Both the absolute amount of MVPA and proportion of time in MVPA were calculated for every setting. Multilevel analyses accounting for the hierarchical structure of the data were conducted to investigate any gender differences.Children achieved most MVPA on streets (34.5% and on school grounds (33.4%. The proportion children spent in MVPA was highest in recreational facilities (19.4%, at other schools (19.2% and on streets (18.6%. Boys accumulated significantly more MVPA overall and on other school grounds (p < 0.05 and showed a significantly higher proportion of time in MVPA at own school and outside of Winterthur (p < 0.05.The results indicate the importance of streets and school grounds as activity-promoting environments. The high use of streets may be an indicator for active transportation, which appears to contribute to an active lifestyle in both genders. In contrast, the school setting is more likely to encourage physical activity in boys. Recreational facilities seem to be conducive for MVPA among both genders, although infrequently visited

  19. Comparison of gait symmetry between poststroke fallers and nonfallers during level walking using triaxial accelerometry

    Science.gov (United States)

    Lien, Wei-Chih; Cheng, Yung-Heng; Kuan, Ta-Shen; Zheng, Yu-Lun; Hsieh, Chao-Hsien; Wang, Wen-Fong

    2017-01-01

    Abstract To compare the degree of gait symmetry of chronic poststroke fallers with that of nonfallers during level walking using triaxial accelerometry. In this cross-sectional study, a total of 14 patients with chronic stroke were recruited from a community hospital from February 2015 to July 2016. Patient characteristics, including the number of falls in the previous 12 months, were obtained from medical records. The Berg Balance Scale (BBS) and timed up and go (TUG) test were used at the onset of the study. Triaxial accelerometers were attached to the back and bilateral lower extremities of each subject with sampling rates of 120 Hz. The cross-correlation between the acceleration signals of the affected and unaffected feet was measured to assess the degree of gait symmetry. The triaxial acceleration signals of the 5 consecutive and bilateral strides from the middle of each trial were processed to measure the cross-correlation and time delay (Ts) between the magnitude of the acceleration vector of the affected and unaffected foot. After controlling for possible confounding factors, the mixed-effect models showed that cross-correlation was significantly higher among nonfallers than fallers (β = −0.093; standard error [SE] = 0.029; P-value = 0.002), and that the Ts was significantly longer among fallers than nonfallers (β = −1.900; SE = 0.719; P-value = 0.011). Cross-correlation and Ts between the affected and unaffected lower extremities may be useful indicators to distinguish poststroke fallers from nonfallers. PMID:28248856

  20. Effect of Varying Accelerometry Criteria on Physical Activity: The Look AHEAD Study

    Science.gov (United States)

    Miller, G. D.; Jakicic, J. M.; Rejeski, W. J.; Whit-Glover, M.; Lang, W.; Walkup, M. P.; Hodges, M.

    2012-01-01

    The importance of physical activity in weight management is widely documented. Although accelerometers offer an objective measure of activity that provide a valuable tool for intervention research, considerations for processing these data need further development. This study tests the effects of using different criteria for accelerometry data reduction. Data were obtained from 2,240 overweight and obese individuals with type 2 diabetes mellitus (T2DM) from the Look AHEAD study, with 2,177 baseline accelerometer files used for analysis. Number, duration, and intensity of moderate (≥3 METS) and vigorous (≥6 METS) activity bouts were compared using various data reduction criteria. Daily wear time was identified as 1,440 minutes per day minus non-wear time. Comparisons of physical activity patterns for non-wear time (using either 20, 30 or 60 minutes of continuous zeros), minimal daily wear time (8, 10, and 12 hours), number of days with available data (4, 5, and 6 days), weekdays versus weekends, and one- or two-minute time interruptions in an activity bout were performed. In this mostly obese population with T2DM (BMI = 36.4 kg/m2; mean age = 59.0 y), there were minimal differences in physical activity patterns using the different methods of data reduction. Altering criteria led to differences in the number of available data (sample size) meeting specific criteria. Although our results are likely directly applicable only to obese individuals with T2DM, an understudied population with regards to physical activity, the systematic analysis for data reduction employed can be more generalizable and provide guidance in this area in the absence of standard procedures. PMID:23505166

  1. Innate immune response development in nestling tree swallows

    Science.gov (United States)

    Stambaugh, T.; Houdek, B.J.; Lombardo, M.P.; Thorpe, P.A.; Caldwell, Hahn D.

    2011-01-01

    We tracked the development of innate immunity in nestling Tree Swallows (Tachycineta bicolor) and compared it to that of adults using blood drawn from nestlings during days 6, 12, and 18 of the ???20-day nestling period and from adults. Innate immunity was characterized using an in vitro assay of the ability of whole blood to kill Escherichia coli. The ability of whole blood to kill E. coli increased as nestlings matured. Neither this component of innate immunity nor right wing chord length on day18 were as developed as in adults indicating that development of the innate immune system and growth both continued after fledging. Narrow sense heritability analyses suggest that females with strong immune responses produced nestlings with strong immune responses. These data suggest nestling Tree Swallows allocated sufficient energy to support rapid growth to enable fledging by day 18, but that further development of innate immunity occurred post-fledging. ?? 2011 by the Wilson Ornithological Society.

  2. Speech and swallowing outcomes in buccal mucosa carcinoma

    Directory of Open Access Journals (Sweden)

    Sunila John

    2011-01-01

    Full Text Available Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carcinoma that need to be addressed by SLPs, and the outcomes of speech and swallowing rehabilitation and prognostic issues.

  3. Elevated frequency of abnormalities in barn swallows from Chernobyl.

    Science.gov (United States)

    Møller, A P; Mousseau, T A; de Lope, F; Saino, N

    2007-08-22

    Ever since the Chernobyl accident in 1986, that contaminated vast areas in surrounding countries with radiation, abnormalities and birth defects have been reported in human populations. Recently, several studies suggested that the elevated frequency of such abnormalities can be attributed to poverty and stress in affected human populations. Here, we present long-term results for a free-living population of barn swallows, Hirundo rustica, demonstrating the presence of 11 morphological abnormalities in populations around Chernobyl, but much less frequently in an uncontaminated Ukrainian control population and three more distant control populations. The presence of these abnormalities in barn swallows is associated with reduced viability. These findings demonstrate a link between morphological abnormalities and radiation in an animal population that cannot be attributed to poverty and stress. The most parsimonious hypothesis for abnormalities in animal and human populations alike is that the effects are caused by the same underlying cause, viz. radiation derived from the Chernobyl accident.

  4. Pulse swallowing frequency divider with low power and compact structure

    Institute of Scientific and Technical Information of China (English)

    Gao Haijun; Sun Lingling; Cai Chaobo; Zhan Haiting

    2012-01-01

    A pulse swallowing frequency divider with low power and compact structure is presented.One of the DFFs in the divided by 2/3 prescaler is controlled by the modulus control signal,and automatically powered off when it has no contribution to the operation of the prescaler.The DFFs in the program counter and the swallow counter are shared to compose a compact structure,which reduces the power consumption further.The proposed multi-modulus frequency divider was implemented in a standard 65 nm CMOS process with an area of 28 ×22 μm2.The power consumption of the divider is 0.6 mW under 1.2 V supply voltage when operating at 988 MHz.

  5. Imaging findings of swallowed dentures: a case series.

    Science.gov (United States)

    Chawla, Ashish; Bosco, Jerome; Subramanian, Manickam; Chokkapan, Kabilan; Shenoy, Jagadish; Lim, Tze Chwan

    2015-12-01

    Dental prosthesis is an uncommon ingested non-food foreign body in adults. Once swallowed, it can lead to serious complications and morbidity. Hence, early localization of the offending foreign body is crucial for timely management. As the dentures are usually made up of non-metallic material and often impacted at or below the level of C7 vertebra, conventional radiograph has limited role in their evaluation. We describe the clinical history and imaging findings of swallowed partial dentures in four patients who presented to the emergency department. The dentures were localized using unenhanced CT of the neck that showed the characteristic mildly hyperdense curvilinear or irregular appearance of the dentures within the upper esophagus. Multiplanar CT reconstructions provide an orientation of the ingested denture within the esophagus, thus guiding the endoscopist.

  6. Successful endoscopic removal of a swallowed toothbrush: case report.

    Science.gov (United States)

    Tonkic, Ante; Bogdanovic, Zoran; Grandić, Leo

    2011-04-06

    Most ingested foreign bodies will pass uneventfully through the gastrointestinal tract. Nevertheless, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation and bleeding. Moreover, there has been no case of spontaneous passage of a toothbrush reported. Therefore, the prompt removal of such ingested foreign objects is recommended before complications develop. This case report describes a case of an 18-year-old woman who accidentally swallowed her toothbrush. The toothbrush was successfully removed via flexible endoscopy using a polypectomy snare. A swallowed toothbrush is a special clinical challenge. Early endoscopic retrieval of the toothbrush is critical for reducing morbidity and mortality. In cases when endoscopic removal fails, a laparoscopic surgical approach may be an alternative.

  7. Successful Endoscopic Removal of a Swallowed Toothbrush: Case Report

    Directory of Open Access Journals (Sweden)

    Ante Tonkic

    2011-04-01

    Full Text Available Most ingested foreign bodies will pass uneventfully through the gastrointestinal tract. Nevertheless, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation and bleeding. Moreover, there has been no case of spontaneous passage of a toothbrush reported. Therefore, the prompt removal of such ingested foreign objects is recommended before complications develop. This case report describes a case of an 18-year-old woman who accidentally swallowed her toothbrush. The toothbrush was successfully removed via flexible endoscopy using a polypectomy snare. A swallowed toothbrush is a special clinical challenge. Early endoscopic retrieval of the toothbrush is critical for reducing morbidity and mortality. In cases when endoscopic removal fails, a laparoscopic surgical approach may be an alternative.

  8. Effect of ill-fitting dentures on the swallowing duration in patients using polygraphy.

    Science.gov (United States)

    Monaco, Annalisa; Cattaneo, Ruggero; Masci, Chiara; Spadaro, Alessandro; Marzo, Giuseppe

    2012-06-01

    Surface electromyography (SEMG) has been widely used in the recent years to study swallowing physiology, offering a valid and reliable tool for identifying normal swallowing. The goal of our study was to assess the contribution of denture fitness in the age-related increase of swallowing duration. Twenty denture wearers and 20 dentate individuals were analysed using SEMG and a computerised kinesiography of mandibular movement. Three spontaneous saliva swallowings were recorded for each patient with both their old and new prostheses. Three spontaneous saliva swallowings were recorded for each dentate person in two different recording sessions. Old prosthesis mean swallowing time was 1.84 (SD ± 0.85) seconds while the new well-fitting prostheses needed a 1.28 (SD ± 0.55) (p = 0.0009) swallowing time. The difference in swallowing time was significant (p = 0.01) between dentate subjects and individuals wearing an old prosthesis. No significant difference was found between dentate subjects and the same prosthesis wearers when a new well-fitting prosthesis was worn. Data presented in this work suggest that part of the increased duration of swallowing showed by elderly and healthy people is because of incorrect an dental prosthesis. Prolongation of swallowing duration in the elderly population could be reconsidered in the light of the quality of dental device worn by the aged population. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  9. Predation by ants controls swallow bug (Hemiptera: Cimicidae: Oeciacus vicarius) infestations.

    Science.gov (United States)

    Brown, Charles R; Page, Catherine E; Robison, Grant A; O'Brien, Valerie A; Booth, Warren

    2015-06-01

    The swallow bug (Oeciacus vicarius) is the only known vector for Buggy Creek virus (BCRV), an alphavirus that circulates in cliff swallows (Petrochelidon pyrrhonota) and house sparrows (Passer domesticus) in North America. We discovered ants (Crematogaster lineolata and Formica spp.) preying on swallow bugs at cliff swallow colonies in western Nebraska, U.S.A. Ants reduced the numbers of visible bugs on active swallow nests by 74-90%, relative to nests in the same colony without ants. Ant predation on bugs had no effect on the reproductive success of cliff swallows inhabiting the nests where ants foraged. Ants represent an effective and presumably benign way of controlling swallow bugs at nests in some colonies. They may constitute an alternative to insecticide use at sites where ecologists wish to remove the effects of swallow bugs on cliff swallows or house sparrows. By reducing bug numbers, ant presence may also lessen BCRV transmission at the spatial foci (bird colony sites) where epizootics occur. The effect of ants on swallow bugs should be accounted for in studying variation among sites in vector abundance. © 2015 The Society for Vector Ecology.

  10. Difficult to swallow: patient preferences for alternative valproate pharmaceutical formulations

    Directory of Open Access Journals (Sweden)

    Monali Bhosle

    2009-06-01

    Full Text Available Monali Bhosle,1 Joshua S Benner,1 Mitch DeKoven,1 Jeff Shelton21Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA; 2Answers and Insights Market Research, Inc, Indianapolis, IN, USAObjective: To determine the degree to which swallowing valproate (VP tablets is an issue, the proportion of patients who would prefer an alternative formulation, and the predictors of preference.Methods: A quantitative telephone survey of eligible adults (n = 400, ≥18 years old who currently take (n = 236 or previously took (n = 164 VP tablets within the past 6 months was conducted.Results: More than half of the patients indicated that VP tablets were ‘uncomfortable to swallow’ (68.5%, n = 274 and were ‘very interested’ (65.8%, n = 263 in medications that were easier to swallow. When choosing conceptually between taking VP tablet once/day or an equally safe and effective but significantly smaller soft gel capsule twice per day, the 82.8%, (n = 331 preferred the soft gel capsule. In the multivariate regression analysis, perceiving soft gel capsules to be easier to swallow (OR = 73.54; 95% CI = 15.01 to 360.40 and taking VP more frequently (OR = 2.02; 95% CI = 1.13 to 3.61 were significant predictors of soft gel capsule treatment preference.Conclusion: VP users would prefer a formulation that is easier to swallow, even if it is needed to be taken twice per day. When choosing between medications with similar efficacy and safety, physicians can consider patient preferences to optimize conditions for medication adherence.Keywords: patient preference, valproate formulations, tablet characteristics

  11. Using a metal detector to locate a swallowed ring pull.

    Science.gov (United States)

    Ryan, J; Perez-Avila, C A; Cherukuri, A; Tidey, B

    1995-03-01

    A 48-year-old man accidently swallowed the ring pull from a soft drink can. He complained of pain in his chest. Chest radiographs were normal. A metal detector emitted a strong response when passed across the front of his chest. Oesophagoscopy was carried out and the ring pull was successfully removed. We recommend the wider use of metal detectors by accident and emergency (A&E) department staff particularly when dealing with patients who have ingested metals of low radiodensity.

  12. Barium Swallow Findings in the Evaluation of Patients with Dysphagia

    Directory of Open Access Journals (Sweden)

    Amirhosein Hashemi Attar

    2011-05-01

    Full Text Available Background/Objective: Dysphagia is a subjective"nsensation of difficulty in swallowing that has a wide"nrange of etiologies from psychosomatic disorders"nto high grade neoplasms. In this study we evaluated"nbarium swallow findings of patients with dysphagia."nPatients and Methods: We evaluated 200 patients"n(117 men, 83 women; mean age, 49.6 years with"ncomplaint of dysphagia. Fluoroscopic barium"nswallow was done for all the patients and they were"nreviewed for primary peristalsis (presence or absence,"nAbstracts"nS62 Iran J Radiol 2011, 8 (Supp.1"nAbstracts"nimpaired lower esophageal sphincter, esophageal dilatation, delayed emptying of barium, nonperistaltic contractions, stricture and filling defects. Clinical and in some cases endoscopic or manometric follow up was done for all patients."nResults: We had 134 (67% normal barium swallow"nexams with uncomplicated clinical courses. Sixty"nsix patients (33% had abnormal imaging findings"nincluding stricture in 24 patients (12%, filling defect"nin 12 patients (6% and mucosal abnormality in 14"n(7% patients (six cases of mucosal irregularity, three"ncases of mucosal ulceration and five cases of mucosal"nherniation, Bird's beak sign in three patients (1.5%,"ntertiary spasm in six patients (3% and hiatal hernia in"nseven patients (3.5%."nConclusion: In the majority of patients with dysphagia,"nbarium swallow is the only paraclinical study needed"nto plan proper treatment. If radiographic findings are"nequivocal, endoscopy or manometry may be required"nfor more certain diagnosis.

  13. Thirty years of blackouts: a case report of swallow syncope

    Directory of Open Access Journals (Sweden)

    Irene Lambiris

    2013-04-01

    Full Text Available Deglutition syncope has been demonstrated in isolated case reports, the first being described over 50 years ago. It is thought to be caused by a hypersensitive vagotonic reflex in response to esophageal dilation after swallowing. It can cause syncope due to complete atrioventricular (AV block and acute reduction of cardiac output. Although rare, its lethality is worthy of discussion, as early recognition can offer complete treatment with placement of a pacemaker. A 54-year-old man presented with 30 years of lightheadedness and syncope, followed by disorientation and tremors, after eating sandwiches or drinking carbonated beverages. He initially was evaluated by a neurologist. Work-up included cardiac 2D transthoracic echocardiogram, electroencephalogram, swallow stud, pulmonary function tests, electrocardiogram, and cardiac stress testing. All tests were within normal limits, and it was determined that he was suffering from convulsive syncope and deglutition syncope. Referral to the cardiac electrophysiology department with tilt-table testing accompanied by swallow evaluation was then recommended. The tests demonstrated marked vagal response resulting in sinus bradycardia with second-degree AV block and pauses up to 3.5 seconds. Patient experienced near syncope. A rate-responsive, dual-chamber Boston Scientific pacemaker with DDDR programming was implanted. Patient has remained asymptomatic at follow-up.

  14. Epidermal electronics for electromyography: An application to swallowing therapy.

    Science.gov (United States)

    Constantinescu, Gabriela; Jeong, Jae-Woong; Li, Xinda; Scott, Dylan K; Jang, Kyung-In; Chung, Hyun-Joong; Rogers, John A; Rieger, Jana

    2016-08-01

    Head and neck cancer treatment alters the anatomy and physiology of patients. Resulting swallowing difficulties can lead to serious health concerns. Surface electromyography (sEMG) is used as an adjuvant to swallowing therapy exercises. sEMG signal collected from the area under the chin provides visual biofeedback from muscle contractions and is used to help patients perform exercises correctly. However, conventional sEMG adhesive pads are relatively thick and difficult to effectively adhere to a patient's altered chin anatomy, potentially leading to poor signal acquisition in this population. Here, the emerging technology of epidermal electronics is introduced, where ultra-thin geometry allows for close contouring of the chin. The two objectives of this study were to (1) assess the potential of epidermal electronics technology for use with swallowing therapy and (2) assess the significance of the reference electrode placement. This study showed comparative signals between the new epidermal sEMG patch and the conventional adhesive patches used by clinicians. Furthermore, an integrated reference yielded optimal signal for clinical use; this configuration was more robust to head movements than when an external reference was used. Improvements for future iterations of epidermal sEMG patches specific to day-to-day clinical use are suggested. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  15. Swallowing before and after tonsillectomy as evaluated by surface electromyography.

    Science.gov (United States)

    Vaiman, Michael; Krakovski, Daniel; Gavriel, Haim

    2007-07-01

    Surface electromyography (sEMG) was performed on adult patients (n = 40) following tonsillectomy to evaluate recovery by objective means. Evaluated parameters included timing of swallowing and continuous drinking, electric amplitude and graphic patterns of masseter (MS), and measurement of infrahyoid (INF) and submental (SUB) muscles after tonsillectomy and comparison with normative database. The duration of drinking periods showed significant increase among patients; single-swallow durations remained normal. The electric activity of MS and INF muscles was significantly higher among the patients compared with normative database. It took one month until all the EMG data returned to normal. Tonsillectomy affects muscle activity during swallowing by involving additional muscles in deglutition. EMG is a simple reliable method for postoperative evaluation and might contribute to comparative analysis of different tonsillectomy techniques. EMG can be used during pre- and postoperative stages to monitor recovery and functional improvement of throat muscles and deglutition. The reported sEMG method and obtained data might be further used: 1) As an additional tool for comparison of different methods of tonsillectomy (eg, cold vs hot dissection, laser surgery, etc); 2) For further development of objective postsurgical pain assessment; 3) As an additional tool for assessment and development of less traumatic surgical technique; and 4) For monitoring of recovery in difficult cases.

  16. Mastication and swallowing: influence of fluid addition to foods

    Directory of Open Access Journals (Sweden)

    Luciano José Pereira

    2007-02-01

    Full Text Available INTRODUCTION: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. OBJECTIVES: The hypothesis examined in the present study was that adding fluids to foods will influence chewing physiology. Materials and METHODS: Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume. Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. RESULTS: Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p0.05. Doubling the volume of tap water had a greater effect. CONCLUSIONS: Fluid addition facilitated chewing of dry foods (melba, cake, but did not influence the chewing of fatty (cheese and wet products (carrot. This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation.

  17. Effect of age on proximal esophageal response to swallowing

    Directory of Open Access Journals (Sweden)

    Roberto Oliveira Dantas

    2010-12-01

    Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

  18. Cine-MRI swallowing evaluation after tongue reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Hartl, Dana M. [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dmhartl@aol.com; Kolb, Frederic; Bretagne, Evelyne [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Bidault, Francois; Sigal, Robert [Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)

    2010-01-15

    Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

  19. Mastication and swallowing: influence of fluid addition to foods.

    Science.gov (United States)

    Pereira, Luciano José; Gavião, Maria Beatriz Duarte; Engelen, Lina; Van der Bilt, Andries

    2007-02-01

    The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. The hypothesis examined in the present study was that adding fluids to foods will influence chewing physiology. Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume). Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p0.05). Doubling the volume of tap water had a greater effect. Fluid addition facilitated chewing of dry foods (melba, cake), but did not influence the chewing of fatty (cheese) and wet products (carrot). This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation.

  20. Effect of tongue thrust swallowing on position of anterior teeth.

    Science.gov (United States)

    Jalaly, Tahereh; Ahrari, Farzaneh; Amini, Foroozandeh

    2009-01-01

    There is no consensus about the effect of tongue thrusting on incisor position. The purpose of this study was to evaluate the position of anterior teeth in growing children with tongue thrust swallowing. In the present study 193 subjects with an age range of 9 to 13 years participated. All the patients were examined by a trained investigator and those having tongue thrust swallowing were selected and the position of their anterior teeth was compared with a control group consisting of 36 subjects with normal occlusion. Data was analyzed by independent sample t-test. Among the 193 students who were examined in this study, 10 cases (5%) were diagnosed to be tongue thrusters. Overjet was significantly increased in tongue thrust individuals (P 0.05). The results indicated that tongue thrust may have an environmental effect on dentofacial structures. Considering the high incidence of tongue thrust in orthodontic patients, it is suggested that dental practitioners observe patients of all ages and those in all stages of orthodontic treatment for evidence of tongue thrust swallowing.

  1. Swallowing and pharyngeal function in postoperative pharyngeal cancer patients.

    Science.gov (United States)

    Martini, D V; Har-El, G; Lucente, F E; Slavit, D H

    1997-07-01

    This study examines the pharyngeal phase of swallowing after the resection of pharyngeal cancer, and focuses on the pharynx as a functional organ. The purpose of the study was to obtain information on both reconstruction and rehabilitation in cases of surgically treated pharyngeal cancer. The records of 21 consecutive patients who underwent surgical treatment of oropharyngeal and hypopharyngeal squamous cell carcinoma between 1990 and 1993 were reviewed. Functional results following surgery were graded on a numerical scale in three categories: pharyngeal swallow, laryngeal and lower airway protection, and oral alimentation. Three treatment groups were observed: group 1 = transoral excision with primary closure (six patients); group 2 = composite resection with primary closure (nine patients); and group 3 = composite resection with deltopectoral or pectoralis major flap closure (six patients). Comparison of pharyngeal swallow and laryngeal protection functions showed no significant difference between the three groups. However, oral alimentation performance in group 1 was significantly better than in group 3, and groups 1 and 2 achieved a similar level. In patients with T3 and T4 tumors postoperative function was poor and no difference in postoperative function was demonstrated between patients undergoing reconstruction with primary closure and patients undergoing reconstruction with deltopectoral or pectoralis major flaps. Patients with T3 and T4 tumors experienced impaired postoperative function regardless of the method of reconstruction used. This is not a condemnation of the surgical treatment of advanced pharyngeal tumors, but rather a suggestion that other reconstruction techniques be considered.

  2. Association of trunk control with mobility performance and accelerometry-based gait characteristics in hemiparetic patients with subacute stroke.

    Science.gov (United States)

    Isho, Takuya; Usuda, Shigeru

    2016-02-01

    Trunk control plays an important role in movement control and postural balance during functional activities. The purpose of this study was to investigate the association of trunk control early after stroke with mobility performance and quantitative gait characteristics derived from trunk accelerations. Fifteen patients with hemiparesis following stroke (median age, 61 years [range, 56-78 years]; median time since stroke, 9 days [range, 7-15 days]) participated in this cross-sectional observational study. Subjects were evaluated using the Trunk Impairment Scale (TIS), the short-form of the Berg Balance Scale (SF-BBS), an isometric knee extension strength test, the Timed Up and Go test (TUG), and a timed walking test. The linear acceleration of the lower trunk was recorded along the 3 axes during walking and quantified using the autocorrelation coefficient and harmonic ratio to assess the variability and smoothness of upper-body movement. The TIS total score had a significant correlation with TUG time. The coordination subscale score of the TIS was significantly correlated with TUG time, walking speed, and accelerometry variables in univariate analysis. The TIS coordination subscale score was significantly related to accelerometry variables in the partial correlation analysis adjusted for SF-BBS score and knee extension strength on the paretic and nonparetic side. These results indicate that trunk motor impairment after stroke is closely associated with poor mobility performance and trunk instability in gait. These findings support intensive rehabilitation treatment targeting trunk control to regain better mobility and stable gait in patients early after stroke.

  3. Kinematic analysis of laryngeal movements in patients with neurogenic dysphagia before and after swallowing rehabilitation.

    Science.gov (United States)

    Prosiegel, M; Heintze, M; Sonntag, E W; Schenk, T; Yassouridis, A

    2000-01-01

    To examine whether kinematic analysis of laryngeal movements (which are closely linked to pharyngeal swallowing) can differentiate between normal and disturbed swallowing, we used a three-dimensional ultrasound movement recording system to measure the movements of the larynx during swallowing in 32 patients with neurogenic dysphagia caused by central nervous system lesions and in 32 age- and sex-matched healthy individuals. At the beginning of an inpatient rehabilitation swallowing program, laryngeal movements in 24 patients were highly disturbed in terms of velocity curve irregularities. After rehabilitation, the majority of patients with hitherto irregular velocity profiles exhibited laryngeal kinematics that were indistinguishable from those of 32 healthy subjects. Kinematic analysis of laryngeal movements, therefore, is suitable for monitoring motor recovery of swallowing disturbances in patients with neurogenic dysphagia while undergoing swallowing rehabilitation.

  4. Neonatal swallowing assessment and practical recommendations for oral feeding in a girl with a severe congenital myopathy.

    Science.gov (United States)

    van den Engel-Hoek, Lenie; Erasmus, Corrie E; de Swart, Bert J M; Sie, Lilian T L; de Groot, Imelda J M

    2011-08-01

    The investigators report the case of a 6-week-old girl with a cap-like congenital myopathy and frequent coughing during feeding. Neonatal swallowing assessments were performed with surface electromyography of the submental muscle group and nasal airflow during sucking and swallowing. A videofluoroscopic swallow study was performed separately. The registration of swallowing and breathing revealed a highly coordinated sequence of sucking, swallowing, and breathing. However, after a series of sucking and swallowing there was residue in the hypopharyngeal area, causing laryngeal penetration and coughing. Based on the findings, specific recommendations such as the use of a soft nipple, diminished suck-swallow sequences, and limited feeding time were made for this girl. These proved to be appropriate to prevent coughing as a signal of penetration or aspiration of milk during swallowing. This case highlights the profit of neonatal swallowing assessment, which can provide recommendations for safe oral feeding.

  5. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions

    OpenAIRE

    Sejdić Ervin; Hung Delbert; Steele Catriona M; Chau Tom

    2009-01-01

    Abstract Background A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. Methodology To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing c...

  6. Detection of walking periods and number of steps in older adults and patients with Parkinsons disease : accuracy of a pedometer and an accelerometry-based method

    NARCIS (Netherlands)

    Dijkstra, Baukje; Zijlstra, Wiebren; Scherder, Erik; Kamsma, Yvo

    The aim of this study was to examine if walking periods and number of steps can accurately be detected by a single small body-fixed device in older adults and patients with Parkinsons disease (PD). Results of an accelerometry-based method (DynaPort MicroMod) and a pedometer (Yamax Digi-Walker

  7. Evaluating Physical Activity Using Accelerometry in Children at Risk of Developmental Coordination Disorder in the Presence of Attention Deficit Hyperactivity Disorder

    Science.gov (United States)

    Baerg, Sally; Cairney, John; Hay, John; Rempel, Lynn; Mahlberg, Nadilein; Faught, Brent E.

    2011-01-01

    Physical activity (PA) is compromised in children and adolescents with developmental coordination disorder (DCD). Approximately half of all children with DCD suffer from attention-deficit hyperactive disorder (ADHD); a cohort often considered more physically active than typically developing youth. Accelerometry is an effective method of assessing…

  8. Surface electromyographic characteristics of swallowing in dysphagia secondary to brainstem stroke.

    Science.gov (United States)

    Crary, M A; Baldwin, B O

    1997-01-01

    Surface electromyography (SEMG) provides an noninvasive avenue for evaluating swallowing physiology. This report describes SEMG characteristics associated with swallow attempts in 6 dysphagic patients who had suffered brainstem stroke compared with 6 age and gender-matched controls. Results indicated that patients with dysphagia secondary to brainstem stroke differed in both amplitude and timing aspects of swallowing attempts from asymptomatic controls. Specifically, the results indicated that during swallow attempts, dysphagic patients produced more muscle activity over a shorter duration and with less coordination than controls. Potential physiological mechanisms of these results are discussed.

  9. Spontaneous swallowing frequency has potential to identify dysphagia in acute stroke.

    Science.gov (United States)

    Crary, Michael A; Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael F

    2013-12-01

    Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. In a cohort of 63 acute stroke cases, swallow frequency rates (swallows per minute [SPM]) were compared with stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with versus without clinically significant dysphagia. Receiver operating characteristic curve analysis was used to identify the optimal threshold in SPM, which was compared with a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was used to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. Receiver operating characteristic curve analysis yielded a threshold of SPM≤0.40 that identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5- to 10-minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel.

  10. Spontaneous Swallowing Frequency [Has Potential to] Identify Dysphagia in Acute Stroke

    Science.gov (United States)

    Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael

    2014-01-01

    Background and Purpose Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. Methods In a cohort of 63 acute stroke cases swallow frequency rates (swallows per minute: SPM) were compared to stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with vs. without clinically significant dysphagia. ROC analysis was used to identify the optimal threshold in SPM which was compared to a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was employed to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. Results SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. ROC analysis yielded a threshold of SPM ≤ 0.40 which identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5 to 10 minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Conclusions Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel. PMID:24149008

  11. The relationship between limit of Dysphagia and average volume per swallow in patients with Parkinson's disease.

    Science.gov (United States)

    Belo, Luciana Rodrigues; Gomes, Nathália Angelina Costa; Coriolano, Maria das Graças Wanderley de Sales; de Souza, Elizabete Santos; Moura, Danielle Albuquerque Alves; Asano, Amdore Guescel; Lins, Otávio Gomes

    2014-08-01

    The goal of this study was to obtain the limit of dysphagia and the average volume per swallow in patients with mild to moderate Parkinson's disease (PD) but without swallowing complaints and in normal subjects, and to investigate the relationship between them. We hypothesize there is a direct relationship between these two measurements. The study included 10 patients with idiopathic PD and 10 age-matched normal controls. Surface electromyography was recorded over the suprahyoid muscle group. The limit of dysphagia was obtained by offering increasing volumes of water until piecemeal deglutition occurred. The average volume per swallow was calculated by dividing the time taken by the number of swallows used to drink 100 ml of water. The PD group showed a significantly lower dysphagia limit and lower average volume per swallow. There was a significantly moderate direct correlation and association between the two measurements. About half of the PD patients had an abnormally low dysphagia limit and average volume per swallow, although none had spontaneously related swallowing problems. Both measurements may be used as a quick objective screening test for the early identification of swallowing alterations that may lead to dysphagia in PD patients, but the determination of the average volume per swallow is much quicker and simpler.

  12. Brain and behavioral effects of swallowing carbonated water on the human pharyngeal motor system.

    Science.gov (United States)

    Elshukri, Omsaad; Michou, Emilia; Mentz, Hannah; Hamdy, Shaheen

    2016-02-15

    Chemical stimulation of the swallowing network with carbonation and citric acid has been investigated, showing potential benefits on swallowing of dysphagic patients. Despite this, the underlying mechanisms for these effects are not fully understood. Here we investigated the effects of 5 ml liquid bolus swallows of carbonated, citric acid, and still water on a swallowing reaction-time tasks paradigm in 16 healthy adults (8 male, mean age 33 ± 3.7 yr, protocol 1). We then investigated the net effects of "sensory bolus interventions" (40 repeated swallows every 15 s) of the three different liquid boluses on corticobulbar excitability, as examined with single-pulse transcranial magnetic stimulation (TMS) in 16 participants (8 female, mean age 33 ± 3.7 yr, protocol 2). The findings showed that a larger number of correctly timed swallows (within a predetermined time window) was accomplished mainly with carbonated liquids (z = -2.04, P = 0.04 vs. still water, protocol 1). Both carbonated and citric acid liquid interventions with 40 swallows increased corticobulbar excitability of the stronger pharyngeal projection, suggesting a similar modulatory pathway for the effects on swallowing. However, carbonation showed superiority (P = 0.04, F = 4.75, 2-way ANOVA), with the changes lasting up to 60 min following the intervention. These results hold significance for future further and in-depth physiological investigations of the differences between different stimuli on swallowing neural network.

  13. Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing

    Science.gov (United States)

    Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Fukuhara, Takako; Gierbolini-Norat, Estela M.; Thexton, Allan J.; German, Rebecca Z.

    2013-01-01

    We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2–3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies. PMID:23417250

  14. The relationship between residue and aspiration on the subsequent swallow: an application of the normalized residue ratio scale.

    Science.gov (United States)

    Molfenter, Sonja M; Steele, Catriona M

    2013-12-01

    Postswallow residue is widely considered to be a sign of swallowing impairment and is assumed to pose risk for aspiration on subsequent swallows. We undertook a preliminary retrospective study to investigate the link between postswallow residue and penetration-aspiration on the immediately occurring subsequent clearing swallow (i.e., without introduction of a new bolus). Videofluoroscopy clips for 156 thin-liquid single bolus swallows by patients with neurogenic dysphagia were selected for study because they displayed multiple swallows per bolus. Residue for each subswallow (n = 407) was analyzed using the Normalized Residue Ratio Scale for the valleculae (NRRSv) and piriform sinuses. The association between residue presence at the end of a swallow and penetration-aspiration on the next swallow was examined. Postswallow residue in one or both pharyngeal spaces was significantly associated with impaired swallowing safety on the subsequent clearing swallow for the same bolus. However, when analyzed separately by residue location, only vallecular residue was significantly associated with impaired swallowing safety on the next clearing swallow. The distribution of NRRSv scores by swallowing safety demonstrated an NRRSv cut-point of 0.09, above which there was a 2.07 times greater relative risk of penetration-aspiration. Postswallow vallecular residue, measured using the NRRS, is significantly associated with penetration-aspiration on subsequent clearing swallows. A clinically meaningful cut-point of 0.09 on the NRRSv scale demarcates this risk. Further research with different bolus consistencies is needed.

  15. Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Bohr, C. [University Hospital Erlangen, Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen (Germany)

    2014-02-15

    To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D{sub mean}, D{sub max} and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D{sub mean} to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target

  16. Identification of swallowing events from sEMG Signals Obtained from Healthy Adults.

    Science.gov (United States)

    Crary, Michael A; Carnaby Mann, Giselle D; Groher, Michael E

    2007-04-01

    Surface electromyography (sEMG) is being used with increasing frequency to identify the occurrence of swallowing, to describe swallow physiology, and to treat impaired swallowing function in dysphagic patients. Despite this increased utilization, limited information is available regarding the validity and reliability of investigators and clinicians to interpret sEMG data in reference to swallowing. This study examines the validity and interjudge reliability of swallow identification using sEMG records obtained from healthy adults. Validity and reliability estimates were compared between experienced and naïve judges in the identification of swallows from graphic sEMG records. Multiple validity estimates were high, indicating a strong degree of accuracy in identification of swallows versus nonswallow movements from sEMG traces. Experienced judges were more accurate than naïve judges (classification accuracy: experienced = 90% vs. naïve = 81%; p = 0.006, kappa: experienced = 0.89 vs. naïve 0.62; p = 0.008). Judges in both groups were more likely to classify swallows as nonswallow movements (false negatives) than to classify nonswallow movements as swallows (false positives). Interjudge reliability estimates indicated a high degree of agreement among judges in the identification of swallows versus nonswallow movements from the sEMG signal, with higher agreement among experienced judges (average kappa coefficient: experienced = 0.75 vs. naïve = 0.51). These results suggest that the sEMG graphic record is a valid and reliable tool for identifying normal swallows and that experience with this technique results in better identification and interjudge agreement.

  17. The coordination of breathing and swallowing in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Gross, Roxann Diez; Atwood, Charles W; Ross, Sheryl B; Olszewski, Joan W; Eichhorn, Kimberly A

    2009-04-01

    During deglutition, a strongly preferred exhale-swallow-exhale pattern has been shown in healthy adults. Disruption of this pattern can provoke prandial aspiration. Impaired coordination of breathing and swallowing has been measured in patients with chronic obstructive pulmonary disease (COPD) during the exacerbated state, but no reports describe the coordination of breathing and swallowing in stable patients with COPD during oral intake. To test the hypothesis that persons with moderate to severe COPD would show disordered coordination of breathing and swallowing during oral intake when compared with a matched, healthy control group. This study used a prospective, repeated measures design using 25 subjects with COPD and 25 control subjects. Respiratory inductance plethysmography and nasal thermistry were used simultaneously to track respiratory signals. Submental surface EMG was used to mark the presence of each swallow within the respiratory cycle. Data were recorded while participants randomly and spontaneously swallowed solids and semi-solids. Logistic regression showed that participants with COPD swallowed solid food during inhalation more frequently than normal subjects (P = 0.002) and had a significantly higher rate of inhaling after swallowing semi-solid material (P swallowed pudding at low Vt significantly more often than they did the cookie (P = 0.006). Conversely, the control subjects swallowed cookie at low Vt significantly more often than pudding (P = 0.034). Significant differences in deglutitive apnea durations were also found. Patients with COPD exhibit disrupted coordination of the respiratory cycle with deglutition. Disrupted breathing-swallowing coordination could increase the risk of aspiration in patients with advanced COPD and may contribute to exacerbations.

  18. Effect of supraglottic and super-supraglottic swallows on tongue pressure production against hard palate.

    Science.gov (United States)

    Fujiwara, Shigehiro; Ono, Takahiro; Minagi, Yoshitomo; Fujiu-Kurachi, Masako; Hori, Kazuhiro; Maeda, Yoshinobu; Boroumand, Sara; Nitschke, Ina; Ursula, Vith; Bohlender, Jörg

    2014-12-01

    The objectives of this study were to evaluate the state of tongue pressure production during supraglottic swallow (SS) and super-supraglottic swallow (SSS) performed by healthy adults, and to investigate the effects of these swallowing maneuvers on the oral stage of swallowing. The participants were 19 healthy individuals. Tongue pressure against the hard palate during swallowing was measured using a tongue pressure sensor sheet system with five pressure-sensitive points. The tasks comprised swallowing 5 mL of water by normal wet swallow, SS, and SSS, and the parameters for analysis were the duration, the maximal magnitude, and the integrated value of tongue pressure during swallowing. The duration of tongue pressure was significantly longer at the anterior-median part of the hard palate during both SS and SSS than with normal wet swallow. The maximal magnitude increased significantly only at the posterior part of the hard palate during SS, but at all points during SSS. The integrated value increased significantly only at the posterior-median part of the hard palate during SS, but at all points except the mid-median part of the hard palate during SSS. The maximal magnitude and integrated value were also significantly higher at the anterior-median and posterior circumferential parts during SSS than during SS. These results show that these two swallowing maneuvers, which are known primarily as techniques to protect the airway, also function to strengthen the tongue pressure produced by the contact between the tongue and the hard palate during swallowing and this effect is more pronounced during SSS.

  19. IMPLICATIONS OF MOUTH BREATHING AND ATYPICAL SWALLOWING IN BODY POSTURE

    OpenAIRE

    Veronique Sousa; Maria Paço; Teresa Pinho

    2017-01-01

    Introduction: The stomatognathic system is a set of structures that are interconnected to perform vital functions. Changes in any of the parts may lead to a general postural imbalance. Purpose: To verify if there is a relation between breathing pattern and swallowing with posture, dental occlusion and harmful oral habits of the sample under study. Materials and methods: The final sample of n=50 consisted of 34 children/ adolescents males and 16 females. The evaluation consisted of a que...

  20. Treatment for dysphagia (swallowing difficulties) in hereditary ataxia.

    Science.gov (United States)

    Vogel, Adam P; Keage, Megan J; Johansson, Kerstin; Schalling, Ellika

    2015-11-13

    Hereditary ataxias are a heterogeneous group of disorders resulting in progressive inco-ordination. Swallowing impairment, also known as dysphagia, is a common and potentially life threatening sequel of disease progression. The incidence and nature of dysphagia in these conditions is largely unknown. The loss of an effective and safe swallow can dramatically affect the health and well-being of an individual. Remediation of difficulties of eating and drinking is an important goal in the clinical care of people with hereditary ataxia. To assess the effects of interventions for swallowing impairment (dysphagia) in people with hereditary ataxias. We searched the Cochrane Neuromuscular Disease Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL Plus, PsycINFO, and the Education Resources Information Center (ERIC) on 14 September 2015. We also searched Linguistics and Language Behavior Abstracts (LLBA), Dissertation Abstracts, and Trials Registries on 24 September 2015. We considered all randomised controlled trials (RCTs) and quasi-RCTs that compared treatments for hereditary ataxia with placebo or no treatment. We only included studies measuring dysphagia. Three review authors (ES, KJ, MK) independently screened all titles and abstracts. In the event of any disagreement or uncertainty over the inclusion of a particular paper, the review authors planned to meet and reach consensus. We identified no RCTs from the 519 titles and abstracts screened. We excluded papers primarily for not including participants with a hereditary ataxia (that is, being focused on other neurological conditions), being theoretical reviews rather than intervention studies, or being neither randomised nor quasi-randomised trials.We identified five papers of various design that described treatment for dysphagia, or improvement to swallow as a by-product of treatment, in people with hereditary ataxia. None of these studies were RCTs or

  1. Difficulty in Swallowing Due to Attempted Manual Strangulation

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    Serdar Ozkan

    2014-03-01

    Full Text Available Pathologies resulting from the traumas applied to the neck region raise life-threatening serious consequences. Although surviving is seen rarely in the cases of strangulation with a ligature or manual strangulation, developing morbidities continues for a long period. Our 46 years old male patient exposed to the attempted homicidal strangulation had complaints of  hoarseness and  inability to swallow. On endoscopic examination, a hematoma was found fully obstructing the esophageal entrance.  The patient was discharged with medical therapy, since no fracture was observed in hyoid bone and thyroid cartilage.

  2. Clinical investigation on application of water swallowing to MR esophagography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jinping, E-mail: zjpmri@163.com [Department of Radiology, Tongling People' s Hospital, Bijiashan Road 468, Tongling 244000, Anhui (China); Hu, Weijian; Zang, Lin [Department of Cardiothoracic Surgery, Tongling People' s Hospital, Bijiashan Road 468, Tongling 244000, Anhui (China); Yao, Yibin; Tang, Yongxiang; Qian, Zhen; Gao, Ping; Wu, Xiaoyan; Li, Shijian [Department of Radiology, Tongling People' s Hospital, Bijiashan Road 468, Tongling 244000, Anhui (China); Xie, Zhenlan; Yuan, Xiaoqing [Department of Pathology, Tongling People' s Hospital, Bijiashan Road 468, Tongling 244000, Anhui (China)

    2012-09-15

    Objective: To verify the clinical outcomes of applying water swallowing to MR esophagography. Methods: Thirty patients confirmed postoperatively or histopathologically with thoracic esophageal carcinoma by endoscopic biopsy and 10 healthy volunteers with normal esophagus underwent respectively conventional magnetic resonance imaging (MRI) detection and water swallowing MR esophagography. Of those patients, 4 underwent second examination after radiotherapy. Assessment on imaging effects of MR esophagography was performed. Assessment on definition on MR esophagography of the tumor in both upper and lower ends, specific localization, tumor size finally measured, coincidence with the gross pathologic types and tumor staging were respectively performed by comparison with conventional MRI. Additionally, we evaluated the outcomes of radiotherapy by comparing the previous MR esophagography with the second one with interventional technique. Results: Of the total 44 images of MR esophagography, 97.7% (43/44) were in high resolution by sagittal view and 81.8% (36/44) by cross-section. 93.3% (56/60) of the MR esophagography were clearly defined with the neoplastic lesion ends in the 30 patients with thoracic esophageal carcinoma, compared with 11.7% (7/60) by conventional MRI. The results were totally different in statistics (P < 0.005). Preoperative conventional MRI detection of the 22 cases in 25 undergone radical resection suggested vague diameter of the primary tumor and impossibly identified it at middle-lower thoracic esophagus in 5, and even failed to confirm gross pathologic types in 19 cases. Yet, MR esophagography with water swallowing represented accurate tumor length (graded as excellent) in 88% (22/25), localization in 100% (25/25), exact gross pathologic types in 88% (22/25), and accuracy for tumor staging in 80.8% (21/26) compared to 92.3% (24/26) by conventional MRI. Therapeutic effects achieved in 4 patients with radiotherapy. Conclusions: MR esophagography

  3. Fluid mechanics of eating, swallowing and digestion - overview and perspectives.

    Science.gov (United States)

    Engmann, Jan; Burbidge, Adam S

    2013-02-26

    From a very simplistic viewpoint, the human digestive system can be regarded as a long tube (with dramatic variations in diameter, cross-section, wall properties, pumping mechanisms, regulating valves and in-line sensors). We single out a few fluid mechanical phenomena along the trajectory of a food bolus from the mouth to the small intestine and discuss how they influence sensorial perception, safe transport, and nutrient absorption from a bolus. The focus is on lubrication flows between the tongue and palate, the oropharyngeal stage of swallowing and effects of flow on absorption in the small intestine. Specific challenges and opportunities in this research area are highlighted.

  4. Reliability of Triaxial Accelerometry for Measuring Load in Men's Collegiate Ice-Hockey.

    Science.gov (United States)

    Van Iterson, Erik H; Fitzgerald, John S; Dietz, Calvin C; Snyder, Eric M; Peterson, Ben J

    2016-08-18

    Wearable microsensor technology incorporating triaxial accelerometry is used to quantify an index of mechanical stress associated with sport-specific movements termed PlayerLoad™. The test-retest reliability of PlayerLoad™ in the environmental-setting of ice-hockey is unknown. The primary aim of this study was to quantify the test-retest reliability of PlayerLoad™ in ice-hockey players during performance of tasks simulating game-conditions. Division I collegiate male ice-hockey players (N=8) wore Catapult Optimeye S5 monitors during repeat performance of 9 ice-hockey tasks simulating game-conditions. Ordered ice-hockey tasks during repeated bouts included: acceleration (forward/backward), 60% top-speed, top-speed (forward/backward), repeated shift circuit, ice-coasting, slap-shot, and bench-sitting. Coefficient of variation (CV), intraclass correlation coefficient (ICC), and minimum differences (MD) were used to assess PlayerLoad™ reliability. Test-retest CVs and ICCs of PlayerLoad™ were: Forward (8.6, 0.54) or backward (13.8, 0.78) acceleration, 60% top-speed (2.2, 0.96), forward (7.5, 0.79) or backwards (2.8, 0.96) top-speed, repeated-shift test (26.6, 0.95), slap-shot (3.9, 0.68), coasting (3.7, 0.98), and bench-sitting (4.1, 0.98), respectively. Raw differences between bouts were not significant for ice-hockey tasks (P>0.05). For each task, between bout raw differences were lower versus MD: Forward (0.06 vs. 0.35) or backward (0.07 vs. 0.36) acceleration, 60% top-speed (0.00 vs. 0.06), forward (0.03 vs. 0.20) or backwards (0.02 vs. 0.09) top-speed, repeated-shift test (0.18 vs. 0.64), slap-shot (0.02 vs. 0.10), coasting (0.00 vs. 0.10), and bench-sitting (0.01 vs. 0.11), respectively. These data suggest PlayerLoad™ demonstrates moderate-to-large test-retest reliability in the environmental-setting of male Division I collegiate ice-hockey. Without previously testing reliability, these data are important as PlayerLoad™ is routinely quantified in

  5. A Dual-Axis Electrostatically Driven MEMS Microgripper

    Directory of Open Access Journals (Sweden)

    Yukun Jia

    2014-11-01

    Full Text Available This paper presents the design of a new monolithic two- axis electrostatically actuated MEMS microgripper with integrated capacitive position and force sensors working at the micro-scale level. Each of the two jaws of the micro‐ gripper possesses two degrees-of-freedom (DOF and is capable of positioning in both x-and y-axes. Unlike existing works, where one gripper arm is actuated and other one is sensed, both arms of the proposed microgripper are actuated and sensed independently. A sensing scheme is constructed to provide the position and force signals in the noncontact and contact phases, respectively. By applying a 120V driving voltage, the jaw can provide 70 μm x-axis and 18 μm y-axis displacements with the force of 190 μN. By this design, the real-time position and grasping force information can be obtained in the dual sensing mode. Both analytical calculation and finite-element analysis (FEA were performed to verify the performance of the proposed design. A scaled-up prototype is designed, fabricated and tested through the experiment to verify the structure design of the microgripper.

  6. Design and Implementation of Dual Axis Solar Tracking system

    Directory of Open Access Journals (Sweden)

    Sirigauri N,

    2015-05-01

    Full Text Available Solar energy is a promising technology that can have huge long term benefits. Solar cells convert the solar energy into electrical energy. Solar tracking system is the most suited technology to improve the efficiency and enhance the performance by utilizing maximum solar energy through the solar cell. In hardware development we utilize LDR’s as sensors and two servomotors to direct the position of the solar panel. The software part is implemented on a code written using an Arduino Uno controller.

  7. Physical Activity Measurement by Accelerometry Among Older Malay Adults Living in Semi-Rural Areas-A Feasibility Study.

    Science.gov (United States)

    Zainol Abidin, Nurdiana; Brown, Wendy J; Clark, Bronwyn; Muhamed, Ahmad Munir Che; Singh, Rabindarjeet

    2016-10-01

    We evaluated feasibility of physical activity measurement by accelerometry among older Malay adults living in semi-rural areas in Malaysia. Results showed that 95% of 146 participants (aged [SD] 67.6 [6.4] years) were compliant in wearing the accelerometer for at least five days. Fifteen participants were asked for re-wear the accelerometer because they did not have enough valid days during the first assessment. Participants wore the accelerometer an average of 15.3 hr in a 24-hr day, with 6.5 (1.2) valid wear days. No significant difference in valid wear day and time was found between men and women. Participants who are single provide more valid wear days compared with married participants (p physical activity level among older Malay adults living in semi-rural areas.

  8. Biomechanical Correlates of Surface Electromyography Signals Obtained during Swallowing by Healthy Adults

    Science.gov (United States)

    Crary, Michael A.; Carnaby (Mann), Giselle D.; Groher, Michael E.

    2006-01-01

    Purpose: The purpose of this study was to describe biomechanical correlates of the surface electromyographic signal obtained during swallowing by healthy adult volunteers. Method: Seventeen healthy adults were evaluated with simultaneous videofluoroscopy and surface electromyography (sEMG) while swallowing 5 mL of liquid barium sulfate. Three…

  9. [Swallowing function after near-total laryngectomy, cricohyoidoepiglottopexy (CHEP), and cricohyoidopexy (CHP)].

    Science.gov (United States)

    Nakayama, Meijin; Yao, Kazuo; Nishiyama, Kouichirou; Nagai, Hiromi; Ito, Akihiko; Yokobori, Satoru; Okamoto, Makito; Hirose, Hajime

    2002-01-01

    We studied postoperative swallowing in 4 patients undergoing CHEP and 1 undergoing CHP. Swallowing was obtained by intense swallowing rehabilitation since only 1/4 of the larynx remained after near-total laryngectomy. Our swallowing rehabilitation program is detailed in this paper. The improvement of swallowing is classified into 3 stages. In stage I, volus directly intrudes into the trachea. In stage II, volus stagnates between laryngeal inlet and tracheal stoma. In stage III, volus directly flows through the esophageal inlet. Stage III indicates that rehabilitation is almost completed. Stage I is shortest at 2 to 14 days and Stage II longest at 7 to 80 days. The MTF (Method, Time, Food) score described by Fujimoto et al was used to analyze swallowing. Three cases following CHEP showed high scores shortly after the introduction of rehabilitation and reached the maximum score at discharge (15 points = normal swallowing). At present, these 3 patients are satisfied with swallowing and enjoy a good quality of life. In 2 other cases (1 CHEP and 1 CHP), both had a wide laryngeal inlet and still have some difficulty with liquids. Further modification of the surgical technique is needed especially for CHP.

  10. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, AJ; Weusten, BLAM; Timmer, R; Akkermans, LMA; Smout, AJPM

    Background: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  11. Tongue Pressure Modulation during Swallowing: Water versus Nectar-Thick Liquids

    Science.gov (United States)

    Steele, Catriona M.; Bailey, Gemma L.; Molfenter, Sonja M.

    2010-01-01

    Purpose: Evidence of tongue-palate pressure modulation during swallowing between thin and nectar-thick liquids stimuli has been equivocal. This mirrors a lack of clear evidence in the literature of tongue and hyoid movement modulation between nectar-thick and thin liquid swallows. In the current investigation, the authors sought to confirm whether…

  12. Platysma Flap with Z-Plasty for Correction of Post-Thyroidectomy Swallowing Deformity

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    Min Kyeong Jeon

    2013-07-01

    Full Text Available Background Recently, the number of thyroid surgery cases has been increasing; consequently, the number of patients who visit plastic surgery departments with a chief complaint of swallowing deformity has also increased. We performed a scar correction technique on post-thyroidectomy swallowing deformity via platysma flap with Z-plasty and obtained satisfactory aesthetic and functional outcomes.Methods The authors performed operations upon 18 patients who presented a definitive retraction on the swallowing mechanism as an objective sign of swallowing deformity, or throat or neck discomfort on swallowing mechanism such as sensation of throat traction as a subjective sign after thyoridectomy from January 2009 till June 2012. The scar tissue that adhered to the subcutaneous tissue layer was completely excised. A platysma flap as mobile interference was applied to remove the continuity of the scar adhesion, and additionally, Z-plasty for prevention of midline platysma banding was performed.Results The follow-up results of the 18 patients indicated that the definitive retraction on the swallowing mechanism was completely removed. Throat or neck discomfort on the swallowing mechanism such as sensation of throat traction also was alleviated in all 18 patients. When preoperative and postoperative Vancouver scar scales were compared to each other, the scale had decreased significantly after surgery (P<0.05. Conclusions Our simple surgical method involved the formation of a platysma flap with Zplasty as mobile interference for the correction of post-thyroidectomy swallowing deformity. This method resulted in aesthetically and functionally satisfying outcomes.

  13. Preliminary studies on seed dispersal of swallow-wort (Vincetoxicum spp.)

    Science.gov (United States)

    Vincetoxicum rossicum (pale swallow-wort) and V. nigrum (black swallow-wort) are invasive, perennial vines that have become problematic in natural areas in the northeastern United States and neighboring southeastern Canada. Both species reproduce primarily via wind-dispersed seeds in the form of ac...

  14. Bilateral Killian-Jamieson diverticula demonstrated by videofluoroscopic swallowing study: case report

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    Betina Scheeren

    2013-06-01

    Full Text Available The authors report the case of a 56-year-old male patient complaining of dysphagia for solids and food impaction, submitted to videofluoroscopic swallowing study that demonstrated the presence of two esophageal diverticula. The videofluoroscopic swallowing study was critical in the identification and diagnosis of the diverticula, an esophageal cause of dysphagia.

  15. Tongue Pressure and Submental Surface Electromyography Measures during Noneffortful and Effortful Saliva Swallows in Healthy Women

    Science.gov (United States)

    Yeates, Erin M.; Steele, Catriona M.; Pelletier, Cathy A.

    2010-01-01

    Purpose: The effortful swallow, a compensatory technique frequently employed by speech-language pathologists for their patients with dysphagia, is still not fully understood in terms of how it modifies the swallow. In particular, although age-related changes are known to reduce maximum isometric tongue pressure, it is not known whether age affects…

  16. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions

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    Sejdić Ervin

    2009-10-01

    Full Text Available Abstract Background A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. Methodology To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing chin tuck swallows. Three yellow markers geometrically arranged on a pair of dark visors were used as tracking cues. Results The algorithm was applied to data collected from 178 healthy participants during neutral and chin tuck position swallows. Our analyses revealed no major influences of body mass index and age on neck flexion angles during swallowing, while gender influenced the average neck angle only during wet swallows in the neutral position. Chin tuck angles seem to be independent of anthropometry and gender in healthy adults, but deserve further study in pathological populations. Conclusion The proposed neck flexion angle extraction algorithm may be useful in future studies where strict participant compliance to swallowing task protocol can be assured.

  17. Prevalence and Severity of Voice and Swallowing Difficulties in Mitochondrial Disease

    Science.gov (United States)

    Read, Jennifer L.; Whittaker, Roger G.; Miller, Nick; Clark, Sue; Taylor, Robert; McFarland, Robert; Turnbull, Douglass

    2012-01-01

    Background: Mutations of mitochondrial DNA (mtDNA) cause a broad spectrum of clinical phenotypes. Anecdotal evidence suggests that voice and swallow problems are a common feature of these diseases. Aims: To characterize accurately the prevalence and severity of voice and swallow problems in a large cohort of patients with mitochondrial disease.…

  18. Patient-reported symptom questionnaires in laryngeal cancer: Voice, speech and swallowing

    NARCIS (Netherlands)

    Rinkel, R.N.P.M.; Verdonck-de Leeuw, I.M.; van den Brakel, N.; de Bree, R.; Eerenstein, S.E.J.; Aaronson, N.K.; Leemans, C.R.

    2014-01-01

    Objectives: To validate questionnaires on voice, speech, and swallowing among laryngeal cancer patients, to assess the need for and use of rehabilitation services, and to determine the association between voice, speech, and swallowing problems, and quality of life and distress. Materials and methods

  19. Vocal Variability Post Swallowing in Individuals with and without Oropharyngeal Dysphagia

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    Santos, Karoline Weber dos

    2014-10-01

    Full Text Available Introduction Voice modification after swallowing may indicate changes in the transit of the bolus. Objective The aim of this study is to verify the use of perceptual voice analysis to detect oropharyngeal dysphagia. Study Design Case series. Methods Twenty-seven patients with dysphagia as diagnosed by videofluoroscopy and 25 without were evaluated. The sustained vowel /a/ was recorded before this exam and after swallowing different consistencies (pasty, liquid and solid. For the voice evaluation, the GRBAS scale (grade, roughness, breathiness, asthenia and strain and the parameter “wet voice” were used. Three judges blinded to study group and time of emission performed voice analysis. Results Individuals with dysphagia showed significant decrease in grade of voice and asthenia and increase in strain after swallowing pasty substances, differing from individuals without dysphagia who showed no modification of the parameters after swallowing. The wet voice parameter showed no difference after swallowing in both study groups. Conclusion The decrease in grade and asthenia and increased strain are indicative of a swallowing disorder, indicating increased vocal strain to clean the vocal tract of food. The modification of vocal production after swallowing proved to be a trusted resource for detection of swallowing disorders.

  20. Biomechanical Correlates of Surface Electromyography Signals Obtained during Swallowing by Healthy Adults

    Science.gov (United States)

    Crary, Michael A.; Carnaby (Mann), Giselle D.; Groher, Michael E.

    2006-01-01

    Purpose: The purpose of this study was to describe biomechanical correlates of the surface electromyographic signal obtained during swallowing by healthy adult volunteers. Method: Seventeen healthy adults were evaluated with simultaneous videofluoroscopy and surface electromyography (sEMG) while swallowing 5 mL of liquid barium sulfate. Three…

  1. Tongue Pressure and Submental Surface Electromyography Measures during Noneffortful and Effortful Saliva Swallows in Healthy Women

    Science.gov (United States)

    Yeates, Erin M.; Steele, Catriona M.; Pelletier, Cathy A.

    2010-01-01

    Purpose: The effortful swallow, a compensatory technique frequently employed by speech-language pathologists for their patients with dysphagia, is still not fully understood in terms of how it modifies the swallow. In particular, although age-related changes are known to reduce maximum isometric tongue pressure, it is not known whether age affects…

  2. Incidence of Pneumonia After Videofluoroscopic Swallowing Study and Associated Factors.

    Science.gov (United States)

    Jo, Hannae; Park, Jung-Gyoo; Min, David; Park, Hee-Won; Kang, Eun Kyoung; Lee, Kun-Jai; Baek, Sora

    2016-02-01

    Pneumonia after videofluoroscopic swallow study (VFSS) is sometimes considered to be caused by aspiration during VFSS; however, to our knowledge, a relationship between these events has not been clearly investigated. The aim of this study was to assess the incidence of VFSS-related pneumonia and related factors. Overall, 696 VFSS cases were retrospectively reviewed. Cases in which blood culture was performed within 3 days after VFSS due to newly developed infectious signs were considered as post-VFSS infection cases. Pneumonia was suspected when there was some evidence of respiratory infectious signs in clinical, radiological, and laboratory findings. The underlying disease, clinical signs, and VFSS findings of the pneumonia group were assessed. Among 696 cases, pneumonia was diagnosed in 15 patients. The patients in the pneumonia group tended to be older and had higher aspiration rate on VFSS than those in the non-pneumonia group. In the pneumonia group, 2 patients showed no aspiration during VFSS. In 6 patients, pneumonia developed after massive aspiration of gastric content in 5 patients and inappropriate oral feeding with risk of aspiration before VFSS in 1 patient. Only 7 patients (1.0 %) were finally determined as having VFSS-related pneumonia. In conclusion, the 72-h incidence of VFSS-related pneumonia was 1.0 %. Old age and severity of swallowing difficulty are associated with occurrence of pneumonia.

  3. A Mathematical Model for Swallowing of Concentrated Fluids in Oesophagus

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    S. K. Pandey

    2011-01-01

    Full Text Available This model investigates particularly the impact of an integral and a non-integral number of waves on the swallowing of food stuff such as jelly, tomato puree, soup, concentrated fruits juices and honey transported peristaltically through the oesophagus. The fluid is considered as a Casson fluid. Emphasis is on the study of the dependence of local pressure distribution on space and time. Mechanical efficiency, reflux limit and trapping are also discussed. The effect of Casson fluid vis-à-vis Newtonian fluid is investigated analytically and numerically too. The result is physically interpreted as that the oesophagus makes more efforts to swallow fluids with higher concentration. It is observed that the pressure is uniformly distributed when an integral number of waves is there in the oesophagus; but it is non-uniform when a non-integral number of waves is present therein. It is further observed that as the plug flow region widens, the pressure difference increases, which indicates that the averaged flow rate will reduce for a Casson fluid. It is also concluded that Casson fluids are more prone to reflux.

  4. Neuropharmacologic correlates of deglutition: lessons from fictive swallowing.

    Science.gov (United States)

    Bieger, D

    1991-01-01

    Pharmacologic investigations into the transmission processes underlying fictive swallowing in the rat have disclosed the potential diversity of chemical signals used in central deglutitive pathways. Monoaminergic mechanisms appear to serve as links between subcortical structures and the medullary pattern generator of swallowing (PGS), and may play a critical role in maintaining internal facilitatory drive, required by the PGS for optimal responsivity to peripheral sensory input. Cholinergic bulbar interneurons form an integral component of the PGS subnetwork controlling esophageal peristalsis. Local GABA neurons exert a tonic inhibition of the buccopharyngeal stage, may regulate buccopharyngeal-esophageal coupling, and may contribute to peristaltic rhythmic generation at both the premotoneuronal and motoneuronal level. Receptor subtypes for excitatory amino acids (glutamate, aspartate) are differentially associated with deglutitive premotoneurons for both the buccopharyngeal and esophageal stage, as well as with ambiguus motoneurons. Preliminary evidence suggests the existence of excitatory peptidergic mechanisms involving thyrotropin-releasing hormone, vasopressin, oxytocin, and somatostatin, a probable candidate for excitatory transmitter in the solitarioambigual internuncial projection to motoneurons innervating esophageal striated musculature. Further validation of this experimental model may ultimately help to establish a framework for the clinical recognition, management, and exploitation of drug actions on central deglutitive neuroeffectors.

  5. Energy intake estimation from counts of chews and swallows.

    Science.gov (United States)

    Fontana, Juan M; Higgins, Janine A; Schuckers, Stephanie C; Bellisle, France; Pan, Zhaoxing; Melanson, Edward L; Neuman, Michael R; Sazonov, Edward

    2015-02-01

    Current, validated methods for dietary assessment rely on self-report, which tends to be inaccurate, time-consuming, and burdensome. The objective of this work was to demonstrate the suitability of estimating energy intake using individually-calibrated models based on Counts of Chews and Swallows (CCS models). In a laboratory setting, subjects consumed three identical meals (training meals) and a fourth meal with different content (validation meal). Energy intake was estimated by four different methods: weighed food records (gold standard), diet diaries, photographic food records, and CCS models. Counts of chews and swallows were measured using wearable sensors and video analysis. Results for the training meals demonstrated that CCS models presented the lowest reporting bias and a lower error as compared to diet diaries. For the validation meal, CCS models showed reporting errors that were not different from the diary or the photographic method. The increase in error for the validation meal may be attributed to differences in the physical properties of foods consumed during training and validation meals. However, this may be potentially compensated for by including correction factors into the models. This study suggests that estimation of energy intake from CCS may offer a promising alternative to overcome limitations of self-report. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Intrarater and interrater reliability for measurements in videofluoroscopy of swallowing

    Energy Technology Data Exchange (ETDEWEB)

    Baijens, Laura, E-mail: laura.baijens@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands); Barikroo, Ali, E-mail: a.Barikroo@ufl.edu [Swallowing Research Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL (United States); Pilz, Walmari, E-mail: walmari.pilz@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands)

    2013-10-01

    Objective: Intrarater and interrater reliability is crucial to the quality of diagnostic and therapy-effect studies. This paper reports on a systematic review of studies on intrarater and interrater reliability for measurements in videofluoroscopy of swallowing. The aim of this review was to summarize and qualitatively analyze published studies on that topic. Materials and methods: Those published up to March 2013 were found through a comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Results: Nineteen studies were included and then qualitatively analyzed. In several of these, methodological problems were found. Moreover, intrarater and interrater reliability varied with the measure applied. A meta-analysis was not carried out as studies were not of sufficient quality to warrant doing so. Conclusion: In order to achieve reliable measurements in videofluoroscopy of swallowing, it is recommended that raters use well-defined guidelines for the levels of ordinal visuoperceptual variables. Furthermore, in order to make the measurements reliable (intrarater and interrater) it is recommended that, following protocolled pre-experimental training, the raters should have maximum consensus about the definition of the measured variables.

  7. Surface electromyographic studies of swallowing in normal children, age 4-12 years.

    Science.gov (United States)

    Vaiman, Michael; Segal, Samuel; Eviatar, Ephraim

    2004-01-01

    Surface electromyographic (sEMG) studies were performed on 100 normal children, age 4-12 years, to establish normative database for duration and amplitude of muscle activity during swallowing and continuous drinking. Prospective observational study of healthy volunteers. Parameters evaluated during swallowing include the timing and amplitude (in microV) of activity of m. orbicularis oris, masseter, submental and infrahyoid (laryngeal strap muscles (LSM)) groups covered by platisma. Four tests were examined: voluntary single swallows of saliva ("dry" swallow), voluntary single water swallows as normal, voluntary single swallows of excessive amount of water (up to 15ml), continuous drinking of 50ml of water (duration and number of swallows). Duration of muscle activity during swallowing (mean plus standard deviation (S.D.)) was measured for two age groups: 4-8 and 9-12 years old. The group of 40 adults, age 18-30 years, was taken as a control group. Normative data for duration and amplitude of muscle activity during single swallowing and continuous drinking are established for healthy children. The duration of muscle activity during swallows and drinking in all tests showed decrease with the age, and this tendency is statistically significant (one-dimensional analysis of variance, SPSS, chi(2) criterion, 95% confidence interval). There was no statistically significant difference in amplitude (range) measurements between children and adults (P=0.05). There was no statistically significant difference between male and female children duration of muscle activity during single swallowing and continuous drinking in all age groups (P>/=0.05). Surface EMG of swallowing is a simple and reliable noninvasive method for screening evaluation of swallowing with low level of discomfort of the examination. The normative timing of events data can be used for evaluation of complaints and symptoms, as well as for comparison purposes in pre- and postoperative stages and in

  8. The influence of tracheotomy tubes on the swallowing frequency in neurogenic dysphagia.

    Science.gov (United States)

    Seidl, Rainer O; Nusser-Müller-Busch, Ricki; Ernst, Arne

    2005-03-01

    To compare the swallowing frequency in patients with neurogenic dysphagia with or without tracheotomy tubes (TT) to assess the underlying mechanisms of dysphagia to improve rehabilitation strategies. Prospective study, 10 patients (64 +/- 7 years) with neurogenic dysphagia. Glasgow Coma Scale (GCS) less than 8 points, tracheotomy due to the dysphagia 2 weeks before the examination. The swallowing frequency (1 or less over 5 min) was assessed over 5 consecutive days with or without TT. The swallowing frequency increased after removal of the TT. These findings did not influence the GCS or the Coma Remission Scale. Over a 5-day period, the frequency of swallowing was increased. TTs decisively influence the swallowing behavior of vegetative patients. This phenomenon could be based on an improved sensitivity under re-established physiological expiration. We strongly favor removing the TT or deflating the cuff of the TT under therapeutic conditions in a rehabilitation therapy setting.

  9. New directions for understanding neural control in swallowing: the potential and promise of motor learning.

    Science.gov (United States)

    Humbert, Ianessa A; German, Rebecca Z

    2013-03-01

    Oropharyngeal swallowing is a complex sensorimotor phenomenon that has had decades of research dedicated to understanding it more thoroughly. However, the underlying neural mechanisms responsible for normal and disordered swallowing remain very vague. We consider this gap in knowledge the result of swallowing research that has been broad (identifying phenomena) but not deep (identifying what controls the phenomena). The goals of this review are to address the complexity of motor control of oropharyngeal swallowing and to review the principles of motor learning based on limb movements as a model system. We compare this literature on limb motor learning to what is known about oropharyngeal function as a first step toward suggesting the use of motor learning principles in swallowing research.

  10. Soft Electronics Enabled Ergonomic Human-Computer Interaction for Swallowing Training

    Science.gov (United States)

    Lee, Yongkuk; Nicholls, Benjamin; Sup Lee, Dong; Chen, Yanfei; Chun, Youngjae; Siang Ang, Chee; Yeo, Woon-Hong

    2017-04-01

    We introduce a skin-friendly electronic system that enables human-computer interaction (HCI) for swallowing training in dysphagia rehabilitation. For an ergonomic HCI, we utilize a soft, highly compliant (“skin-like”) electrode, which addresses critical issues of an existing rigid and planar electrode combined with a problematic conductive electrolyte and adhesive pad. The skin-like electrode offers a highly conformal, user-comfortable interaction with the skin for long-term wearable, high-fidelity recording of swallowing electromyograms on the chin. Mechanics modeling and experimental quantification captures the ultra-elastic mechanical characteristics of an open mesh microstructured sensor, conjugated with an elastomeric membrane. Systematic in vivo studies investigate the functionality of the soft electronics for HCI-enabled swallowing training, which includes the application of a biofeedback system to detect swallowing behavior. The collection of results demonstrates clinical feasibility of the ergonomic electronics in HCI-driven rehabilitation for patients with swallowing disorders.

  11. Visual and auditory stimuli associated with swallowing activate mirror neurons: a magnetoencephalography study.

    Science.gov (United States)

    Ushioda, Takashi; Watanabe, Yutaka; Sanjo, Yusuke; Yamane, Gen-Yuki; Abe, Shinichi; Tsuji, Yusuke; Ishiyama, Atushi

    2012-12-01

    In the present study, we evaluated activated areas of the cerebral cortex with regard to the mirror neuron system during swallowing. To identify the activated areas, we used magnetoencephalography. Subjects were ten consenting volunteers. Swallowing-related stimuli comprised an animated image of the left profile of a person swallowing water with laryngeal elevation as a visual swallowing trigger stimulus and a swallowing sound as an auditory swallowing trigger stimulus. As control stimuli, a still frame image of the left profile without an additional trigger was shown, and an artificial sound as a false auditory trigger was provided. Triggers were presented at 3,000 ms after the start of image presentation. The stimuli were combined and presented and the areas activated were identified for each stimulus. With animation and still-frame stimuli, the visual association area (Brodmann area (BA) 18) was activated at the start of image presentation, while with the swallowing sound and artificial sound stimuli, the auditory areas BA 41 and BA 42 were activated at the time of trigger presentation. However, with animation stimuli (animation stimulus, animation + swallowing sound stimuli, and animation + artificial sound stimuli), activation in BA 6 and BA 40, corresponding to mirror neurons, was observed between 620 and 720 ms before the trigger. Besides, there were also significant differences in latency time and peak intensity between animation stimulus and animation + swallowing sound stimuli. Our results suggest that mirror neurons are activated by swallowing-related visual and auditory stimuli.

  12. Evaluation of an EMG bioimpedance measurement system for recording and analysing the pharyngeal phase of swallowing.

    Science.gov (United States)

    Schultheiss, Corinna; Schauer, Thomas; Nahrstaedt, Holger; Seidl, Rainer O

    2013-07-01

    A neuroprosthetic device for treating swallowing disorders requires an implantable measurement system capable to analysing the timing and quality of the swallowing process in real time. A combined EMG bioimpedance (EMBI) measurement system was developed and is evaluated here. The study was planned and performed as a case-control study. The studies were approved by the Charité Berlin ethics committee in votes EA1/160/09 and EA1/161/09. Investigations were carried out on healthy volunteers in order to examine the usefulness and reproducibility of measurements, the ability to distinguish between swallowing and head movements and the effect of different food consistencies. The correlation between bioimpedance and anatomical and functional changes occurring during the pharyngeal phase of swallowing in non-healthy patients was examined using videofluoroscopy (VFSS). 31 healthy subjects (15♂, 16♀) were tested over the course of 1350 swallows and 19 (17♂, 2♀) non-healthy patients over the course of 54 swallows. The signal curves obtained from both transcutaneous and subcutaneous measurement were similar, characteristic and reproducible (r > 0.5) and correlated with anatomical and functional changes during the pharyngeal phase of swallowing observed using VFSS. Statistically significant differences between head movements and swallowing movements, food volumes and consistencies were found. Neither the conductivity of the food, the sex of the test subject nor the position of the measurement electrodes exerted a statistically significant effect on the measured signal. EMBI is able to reproducibly map the pharyngeal phase of swallowing and changes associated with it both transcutaneously and subcutaneously. The procedure therefore appears to be suitable for use in performing automated evaluation of the swallowing process and for use as a component of an implant.

  13. Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pearson, William G., E-mail: bp1@bu.edu [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States); Hindson, David F. [Department of Radiology, Boston Medical Center, Boston, Massachusetts (United States); Langmore, Susan E. [Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts (United States); Speech and Hearing Sciences, Boston University, Boston, Massachusetts (United States); Zumwalt, Ann C. [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States)

    2013-03-01

    Purpose: Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials: mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results: Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions

  14. Combined neuromuscular electrical stimulation (NMES) with fiberoptic endoscopic evaluation of swallowing (FEES) and traditional swallowing rehabilitation in the treatment of stroke-related dysphagia.

    Science.gov (United States)

    Sun, Shu-Fen; Hsu, Chien-Wei; Lin, Huey-Shyan; Sun, Hsien-Pin; Chang, Ping-Hsin; Hsieh, Wan-Ling; Wang, Jue-Long

    2013-12-01

    Dysphagia is common after stroke. Neuromuscular electrical stimulation (NMES) and fiberoptic endoscopic evaluation of swallowing (FEES) for the treatment of dysphagia have gained in popularity, but the combined application of these promising modalities has rarely been studied. We aimed to evaluate whether combined NMES, FEES, and traditional swallowing rehabilitation can improve swallowing functions in stroke patients with moderate to severe dysphagia. Thirty-two patients with moderate to severe dysphagia poststroke (≥3 weeks) were recruited. Patients received 12 sessions of NMES for 1 h/day, 5 days/week within a period of 2-3 weeks. FEES was done before and after NMES for evaluation and to guide dysphagic therapy. All patients subsequently received 12 sessions of traditional swallowing rehabilitation (50 min/day, 3 days/week) for 4 weeks. Primary outcome measure was the Functional Oral Intake Scale (FOIS). Secondary outcome measures included clinical degree of dysphagia, the patient's self-perception of swallowing ability, and the patient's global satisfaction with therapy. Patients were assessed at baseline, after NMES, at 6-month follow-up, and at 2-year follow-up. Twenty-nine patients completed the study. FOIS, degree of dysphagia, and patient's self-perception of swallowing improved significantly after NMES, at the 6-month follow-up, and at the 2-year follow-up (p rehabilitation showed promise for improving swallowing functions in stroke patients with moderate-to-severe dysphagia. The benefits were maintained for up to 2 years. The results are promising enough to justify further studies.

  15. Quantitative assessment of swallowing activity by MMG measurement with PVDF film.

    Science.gov (United States)

    Takuya, Hashimoto; Keita, Tsukagoshi; Takuji, Koike

    2017-07-01

    Difficulty of swallowing, called dysphagia, leads to aspiration pneumonia which is particularly a big health concern in aging societies. Therefore, prevention and treatment of dysphagia would contribute to extending healthy-life and QOL of elderly people and decreasing healthcare cost. Robotics technologies are expected as one of the effective methods to solve the problem in terms of detecting malfunction in swallowing and recovering swallowing function. The aim of this study is to investigate muscle activity during normal swallowing using mechanomyography (MMG) with PolyVinylidene DiFluoride (PVDF) film which is a ferroelectrics polymer. Measurement of MMG signal during voluntary isometric contraction of the biceps brachii muscle was conducted to confirm whether PVDF film can detect MMG signal. In the experiment, surface electromyography (sEMG) was also measured as a reference to estimate muscle activity for comparison. Then, activities of swallowing muscles during normal swallowing with different volume of bolus were measured using MMG signal. As the result, it was confirmed that swallowing activity can be quantified by the detected MMG signal from different region of neck.

  16. Assessment of swallowing and its disorders—A dynamic MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Vijay Kumar, K.V., E-mail: vijaykumarkv@yahoo.in [Department of Speech, Language and Hearing Sciences, SRU (India); Shankar, V., E-mail: drshankarv@yahoo.co.in [Department of Neurology, SRU (India); Santosham, Roy, E-mail: santoshamroy@yahoo.com [Department of Radiology and Imaging Sciences, SRU (India)

    2013-02-15

    Magnetic resonance imaging overcomes the limitations of videofluoroscopy in assessing without radiation exposure. The clinical utility of dynamic MRI for swallowing disorders is not well documented. This study demonstrates the feasibility of using dynamic MRI in assessment of swallowing disorders. Ten normal and three brainstem lesion patients participated in this study. GE Signa HDxt 1.5 Tesla MRI scanner with head-and-neck coil as a receiver and fast imaging employing steady state acquisition sequence was used. The swallow was analyzed in terms of symmetry and amplitude of movements of velum, faucial pillars, tongue, epiglottis and cricopharyngeous and images from the sagittal, coronal and axial planes. In sagittal plane posterior movement of tongue and its compression on velum, elevation of hyoid bone, elevation of larynx and lid action of epiglottis, in the coronal view the symmetrical movements of the faucial pillars and pharyngeal constrictor muscles and in axial plane three anatomical landmarks were targeted based on their role in swallowing, viz. velum, epiglottis and cricopharyngeous were studied. In brainstem lesion individuals, posterior movement of tongue, and elevation of larynx were not seen. Asymmetrical movements of faucial pillars and cricopharyngeous muscle were appreciated in the dynamic MRI. This demonstrates that, dynamic MRI is an efficient tool to understand the swallowing physiology and helps the speech language pathologist in modifying the swallowing maneuvers. Dynamic MRI is an effective tool in assessing swallowing and its disorders. This muscle specific information is not appreciated in videofluoroscopy and this information is necessary to modify the therapy maneuvers.

  17. The mandible advancement may alter the coordination between breathing and the non-nutritive swallowing reflex.

    Science.gov (United States)

    Ayuse, T; Ayuse, T; Ishitobi, S; Yoshida, H; Nogami, T; Kurata, S; Hoshino, Y; Oi, K

    2010-05-01

    The coordination between nasal breathing and non-nutritive swallowing serves as a protective reflex against potentially asphyxiating material, i.e. saliva and secretions, entering the respiratory tract. Although this protective reflex is influenced by positional changes in the head and body, the effect of mandible position on this reflex is not fully understood. We examined the effect of mandible advancement associated with mouth opening on the coordination between nasal breathing and non-nutritive swallowing induced by continuous infusion of distilled water into the pharyngeal cavity. The combination of mandible advancement and mouth opening increased the duration of swallowing apnoea and submental electromyographic burst duration. When the mandible was advanced with the mouth open, the duration of swallowing apnoea increased significantly compared with the centric position (0.79 +/- 0.23 vs. 0.64 +/- 0.12 s, P swallowing and the timing of swallow in relation to respiratory cycle phase. We conclude that mandible re-positioning may strongly influence the coordination between nasal breathing and non-nutritive swallowing by altering respiratory parameters and by inhibiting movement of the tongue-jaw complex.

  18. Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

    Science.gov (United States)

    Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

    2017-04-01

    For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Behavioural and neurophysiological disruption of corticobulbar motor systems and their effects on sequential pharyngeal swallowing.

    Science.gov (United States)

    Al-Toubi, Aamir; Daniels, Stephanie K; Huckabee, Maggie-Lee; Corey, David M; Doeltgen, Sebastian H

    2016-10-15

    Primary motor networks are known to be involved in the control of voluntary oral movements as well as the modulation of pharyngeal movements during experimentally controlled single swallows performed on command. The role of these networks in the more typical task of sequential swallowing remains unexplored. This study evaluated the hypothesis that experimental disruption of motor cortical activation would reduce the rate and regularity of repeatedly performed volitional or volitionally initiated motor tasks controlled by corticospinal (finger tapping) and corticobulbar (eyebrow movement, jaw opening, volitional sequential swallowing) motor systems, but would not influence a more reflexive corticobulbar task (reflexive sequential swallowing to pharyngeal water infusion). This premise was investigated in 24 healthy participants using two techniques: a dual task paradigm and a transcranial magnetic stimulation paradigm. Disruption effects were quantified by changes in rate and regularity of performance for each tested motor task. In summary, volitional motor tasks controlled by corticospinal motor networks (finger tapping) are more susceptible to behavioural and neurophysiological disruption than tasks controlled by cortiobulbar motor networks containing a reflexive component (both volitional and experimentally initiated consecutive swallowing). Purely volitional motor tasks controlled by the corticobulbar motor system (eyebrow raising or jaw opening) were affected in similar ways as the volitional corticospinal motor tasks. In summary, tasks involving sequential pharyngeal swallowing - whether volitionally or experimentally initiated - are largely robust against disruption of primary cortical motor networks, supporting a key role of medullary CPGs in the motor control of sequential pharyngeal swallowing.

  20. Swallowing and deep brain stimulation in Parkinson's disease: a systematic review.

    Science.gov (United States)

    Troche, Michelle S; Brandimore, Alexandra E; Foote, Kelly D; Okun, Michael S

    2013-09-01

    The purpose of this review is to assess the current state of the literature on the topic of deep brain stimulation (DBS) and its effects on swallowing function in Parkinson's disease (PD). Pubmed, Cochrane review, and web of science searches were completed on all articles addressing DBS that contained a swallowing outcome measure. Outcome measures included the penetration/aspiration scale, pharyngeal transit time, oropharyngeal residue, drooling, aspiration pneumonia, death, hyolaryngeal excursion, epiglottic inversion, UPDRS scores, and presence of coughing/throat clearing during meals. The search identified 13 studies specifically addressing the effects of DBS on swallowing. Critical assessment of the 13 identified peer-reviewed publications revealed nine studies employing an experimental design, (e.g. "on" vs. "off", pre- vs. post-DBS) and four case reports. None of the nine experimental studies were found to identify clinically significant improvement or decline in swallowing function with DBS. Despite these findings, several common threads were identified across experimental studies and will be examined in this review. Additionally, available data demonstrate that, although subthalamic nucleus (STN) stimulation has been considered to cause more impairment to swallowing function than globus pallidus internus (GPi) stimulation, there are no experimental studies directly comparing swallowing function in STN vs. GPi. Moreover, there has been no comparison of unilateral vs. bilateral DBS surgery and the coincident effects on swallowing function. This review includes a critical analysis of all experimental studies and discusses methodological issues that should be addressed in future studies.

  1. New Swallowing Evaluation Using Piezoelectricity in Normal Individuals.

    Science.gov (United States)

    Sogawa, Yuichiro; Kimura, Shinji; Harigai, Toru; Sakurai, Naoki; Toyosato, Akira; Nishikawa, Taro; Inoue, Makoto; Murasawa, Akira; Endo, Naoto

    2015-12-01

    This study aimed to elucidate the relationship between the piezoelectric waveform latency, hyoid bone movement, surface electromyogram (sEMG), and the pharyngeal transit time (PTT) during swallowing. Forty-one healthy subjects were divided into three age groups: younger (20-39 years, n = 8), middle-aged (40-59 years, n = 9), and older (60-79 years, n = 24). Motion analysis of the hyoid bone using videofluorography (VF), waveform analysis of the front neck using piezoelectric films, and sEMG of the suprahyoid muscle group were performed simultaneously. Latencies of the three movement phases were defined as upward (VFS1), forward (VFS2), and returning to starting position (VFS3). The three phases of the piezoelectric waveform-from wave initiation of the negative wave to the start of the second deep negative wave; from the start of the second deep negative wave to the start of the last positive wave (SLPW); and from the SLPW to the end of the last positive wave-were defined as PS1, PS2, and PS3, respectively. VFS1-3 and PS1-3 were significantly correlated. VFS1 and PS1 latencies were significantly longer with thick liquid than with thin liquid. VFS2, PS1, and PS2 latencies were longer in the older group than in the other two groups. The start of PS1 was nearly equal to those of sEMG and VFS1. Bolus arrival time in the valleculae was statistically equal to the end of the PS1 with both thin and thick liquids. To establish the swallowing screening using Piezoelectric film, further investigation is necessary in the dysphagia patients.

  2. Effects of carbonated liquid on swallowing dysfunction in dementia with Lewy bodies and Parkinson's disease dementia.

    Science.gov (United States)

    Larsson, Victoria; Torisson, Gustav; Bülow, Margareta; Londos, Elisabet

    2017-01-01

    Swallowing dysfunction is an increasingly recognized problem in patients with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), which can result in aspiration pneumonia and death. Few studies have examined potential ways of improving swallowing function in this fragile patient group. The aim of this study was to evaluate swallowing dysfunction and carbonated liquid using videofluoroscopy in DLB and PDD patients. A total of 48 patients with DLB and PDD were referred for a clinical examination with videofluoroscopy. Descriptive overall assessments were provided at the time of the examination regarding swallowing function and the effects of different modifications, including carbonated thin liquid (CTL). Additionally, a repeated measures quantitative retrospective analysis has been performed comparing 1) thin liquids; 2) thickened liquids and 3) CTLs, with regard to the quantitative variables 1) pharyngeal transit time (PTT); 2) pharyngeal retention and 3) tracheal penetration. In all, 40/48 (83%) of the patients had a swallowing dysfunction, which was confirmed on videofluoroscopy, with 34/40 (85%) patients having a pharyngeal-type dysfunction. A total of 14/40 (35%) patients with an objective swallowing impairment did not have any subjective swallowing symptoms. Out of the patients with swallowing dysfunction, 87% had an overall improved swallowing function with carbonated liquid. PTT for carbonated liquid (median 633 ms, interquartile range [IQR] 516-786 ms) was quicker than for thin liquid (760 ms, IQR 613-940 ms, P=0.014) and thickened liquid (880.0 ms, IQR 600-1,500 ms, Pcarbonated liquid. This highlights the importance of investigating patients with videofluoroscopy and to carry out a prospective interventional study to further evaluate carbonated liquid, also addressing the effects on quality of life, aspiration and mortality.

  3. Swallowing difficulties with oral drugs among polypharmacy patients attending community pharmacies.

    Science.gov (United States)

    Marquis, Julien; Schneider, Marie-Paule; Payot, Valérie; Cordonier, Anne-Christine; Bugnon, Olivier; Hersberger, Kurt E; Arnet, Isabelle

    2013-12-01

    Swallowing difficulties are common and can affect patients' ability to take solid oral dosage forms, thus compromising medication adherence. Strategies developed by patients to overcome such difficulties while taking medicines have seldom been described. To determine prevalence and characteristics of swallowing difficulties among primary care patients attending their community pharmacies; to explore strategies developed by patients to overcome their difficulties, and health professionals' awareness of these problems. Prospective study with a semi-structured questionnaire in random community pharmacies located in two Swiss regions. In each pharmacy, an interviewer asked 16 questions to each consecutive patient (18 years and older) with a prescription for at least 3 different solid oral forms. Quantification of number of patients with swallowing difficulties and detailed description of difficulties. Among 122 pharmacies, 59 (48 %) accepted to join the study and 410 patients were enrolled. Thirty-seven patients (9.0 %) reported ongoing swallowing difficulties, while 55 patients (13.4 %) reported past difficulties. For the majority of patients, difficulties occurred at each single dose (83.7 %), with a single medication (59.8 %) and lasted for less than 12 months (53.8 %). Number of tablets was not the main trigger. Swallowing difficulties impaired extremely daily life in 12 % of the patients. Intentional non adherence (23 % of patients) and altering the oral dose formulation were the most common and potentially harmful strategies used by patients to overcome their swallowing difficulties. According to the patients, pharmacists and physicians rarely inquired about their swallowing difficulties. We report a fairly high prevalence of swallowing difficulties in polypharmacy patients attending their community pharmacies. Pharmacists have to interview patients on their swallowing difficulties in a more systematic way, support patients in finding solutions and refer them to

  4. Submental Muscle Activity is Delayed and Shortened During Swallowing Following Stroke.

    Science.gov (United States)

    Kim, Hye-Ri; Lee, Seung Ah; Kim, Keewon; Leigh, Ja-Ho; Han, Tai Ryoon; Oh, Byung-Mo

    2015-09-01

    To evaluate the activities of the submental muscles using surface electromyography (sEMG) in patients presenting with dysphagia secondary to middle cerebral artery (MCA) infarction, and to compare the results with those in healthy volunteers. Retrospective study design. A dysphagia clinic at a tertiary care university hospital. Twenty-one patients presenting with dysphagia after unilateral MCA infarction were recruited into the study within 2 months of stroke onset. To serve as a control group, 13 healthy volunteers were enrolled. The primary sEMG parameters were swallowing onset, pretrigger duration, swallowing duration, and swallowing amplitude. Swallowing functional outcome was evaluated using the Videofluoroscopic Dysphagia Scale and the American Speech-Language-Hearing Association National Outcome Measurement System. Patients with MCA infarction demonstrated significantly delayed swallowing onset (P swallowing duration (P = .003) compared with the controls. Duration from the start of sEMG activity and actual laryngeal elevation also was delayed in the patient group (P = .042). At a cut-off point of 0.13 seconds for swallowing onset, sensitivity was 85.7% and specificity was 69.2%. For swallowing duration, sensitivity was 84.6% and specificity was 66.7% with 1.05 seconds as the cut-off point. Patients with MCA infarction showed not only delayed swallowing onset and pretrigger duration, but also shorter duration of sEMG activity compared with those in healthy volunteers. Our results suggest that dysphagia after stroke might be further compromised by delayed laryngeal response especially after the start of suprahyoid muscle activity, which represents impaired laryngeal protection mechanism. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  5. Swallowing transit times and valleculae residue in stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    de Deus Chaves, Rosane; Chiarion Sassi, Fernanda; Davison Mangilli, Laura; Jayanthi, Shri Krishna; Cukier, Alberto; Zilberstein, Bruno; Furquim de Andrade, Claudia Regina

    2014-04-16

    Breathing and swallowing are physiologically linked to ensure effortless gas exchange during oronasal breathing and to prevent aspiration during swallowing. Studies have indicated consistent aspiration in chronic obstructive pulmonary disease, mainly related to delayed swallowing reflex and problems with lingual propulsion and pharyngeal peristalsis as a result of bilateral weakness and incoordination of the related muscles. The purpose of the present study was to evaluate swallowing transit times and valleculae residue characteristics of stable COPD patients who have no swallowing complaints. Our study population included 20 stable patients with COPD and no swallowing complaints and 20 healthy controls. Swallowing was assessed through videofluoroscopic examination and involved the analysis of the following parameters: (1) pharyngeal stages of deglutition; (2) the duration of bolus movement through the oral cavity and pharynx (i.e. transit times); (3) valleculae residue ratio; (4) penetration/aspiration. Participants of the study did not present any signs of penetration-aspiration for any of the tested consistencies. Patients with COPD presented longer pharyngeal transit times during the ingestion of the liquid consistency and during the ingestion of the paste consistency. Regarding the duration of tongue base contact with the posterior pharyngeal wall, COPD patients also presented longer durations for the liquid and paste consistencies. No significant difference was observed for the distribution of individuals among the different valleculae residue severity levels. Our study suggests that stable COPD patients may present physiological adaptations as a protective swallowing maneuver to avoid aspiration/penetration of pharyngeal contents. Moreover, valleculae residue cannot be seen as an isolated factor when trying to explain swallowing alterations in this population.

  6. An investigation into the minimum accelerometry wear time for reliable estimates of habitual physical activity and definition of a standard measurement day in pre-school children.

    Science.gov (United States)

    Hislop, Jane; Law, James; Rush, Robert; Grainger, Andrew; Bulley, Cathy; Reilly, John J; Mercer, Tom

    2014-11-01

    The purpose of this study was to determine the number of hours and days of accelerometry data necessary to provide a reliable estimate of habitual physical activity in pre-school children. The impact of a weekend day on reliability estimates was also determined and standard measurement days were defined for weekend and weekdays.Accelerometry data were collected from 112 children (60 males, 52 females, mean (SD) 3.7 (0.7)yr) over 7 d. The Spearman-Brown Prophecy formula (S-B prophecy formula) was used to predict the number of days and hours of data required to achieve an intraclass correlation coefficient (ICC) of 0.7. The impact of including a weekend day was evaluated by comparing the reliability coefficient (r) for any 4 d of data with data for 4 d including one weekend day.Our observations indicate that 3 d of accelerometry monitoring, regardless of whether it includes a weekend day, for at least 7 h  d(-1) offers sufficient reliability to characterise total physical activity and sedentary behaviour of pre-school children. These findings offer an approach that addresses the underlying tension in epidemiologic surveillance studies between the need to maintain acceptable measurement rigour and retention of a representatively meaningful sample size.

  7. Radial forearm versus anterolateral thigh flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech.

    Science.gov (United States)

    Hsiao, Hung-Tao; Leu, Yi-Shing; Liu, Chung-Ji; Tung, Kwang-Yi; Lin, Chang-Ching

    2008-02-01

    The authors retrospectively compared the results of postoperative speech and swallowing in patients who had undergone hemiglossectomy for carcinoma of the anterior tongue. Immediate reconstruction in 16 patients was with a free radial forearm flap and in another 16 with an anterolateral thigh flap. Clinical speech pathology evaluation included the Fletcher time-to-time maximum syllable repetition rate, multiple rhyme test, and overall quality and intelligibility of the patients' speech. Evaluation of swallowing included deglutition duration, bolus volume, and ingestion rate. The functional results with both flaps were adequate, and the two groups did not differ significantly between each other for either speech or swallowing.

  8. Effect of citric acid and citric acid-sucrose mixtures on swallowing in neurogenic oropharyngeal dysphagia.

    Science.gov (United States)

    Pelletier, Cathy A; Lawless, Harry T

    2003-01-01

    The ability of sour and sweet-sour mixtures to improve swallowing in 11 nursing home residents with neurogenic oropharyngeal dysphagia was investigated using fiberoptic endoscopic evaluation of swallowing. Citric acid (2.7%) significantly reduced aspiration and penetration compared with water. Teaspoon delivery of liquids significantly reduced aspiration and penetration compared with natural cup drinking. Subjects tended to appropriately self-regulate the cup volume they consumed after the first trial. A significant increase in spontaneous dry swallows was observed after both taste stimuli. The mechanisms for improved swallowing due to citric acid are not understood but may be due to increased gustatory and trigeminal stimulation of acid to the brainstem in neurologically impaired subjects.

  9. Development of a portable non-invasive swallowing and respiration assessment device

    National Research Council Canada - National Science Library

    Shieh, Wann-Yun; Wang, Chin-Man; Chang, Chia-Shuo

    2015-01-01

    .... Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend...

  10. Effect of the Enveloppe Linguale Nocturne on atypical swallowing: surface electromyography and computerised postural test evaluation

    National Research Council Canada - National Science Library

    Ciavarella, D; Mastrovincenzo, M; Sabatucci, A; Parziale, V; Chimenti, C

    2010-01-01

    .... Seven patients affected by AS were evaluated. Surface Electromyography (sEMG) testing was performed on each patient with different tongue positions, and swallowing was evaluated with and without the ELN...

  11. Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, W.; Steinbrich, W. [Institute of Diagnostic Radiology, University Hospital of Basel (Switzerland); Wetzel, S.G.; Radue, E.W. [Institute of Neuroradiology, University Hospital Basel (Switzerland); Kappos, L.; Hoshi, M.M. [Department of Neurology, University Hospital of Basel (Switzerland); Witte, U. [Section of Logopedia, University Hospital of Basel (Switzerland)

    2002-04-01

    The purpose of this study was to evaluate if subjective symptoms indicating an impaired deglutition correlate with videofluoroscopic findings in patients with multiple sclerosis (MS). Videofluoroscopic examinations of 18 MS patients were analyzed by a radiologist and a logopedist and compared with the symptoms of these patients. Four patients complained about permanent dysphagia. Six patients reported mild and intermittent difficulties in swallowing, but were asymptomatic at the time of videofluoroscopy. Eight patients had no symptoms regarding their deglutition. All patients (n=4) who complained of permanent dysphagia showed aspiration. All patients (n=6) with mild and intermittent difficulties in swallowing showed undercoating of the epiglottis and/or laryngeal penetration. Of those 8 patients without any swallowing symptoms, only 2 had a normal videofluoroscopy. Swallowing abnormalities seem to be much more frequent in patients with MS than generally believed and they may easily be missed clinically as long as the patients do not aspirate. (orig.)

  12. Randomized trial of two swallowing assessment approaches in patients with acquired brain injury

    DEFF Research Database (Denmark)

    Kjaersgaard, Annette; Nielsen, Lars Hedemann; Sjölund, Bengt H.

    2014-01-01

    OBJECTIVE: To examine whether patients assessed for initiation of oral intake only by Facial-Oral Tract Therapy had a greater risk of developing aspiration pneumonia during neurorehabilitation than patients assessed by Fibreoptic Endoscopic Evaluation of Swallowing. DESIGN: Randomized controlled ...

  13. SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

    Directory of Open Access Journals (Sweden)

    STANESCU Ioana

    2014-09-01

    Full Text Available Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition. KEY WORDS: swallowing, dysphagia, functional anatomy, rehabilitation, neuroplasticity

  14. Lost and found…Tracking a swallowed denture: Role of radiology

    Directory of Open Access Journals (Sweden)

    Yogita Khalekar

    2017-01-01

    Full Text Available Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, and anesthesiologists for prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscous necrosis, perforation, and penetration to neighbouring organs leading to fistulae, bleeding and obstruction. Here, we present the case of a 65 year old female patient who swallowed the denture, which was detected by barium swallow and removed by endoscopy. Hence, the management of swallowed denture needs a multidisciplinary approach with the help of a dentist, otolaryngologist and anesthesiologists. Dentists should recommend patients to visit them for planned check ups or revisit them in case of denture dislodgement or loosening as soon as possible to prevent such life threatening events.

  15. Video-fluoroscopic study of swallowing in children with neurodevelopmental disorders.

    Science.gov (United States)

    Fung, Cheuk-Wing; Khong, Pek-Lan; To, Raymond; Goh, Winnie; Wong, Virginia

    2004-02-01

    Children with neurodevelopmental disorders can have feeding problems. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Video-fluoroscopic study of swallowing (VFSS) is essential in understanding the pathological mechanisms involved during swallowing. The aim of the present study was to assess the role of VFSS in assessment and management of four children with various neurodevelopmental disorders in a multidisciplinary feeding team. We describe the team approach, with the participation of child neurologist, radiologist with the rehabilitation team including the speech therapist, occupational therapist and dietician, in the assessment and plan of management. Video-fluoroscopic study of swallowing had been useful in assessing the type of swallowing problems with treatment goals targeted to the basic underlying pathophysiological mechanism. A child neurologist should be involved in the multidisciplinary oromotor rehabilitation program for neurologically impaired children with feeding problems.

  16. Randomized trial of two swallowing assessment approaches in patients with acquired brain injury

    DEFF Research Database (Denmark)

    Kjaersgaard, Annette; Nielsen, Lars Hedemann; Sjölund, Bengt H.

    2014-01-01

    OBJECTIVE: To examine whether patients assessed for initiation of oral intake only by Facial-Oral Tract Therapy had a greater risk of developing aspiration pneumonia during neurorehabilitation than patients assessed by Fibreoptic Endoscopic Evaluation of Swallowing. DESIGN: Randomized controlled ...

  17. Accelerometry-based gait analysis and its application to Parkinson's disease assessment--part 1: detection of stride event.

    Science.gov (United States)

    Yoneyama, Mitsuru; Kurihara, Yosuke; Watanabe, Kajiro; Mitoma, Hiroshi

    2014-05-01

    Gait analysis is widely recognized as a promising tool for obtaining objective information on the walking behavior of Parkinson's disease (PD) patients. It is especially useful in clinical practices if gait properties can be captured with minimal instrumentation that does not interfere with the subject's usual behavioral pattern under ambulatory conditions. In this study, we propose a new gait analysis system based on a trunk-mounted acceleration sensor and automatic gait detection algorithm. The algorithm identifies the acceleration signal with high intensity, periodicity, and biphasicity as a possible gait sequence, from which gait peaks due to stride events are extracted by utilizing the cross-correlation and anisotropy properties of the signal. A total of 11 healthy subjects and 12 PD patients were tested to evaluate the performance of the algorithm. The result indicates that gait peaks can be detected with an accuracy of more than 94%. The proposed method may serve as a practical component in the accelerometry-based assessment of daily gait characteristics.

  18. Combining GPS, GIS, and accelerometry to explore the physical activity and environment relationship in children and young people - a review.

    Science.gov (United States)

    McCrorie, Paul R W; Fenton, Candida; Ellaway, Anne

    2014-09-13

    The environment has long been associated with physical activity engagement, and recent developments in technology have resulted in the ability to objectively quantify activity behaviours and activity context. This paper reviews studies that have combined Global Positioning Systems (GPS), Geographic Information Systems (GIS) and accelerometry to investigate the PA-environment relationship in children and young people (5-18 years old). Literature searches of the following bibliographic databases were undertaken: Sportdiscus, Medline, Embase, CINAHL, Psychinfo and Applied Social Sciences Index and Abstracts (ASSIA). Fourteen studies met the inclusion criteria, and covered topics including greenspace use, general land use, active travel, and the built environment. Studies were largely cross-sectional and took place across developed countries (UK, USA, Canada, New Zealand, and Australia). Findings suggest that roads and streets, school grounds, and the home location are important locations for total PA, and moderate to vigorous PA (MVPA). The relationship between greenspace was positive, however, multiple definitions and outcome measures add complexity to the results. MVPA was more likely in those exposed to higher levels of greenspace compared to sedentary individuals. Total MVPA time in greenspace is low, but when framed as a proportion of the total can be quite high. Domestic gardens may be an important area for higher intensity activity.

  19. Wearable accelerometry-based technology capable of assessing functional activities in neurological populations in community settings: a systematic review.

    Science.gov (United States)

    Steins, Dax; Dawes, Helen; Esser, Patrick; Collett, Johnny

    2014-03-13

    Integrating rehabilitation services through wearable systems has the potential to accurately assess the type, intensity, duration, and quality of movement necessary for procuring key outcome measures. This review aims to explore wearable accelerometry-based technology (ABT) capable of assessing mobility-related functional activities intended for rehabilitation purposes in community settings for neurological populations. In this review, we focus on the accuracy of ABT-based methods, types of outcome measures, and the implementation of ABT in non-clinical settings for rehabilitation purposes. Cochrane, PubMed, Web of Knowledge, EMBASE, and IEEE Xplore. The search strategy covered three main areas, namely wearable technology, rehabilitation, and setting. Potentially relevant studies were categorized as systems either evaluating methods or outcome parameters. Methodological qualities of studies were assessed by two customized checklists, depending on their categorization and rated independently by three blinded reviewers. Twelve studies involving ABT met the eligibility criteria, of which three studies were identified as having implemented ABT for rehabilitation purposes in non-clinical settings. From the twelve studies, seven studies achieved high methodological quality scores. These studies were not only capable of assessing the type, quantity, and quality measures of functional activities, but could also distinguish healthy from non-healthy subjects and/or address disease severity levels. While many studies support ABT's potential for telerehabilitation, few actually utilized it to assess mobility-related functional activities outside laboratory settings. To generate more appropriate outcome measures, there is a clear need to translate research findings and novel methods into practice.

  20. Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study

    OpenAIRE

    Paul Glad Mihai; Mareile Otto; Martin Domin; Thomas Platz; Shaheen Hamdy; Martin Lotze

    2016-01-01

    Neurogenic dysphagia frequently occurs after stroke and deglutitive aspiration is one of the main reasons for subacute death after stroke. Although promising therapeutic interventions for neurogenic dysphagia are being developed, the functional neuroanatomy of recovered swallowing in this population remains uncertain. Here, we investigated 18 patients post-stroke who recovered from dysphagia using an event related functional magnetic resonance imaging (fMRI) study of swallowing. Patients were...

  1. Dysphagia in Lewy body dementia - a clinical observational study of swallowing function by videofluoroscopic examination

    OpenAIRE

    Londos, Elisabet; Hansson, Oskar; Hirsch, Ingrid Alm; Janneskog, Anna; Bülow, Margareta; Palmqvist, Sebastian

    2013-01-01

    Background: Dysphagia, which can result in aspiration pneumonia and death, is a well-known problem in patients with dementia and Parkinson's disease. There are few studies on dysphagia in patients with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), especially studies objectively documenting the type of swallowing dysfunction. The aim of this study was therefore to investigate the prevalence, and define the actual swallowing dysfunction according to a videofluo...

  2. Effect of aging on oral and swallowing function after meal consumption

    Directory of Open Access Journals (Sweden)

    Hiramatsu T

    2015-01-01

    Full Text Available Tetsuya Hiramatsu,1,2 Hideyuki Kataoka,3 Mari Osaki,4 Hiroshi Hagino3,4 1Department of Speech Pathology and Audiology, Matsue Co-medical College, Matsue, Japan; 2Graduate School of Medical Sciences, Tottori University, 3School of Health Science, Faculty of Medicine, Tottori University, 4Rehabilitation Division, Tottori University Hospital, Yonago, Japan Background/purpose: Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs.Methods: Tongue–palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs and 23 OA volunteers.Results: There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption.Conclusion: Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their

  3. SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

    OpenAIRE

    STANESCU, Ioana; Gabriela DOGARU

    2014-01-01

    Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting esp...

  4. Sequential swallows have no influence on esophageal contractions of patients with iron deficiency anemia

    OpenAIRE

    Roberto Oliveira DANTAS; Miranda,Adriana Leonarda Martins

    2004-01-01

    BACKGROUND: An experimental study showed that thyropharyngeal, cricopharyngeal and cervical esophageal muscles of rabbits with iron deficiency anemia had morphological changes similar to those observed in muscular dystrophy, causing myastenic changes in muscles involved in swallowing. Our hypothesis is that patients with iron deficiency anemia may have a decrease in esophageal contractions with successive swallows. PATIENTS AND METHOD: We studied the esophageal motility of 12 women with iron ...

  5. Taste and Temperature in Swallowing Transit Time after Stroke

    Directory of Open Access Journals (Sweden)

    Paula C. Cola

    2012-09-01

    Full Text Available Background: Oropharyngeal dysphagia is common in individuals after stroke. Taste and temperature are used in dysphagia rehabilitation. The influence of stimuli, such as taste and temperature, on swallowing biomechanics has been investigated in both healthy individuals and in individuals with neurological disease. However, some questions still remain unanswered, such as how the sequence of offered stimuli influences the pharyngeal response. The goal of the present study was to determine the influence of the sequence of stimuli, sour taste and cold temperature, on pharyngeal transit time during deglutition in individuals after stroke. Methods: The study included 60 individuals with unilateral ischemic stroke, 29 males and 31 females, aged 41–88 years (mean age: 66.2 years examined 0–50 days after ictus (median: 6 days, with mild to moderate oropharyngeal dysphagia. Exclusion criteria were hemorrhagic stroke patients, patients with decreased level of consciousness, and clinically unstable patients, as confirmed by medical evaluation. The individuals were divided into two groups of 30 individuals each. Group 1 received a nonrandomized sequence of stimuli (i.e. natural, cold, sour, and sour-cold and group 2 received a randomized sequence of stimuli. A videofluoroscopic swallowing study was performed to analyze the pharyngeal transit time. Four different stimuli (natural, cold, sour, and sour-cold were offered. The images were digitalized and specific software was used to measure the pharyngeal transit time. Since the values did not present regular distribution and uniform variances, nonparametric tests were performed. Results: Individuals in group 1 presented a significantly shorter pharyngeal transit time with the sour-cold stimulus than with the other stimuli. Individuals in group 2 did not show a significant difference in pharyngeal transit time between stimuli. Conclusions: The results showed that the sequence of offered stimuli influences

  6. Development of a Portable Non-Invasive Swallowing and Respiration Assessment Device

    Directory of Open Access Journals (Sweden)

    Wann-Yun Shieh

    2015-05-01

    Full Text Available Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders.

  7. Development of a portable non-invasive swallowing and respiration assessment device.

    Science.gov (United States)

    Shieh, Wann-Yun; Wang, Chin-Man; Chang, Chia-Shuo

    2015-05-27

    Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR) to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG) to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders.

  8. Development of a Portable Non-Invasive Swallowing and Respiration Assessment Device †

    Science.gov (United States)

    Shieh, Wann-Yun; Wang, Chin-Man; Chang, Chia-Shuo

    2015-01-01

    Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR) to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG) to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders. PMID:26024414

  9. Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study

    Directory of Open Access Journals (Sweden)

    Paul Glad Mihai

    2016-01-01

    Full Text Available Neurogenic dysphagia frequently occurs after stroke and deglutitive aspiration is one of the main reasons for subacute death after stroke. Although promising therapeutic interventions for neurogenic dysphagia are being developed, the functional neuroanatomy of recovered swallowing in this population remains uncertain. Here, we investigated 18 patients post-stroke who recovered from dysphagia using an event related functional magnetic resonance imaging (fMRI study of swallowing. Patients were characterized by initial dysphagia score (mild to severe, lesion mapping, white matter fractional anisotropy (FA of the pyramidal tracts, and swallowing performance measurement during fMRI scanning. Eighteen age matched healthy participants served as a control group. Overall, patients showed decreased fMRI-activation in the entire swallowing network apart from an increase of activation in the contralesional primary somatosensory cortex (S1. Moreover, fMRI activation in contralesional S1 correlated with initial dysphagia score. Finally, when lesions of the pyramidal tract were more severe, recovered swallowing appeared to be associated with asymmetric activation of the ipsilesional anterior cerebellum. Taken together, our data support a role for increased contralesional somatosensory resources and ipsilesional anterior cerebellum feed forward loops for recovered swallowing after dysphagia following stroke.

  10. A model experiment to study swallowing of spherical and elongated particles

    Directory of Open Access Journals (Sweden)

    Marconati Marco

    2017-01-01

    Full Text Available Swallowing disorders are not uncommon among elderly and people affected by neurological diseases. For these patients the ingestion of solid grains, such as pharmaceutical oral solid formulations, could result in choking. This generally results in a low compliance in taking solid medications. The effect of the solid medication size on the real or perceived ease of swallowing is still to be understood from the mechanistic viewpoint. The interplay of the inclusion shape and the rheology of the liquid being swallowed together with the medication is also not fully understood. In this study, a model experiment was developed to study the oropharyngeal phase of swallowing, replicating the dynamics of the bolus flow induced by the tongue (by means of a roller driven by an applied force. Experiments were performed using a wide set of solid inclusions, dispersed in a thick Newtonian liquid. Predictions for a simple theory are compared with experiments. Results show that an increase in the grain size results in a slower dynamics of the swallowing. Furthermore, the experiments demonstrated the paramount role of shape, as flatter and more streamlined inclusions flow faster than spherical. This approach can support the design of new oral solid formulations that can be ingested more easily and effectively also by people with mild swallowing disorders.

  11. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    Science.gov (United States)

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients.

  12. Efficacy of EMG/bioimpedance-triggered functional electrical stimulation on swallowing performance

    Directory of Open Access Journals (Sweden)

    Corinna Schultheiss

    2016-08-01

    Full Text Available In order to support swallowing, the efficacy of functional electrical stimulation for different stimulation settings of the submental musculature has been investigated. The stimulation was administrated at rest and synchronously to voluntary initiated swallows. The onset of a swallow was detected in real-time by a combined electromyography/ bioimpedance measurement at the neck in order to trigger the stimulation. The amplitude and speed of larynx elevation caused by the FES has been assessed by the observed change in bioimpedance whereas a reduction of bioimpedance corresponds to an increase in larynx elevation. Study results from 40 healthy subjects revealed that 73% of the subjects achieved a larger and faster larynx elevation during swallowing with triggered FES and therefor a better protection of their airways. However, we also observed a decrease in larynx elevation compared to normal swallowing in 11 out of the 40 subjects what might not benefit from such a treatment. The largest improvement of larynx elevation and speed during swallowing could be achieved with three stimulation channels formed by four electrodes in the submental region.

  13. Contemporary management of voice and swallowing disorders in patients with advanced lung cancer.

    Science.gov (United States)

    Brady, Grainne C; Carding, Paul N; Bhosle, Jaishree; Roe, Justin W G

    2015-06-01

    Advanced lung cancer can cause changes to swallowing and communication function. Direct tumour invasion, dyspnoea and deconditioning can all impact on swallowing function and communication. Cancer treatment, if administered, may cause or compound symptoms. In this study, the nature of swallowing and communication difficulties in patients with advanced lung cancer will be discussed, and management options including medical management, speech and language therapy (SLT) intervention, and surgical interventions will be considered. Advanced lung cancer can result in voice and swallowing difficulties, which can increase symptom burden and significantly impact on quality of life (QOL). There is a growing evidence base to support the use of injection laryngoplasty under local anaesthetic to offer immediate improvement in voice, swallowing and overall QOL. There is limited literature on the nature and extent of voice and swallowing impairment in patients with lung cancer. Well designed studies with robust and sensitive multidimensional dysphagia and dysphonia assessments are required. Outcome studies examining interventions with clearly defined treatment goals are required. These studies should include both functional and patient-reported outcome measures to develop the evidence base and to ensure that interventions are both timely and appropriate.

  14. Physiology of oropharyngeal swallow in the cat: a videofluoroscopic and electromyographic study.

    Science.gov (United States)

    Kobara-Mates, M; Logemann, J A; Larson, C; Kahrilas, P J

    1995-02-01

    The majority of animal studies of deglutition have examined electrically stimulated swallows in sedated animals. This present investigation examined oropharyngeal and cervical esophageal swallow physiology in three awake normal domestic cats using concurrent electromyography (EMG) and videofluorography (VFG). Hooked wire electrodes were surgically implanted into six oropharyngeal muscles in each cat. During collection of VFG and EMG data, each cat ate barium-impregnated cat food while the fluorography tube focused on a lateral view of the oral cavity, pharynx, and cervical esophagus. A number of significant differences in the physiology of swallowing were found between the cat and human adult. The oral stage of swallow is much longer in the cat with bolus accumulation in the valleculae. Duration and components of the pharyngeal stage of swallow are much faster, and the pharyngeal stage occurs earlier in relation to bolus passage through the cricopharyngeus. In addition, the cat exhibits a marked superior constrictor bulge at the onset of the pharyngeal contractile wave and summation of the peristaltic waves in the esophagus, whereas the human adult does not. Feline swallow physiology is more similar to that of the human infant than that of human adults.

  15. Effects of mercury exposure on the reproductive success of tree swallows (Tachycineta bicolor).

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    Brasso, Rebecka L; Cristol, Daniel A

    2008-02-01

    An experimental tree swallow population was established in the headwaters of the Shenandoah River, Virginia, USA to assess the accumulation and effects of mercury contamination on birds that eat emergent aquatic insects. One tributary, the South River, was contaminated with mercury before 1950. Reproductive success of swallows nesting within 50 m of this river was compared to that of three uncontaminated reference tributaries in 2005 and 2006. Female swallows on the contaminated stretch of river had significantly elevated blood and feather total mercury (blood: 3.56 +/- 2.41 ppm ww vs. 0.17 +/- 0.15 ppm reference; feather: 13.55 +/- 6.94 ppm vs. 2.34 +/- 0.87 ppm reference), possibly the highest ever reported for an insectivorous songbird. Insects collected by the swallows to be fed to nestlings averaged 0.97 +/- 1.11 ppm dw total mercury, significantly higher than on reference sites. Swallows in the contaminated area produced fewer fledglings than those in reference areas. The effect of mercury contamination on productivity was detectable only for young females in the contaminated area that were breeding for the first time in 2006, a segment of the population that may already have been stressed by inexperience. Tree swallows served as practical and effective biomonitors for mercury levels and effects and have great potential as proxy biomonitors for more logistically challenging birds such as loons or eagles.

  16. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

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    Abysique, Anne; Tardivel, Catherine; Troadec, Jean-Denis; Félix, Bernadette

    2015-01-01

    Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation.

  17. Brain regions involved in swallowing: Evidence from stroke patients in a cross-sectional study

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    Shiva Ebrahimian Dehaghani

    2016-01-01

    Full Text Available Background: Limited data available about the mechanisms of dysphagia and areas involving swallow after brain damage; accordingly it is hard to predict which cases are more likely to develop swallowing dysfunction based on the neuroimaging. The aim of this study was to investigate the relationship between brain lesions and dysphagia in a sample of acute conscious stroke patients.Materials and Methods: In a cross-sectional study, 113 acute conscious stroke patients (69 male mean [standard deviation (SD] age 64.37 [15.1], participated in this study. Two neurologists and one radiologist localized brain lesions according to neuroimaging of the patients. Swallowing functions were assessed clinically by an expert speech pathologist with the Mann Assessment of Swallowing Ability (MASA. The association of brain region and swallowing problem was statistically evaluated using Chi-square test. Results: Mean (SD MASA score for the dysphagic patients was 139.61 (29.77. Swallowing problem was significantly more prevalent in the right primary sensory (P = 0.03, right insula (P = 0.005, and right internal capsule (P = 0.05. Conclusion: It may be concluded from these findings that the right hemisphere lesions associated with occurring dysphagia. Further studies using more advanced diagnostic tools on big samples particularly in a perspective structure are needed.

  18. Viscosity threshold that allows safe swallow in elderly with post-stroke dysphagia

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    Rodolfo Peña

    2017-08-01

    Full Text Available Objective: To determine the viscosity threshold that allows safe swallowing in older adults with post-stroke dysphagia. Method: Cross-sectional analytical study. 6 patients over 60 years old with dysphagia participated. Were given six viscosities (50mPa s, 110mPa s, 170mPa s, 230mPa s, 290mPa s and 350mPa s made from no carbonated water and a corn starch-based thickener. Swallowing safety signs (wet voice, cough and oxygen saturation were assessed in each viscosity by Fiberoptic Endoscopic Evaluation of Swallowing (FEES. Viscosities’ performances in swallowing safety signs were compared in order to know which viscosity would be the safest. Results: 100% of swallowing safety signs did not appear in any viscosity assessed. Conclusions: It is not possible to determine the viscosity threshold that allows safe swallowing in patients with post-stroke dysphagia in the viscosities assessed. We discuss about multiple factors that had had affect our results: size sample, use of FEES to assess low viscosities, and viscosities’ intervals used.

  19. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

    Directory of Open Access Journals (Sweden)

    Anne Abysique

    Full Text Available Deoxynivalenol (DON, one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation.

  20. [Application of fibreoptic endoscope in evaluation of swallowing].

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    Qiang, Bi; Tian, Xing-de; Wang, Hua; Lei, Hong-wei

    2009-05-01

    To investigate the effect of fibreoptic endoscopic evaluation of swallowing (FEES) in the assessment of dysphagia. Fifty-two patients with neurogenic dysphagia underwent FEES and videofluoroscopy (VF) within a 2-day period. The results obtained were compared. FEES with all consistencies revealed premature leakage in 48.1%, pooling in 75.0%, penetration in 69.2%, and aspiration in 55.8%, silent aspiration in 28.8% of patients. VF revealed above items in 44.2%, 63.5%, 57.7%, 46.2%, 21.2%, respectively. The FEES was then measured against the VF for sensitivity, specificity, positive predictive value, and negative predictive value. FEES showed higher sensibility and negative coincidence rate of penetration (90.0%, 81.3%), aspiration (87.5%, 87.0%) and silent aspiration (90.9%, 97.3%). According to the severity, the dysphagia in patients was classified into no penetration, penetration, aspiration and silent aspiration. A weighted Kappa value of 0.713 signified "substantial" agreement between the two tests. FEES is an effective and valuable tool for evaluating oropharyngeal dysphagia, and is helpful in guiding the patients for diet and rehabilitation.

  1. Functional profile of swallowing in clinical intensive care

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    Aline Rodrigues Padovani

    2007-12-01

    Full Text Available Objective: To describe the functional profile of swallowing and feedingin patients admitted to a clinical intensive care unit. Methods: Asurvey on the speech therapy care provided at clinical intensive careunit, from May to August 2006, to establish indicators to describeswallowing functional profile. In this study we included patients referredfor suspected dysphagia after undergoing long periods of mechanicalventilation and/or tracheostomy, and we excluded those suspectedof neurogenic dysphagia. Results: We observed a 65% prevalence oforopharyngeal dysphagia in four months of speech therapy. Amongthe patients who were previously submitted to orotracheal intubation,we observed oropharyngeal dysphagia in 64% of assessments, and wenoticed a reduction in dysphagia severity after speech therapy. Thirtyninepercent of cases required further speech therapy. Conclusion:Speech therapy in non-neurogenic dysphagia in clinical intensive careunit focuses mainly on patients who were intubated for more than 48hours. These patients benefited from the intervention through the useof therapeutic techniques based on the necessary criteria for safefeeding habits.

  2. The mechanics and behavior of cliff swallows during tandem flights.

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    Shelton, Ryan M; Jackson, Brandon E; Hedrick, Tyson L

    2014-08-01

    Cliff swallows (Petrochelidon pyrrhonota) are highly maneuverable social birds that often forage and fly in large open spaces. Here we used multi-camera videography to measure the three-dimensional kinematics of their natural flight maneuvers in the field. Specifically, we collected data on tandem flights, defined as two birds maneuvering together. These data permit us to evaluate several hypotheses on the high-speed maneuvering flight performance of birds. We found that high-speed turns are roll-based, but that the magnitude of the centripetal force created in typical maneuvers varied only slightly with flight speed, typically reaching a peak of ~2 body weights. Turning maneuvers typically involved active flapping rather than gliding. In tandem flights the following bird copied the flight path and wingbeat frequency (~12.3 Hz) of the lead bird while maintaining position slightly above the leader. The lead bird turned in a direction away from the lateral position of the following bird 65% of the time on average. Tandem flights vary widely in instantaneous speed (1.0 to 15.6 m s(-1)) and duration (0.72 to 4.71 s), and no single tracking strategy appeared to explain the course taken by the following bird.

  3. Observers' Agreement on Measurements in Fiberoptic Endoscopic Evaluation of Swallowing.

    Science.gov (United States)

    Pilz, Walmari; Vanbelle, Sophie; Kremer, Bernd; van Hooren, Michel R; van Becelaere, Tine; Roodenburg, Nel; Baijens, Laura W J

    2016-04-01

    This study analyzed the effect that dysphagia etiology, different observers, and bolus consistency might have on the level of agreement for measurements in FEES images reached by independent versus consensus panel rating. Sixty patients were included and divided into two groups according to dysphagia etiology: neurological or head and neck oncological. All patients underwent standardized FEES examination using thin and thick liquid consistencies. Two observers scored the same exams, first independently and then in a consensus panel. Four ordinal FEES variables were analyzed. Statistical analysis was performed using a linear weighted kappa coefficient and Bayesian multilevel model. Intra- and interobserver agreement on FEES measurements ranged from 0.76 to 0.93 and from 0.61 to 0.88, respectively. Dysphagia etiology did not influence observers' agreement level. However, bolus consistency resulted in decreased interobserver agreement for all measured FEES variables during thin liquid swallows. When rating on the consensus panel, the observers deviated considerably from the scores they had previously given on the independent rating task. Observer agreement on measurements in FEES exams was influenced by bolus consistency, not by dysphagia etiology. Therefore, observer agreement on FEES measurements should be analyzed by taking bolus consistency into account, as it might affect the interpretation of the outcome. Identifying factors that might influence agreement levels could lead to better understanding of the rating process and assist in developing a more precise measurement scale that would ensure higher levels of observer agreement for measurements in FEES exams.

  4. Regaining water swallowing function in the rehabilitation of critically ill patients with intensive-care-unit acquired muscle weakness.

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    Thomas, Simone; Sauter, Wolfgang; Starrost, Ulrike; Pohl, Marcus; Mehrholz, Jan

    2017-03-21

    Treatment in intensive care units (ICUs) often results in swallowing dysfunction. Recent longitudinal studies have described the recovery of critically ill people, but we are not aware of studies of the recovery of swallowing function in patients with ICU-acquired muscle weakness. This paper aims to describe the time course of regaining water swallowing function in patients with ICU-acquired weakness in the post-acute phase and to describe the risks of regaining water swallowing function and the risk factors involved. This cohort study included patients with ICU-acquired muscle weakness in our post-acute department, who were unable to swallow. We monitored the process of regaining water swallowing function using the 3-ounce water swallowing test. We included 108 patients with ICU-acquired muscle weakness. Water swallowing function was regained after a median of 12 days (interquartile range =17) from inclusion in the study and after a median of 59 days (interquartile range= 36) from the onset of the primary illness. Our multivariate Cox Proportional Hazard model yielded two main risk factors for regaining water swallowing function: the number of medical tubes such as catheters at admission to the post-acute department (adjusted hazard ratio [HR] = 1.282; 95% confidence interval [CI]: 1.099-1.495) and the time until weaning from the respirator in days (adjusted HR =1.02 per day; 95%CI: 0.998 to 1.008). We describe a time course for regaining water swallowing function based on daily tests in the post-acute phase of critically ill patients. Risk factors associated with regaining water swallowing function in rehabilitation are the number of medical tubes and the duration of weaning from the respirator. Implications for rehabilitation Little guidance is available for the management of swallowing dysfunction in the rehabilitation of critically ill patients with intensive-care-units acquired muscle weakness. There is a time dependent pattern of recovery from

  5. Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke

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    Jalal Bakhtiyari

    2015-10-01

    Full Text Available Background: Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke.Methods: Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8, participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated measure ANOVA, Bonferroni and χ2 tests.Results: Three groups of patients in terms of demographic and clinical characteristics were similar in the pre-treatment P > 0.050. Onset time of swallowing therapy after stroke was effective on swallowing recovery on the main outcome variables. So that in first group patients, recovery was rather than other groups P < 0.050. Furthermore, the frequency of pneumonia in the early group was less than other groups and in the early group no patients experienced pneumonia P = 0.002.Conclusion: Our data suggested that early interventions for dysphagia in stroke have an important role in recovery from dysphagia and prevention of complications like aspiration pneumonia.

  6. Natural capsaicinoids improve swallow response in older patients with oropharyngeal dysphagia.

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    Rofes, Laia; Arreola, Viridiana; Martin, Alberto; Clavé, Pere

    2013-09-01

    There is no pharmacological treatment for oropharyngeal dysphagia (OD). The aim of this study was to compare the therapeutic effect of stimulation of oropharyngeal transient receptor potential vanilloid type 1 (TRPV1) with that of thickeners in older patients with OD. A clinical videofluoroscopic non-randomised study was performed to assess the signs of safety and efficacy of swallow and the swallow response in (1) 33 patients with OD (75.94 ± 1.88 years) while swallowing 5, 10 and 20 ml of liquid (20.4 mPa.s), nectar (274.4 mPa.s), and pudding (3930 mPa.s) boluses; (2) 33 patients with OD (73.94 ± 2.23 years) while swallowing 5, 10 and 20 ml nectar boluses, and two series of nectar boluses with 150 μM capsaicinoids and (3) 8 older controls (76.88 ± 1.51 years) while swallowing 5, 10 and 20 ml nectar boluses. Increasing bolus viscosity reduced the prevalence of laryngeal penetrations by 72.03% (p < 0.05), increased pharyngeal residue by 41.37% (p < 0.05), delayed the upper esophageal sphincter opening time and the larynx movement and did not affect the laryngeal vestibule closure time and maximal hyoid displacement. Treatment with capsaicinoids reduced both, penetrations by 50.% (p < 0.05) and pharyngeal residue by 50.% (p < 0.05), and shortened the time of laryngeal vestibule closure (p < 0.001), upper esophageal sphincter opening (p < 0.05) and maximal hyoid and laryngeal displacement. Stimulation of TRPV1 by capsaicinoids strongly improved safety and efficacy of swallow and shortened the swallow response in older patients with OD. Stimulation of TRPV1 might become a pharmacologic strategy to treat OD.

  7. Endoscopic characteristics and levodopa responsiveness of swallowing function in progressive supranuclear palsy.

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    Warnecke, Tobias; Oelenberg, Stephan; Teismann, Inga; Hamacher, Christina; Lohmann, Hubertus; Ringelstein, Erich Bernd; Dziewas, Rainer

    2010-07-15

    Dysphagia is a frequent and early symptom in progressive supranuclear palsy (PSP) predisposing patients to aspiration pneumonia. Fiberoptic endoscopic evaluation of swallowing (FEES) has emerged as a valuable apparative tool for objective evaluation of neurogenic dysphagia. This is the first study using FEES to investigate the nature of swallowing impairment in PSP. Eighteen consecutive PSP patients (mean age 69.7 +/- 9.0 years) were included. The salient findings of FEES in PSP patients were compared with those of 15 patients with Parkinson's disease (PD). In 7 PSP patients, a standardized FEES protocol was performed to explore levodopa (L-dopa) responsiveness of dysphagia. Most frequent abnormalities detected by FEES were bolus leakage, delayed swallowing reflex, and residues in valleculae and piriformes. Aspiration events with at least one food consistency occurred in nearly 30% of PSP patients. Significant pharyngeal saliva pooling was observed in 4 PSP patients. We found no difference of salient endoscopic findings between PSP and PD patients. Endoscopic dysphagia severity in PSP correlated positively with disease duration, clinical disability, and cognitive impairment. No correlation was found with dysarthria severity. In early PSP patients, swallowing dysfunction was solely characterized by liquid leakage with the risk of predeglutitive aspiration during the oral phase of swallowing. Two PSP patients showed relevant improvement of swallowing function after L-dopa challenge. Chin tuck-maneuver, hard swallow, and modification of food consistency were identified as the most effective therapeutic interventions. In conclusion, FEES assessment can deliver important findings for the diagnosis and refined therapy of dysphagia in PSP patients.

  8. Impact of proprioception during the oral phase on initiating the swallowing reflex.

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    Takeda, Hikaru; Saitoh, Kazuya

    2016-07-01

    We hypothesized that proprioceptive signals during the oral phase play a pivotal role in the initiation of pharyngeal phase during volitional swallowing. Therefore, we tested if swallowing could be modified by changing the amount of proprioceptive feedback from a number of different receptors while holding a food bolus in the mouth and clenching. Basic research. Surface electromyography (sEMG) recordings of the masticatory muscles were obtained during volitional swallowing movements from seven healthy adults with no clinical history of swallowing difficulties. The swallowing procedure involved holding 5 ml of jelly on the tongue before swallowing it completely, according to visual cues on a computer display. Initiation of the swallowing reflex was detected by an anterior shift of the thyroid cartilage using a laser displacement sensor and by submental sEMG signals. To vary the proprioceptive input, the participants were instructed to occlude their teeth at various intensities (weak, intermediate, and strong) while holding the 5-ml jelly bolus on the tongue. Rectified and integrated sEMG (iEMG) signals obtained from the submental area showed two upward deflections. Contractile forces of the masseter muscles showed significant negative values for Pearson correlation coefficient against time intervals from the onset of the second submental iEMG deflection to the onset of the anterior shift of the thyroid cartilage in six of the seven participants (average -0.534, standard deviation 0.176). Contractile forces of the masseter muscles during occlusion tended to correlate negatively with electromechanical delays on suprahyoid muscle contraction. NA Laryngoscope, 126:1595-1599, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia.

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    Yamashita, M; Yokoyama, K; Takei, Y; Furuya, N; Nakamichi, Y; Ihara, Y; Takahashi, K; Groher, M E

    2014-09-01

    This research was designed to investigate the acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia. Forty-nine patients with complaints of swallow difficulty received a videofluorographic (VF) examination. They were divided into three groups: nine who did not have any apparent disease (Group N), 22 patients with head and neck cancer (Group H&N) and 18 patients with other diseases including cerebrovascular disease (Group OD). After liquid barium swallows, they exhaled voluntarily without voicing. Videofluorographic findings were classified into four groups: normal (Normal), acceptable swallow (Acceptable), swallow with residue (Resid) and swallows with penetration or aspiration (Pen/Asp). The duration of expiratory sounds was measured on the time waveform. Frequency characteristics of expiratory sounds were obtained using one-third octave band analysis ranging from 62·5 to 2000·0 Hz of central frequency. The averaged level of the 1000·0-Hz band was chosen as the reference band level (RB level). The revised averaged level of each band was obtained by subtracting the RB level from the averaged level of each band. Zero decibel of the revised magnitude of the 125·0-Hz band was set as the critical value to differentiate dysphagia (Resid or Pen/Asp) from no dysphagia (Normal or Acceptable). Comparison of this assessment with VF findings showed a significant percentage agreement (85·4%). These results suggest that frequency characteristics of post-swallow expiratory sounds can differentiate dysphagia from no dysphagia among multiple dysphagic patient groups. © 2014 John Wiley & Sons Ltd.

  10. Swallowing abnormalities in HIV infected children: an important cause of morbidity

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    Nel Etienne D

    2012-06-01

    Full Text Available Abstract Background Swallowing disorders, well recognised in adults, contribute to HIV-infection morbidity. Little data however is available for HIV-infected children. The purpose of this study is to describe swallowing disorders in a group of HIV-infected children in Africa after the introduction of combined anti-retroviral therapy. Methods We describe 25 HIV-infected children referred for possible swallowing disorders. Clinical and videofluoroscopic assessment of swallowing (VFSS, HIV stage, and respiratory and neurological examination were recorded. Results Median age was 8 months (range 2.8-92 and 15 (60% were male. Fifteen (60% were referred for recurrent respiratory complaints, 4 (16% for poor growth, 4 (16% for poor feeding and 2 (8% patients for respiratory complaints and either poor growth or feeding. Twenty patients (80% had clinical evidence of swallowing abnormalities: 11 (44% in the oral phase, 4 (16% in the pharyngeal phase, and 5 (25% in both the oral and pharyngeal phases. Thirteen patients had a videofluoroscopic assessment of which 6 (46% where abnormal. Abnormalities were detected in the oral phase in 2, in the pharyngeal phase in 3, and in the oral and pharyngeal phase in 1; all of these patients also had evidence of respiratory involvement. Abnormal swallowing occurred in 85% of children with central nervous system disease. CNS disease was due to HIV encephalopathy (8 and miscellaneous central nervous system diseases (5. Three of 4 (75% patients with thrush had an abnormal oral phase on assessment. No abnormalities of the oesophagus were found. Conclusions This report highlights the importance of swallowing disorders in HIV infected children. Most patients have functional rather than structural or mucosal abnormalities. VFSS makes an important contribution to the diagnosis and management of these patients.

  11. [Cervicogenic dysphagia: swallowing difficulties caused by functional and organic disorders of the cervical spine].

    Science.gov (United States)

    Grgić, Vjekoslav

    2013-01-01

    Cervical spine disorders which can cause swallowing difficulties (cervicogenic dysphagia; CD) are: chronic multisegmental/MS dysfunction (dysfunction=functional blockade) of the facet joints, changes in physiological curvature of the cervical spine, degenerative changes (anterior osteophytes, anterior disc herniation, osteochondrosis, osteoarthritis), inflammatory rheumatic diseases, diffuse idiopathic skeletal hyperostosis, injuries, conditions after anterior cervical spine surgery, congenital malformations and tumors. According to our clinical observations, degenerative changes in the cervical discs and facet joints and chronic MS dysfunction of the cervical spine facet joints are disorders which can cause swallowing difficulties. However, these disorders have not been recognized enough as the causes of dysphagia and they are not even mentioned in differential diagnosis. Because of the close anatomical relationship of cervical spine with the pharynx and cervical part of esophagus, the consequences of the degenerative changes in the cervical discs and facet joints and chronic MS dysfunction of the cervical spine facet joints such as the changes in the physiological curvature of the cervical spine, changes in elasticity and contractility in the neck muscles and decreased mobility of the cervical spine, adversely affect the dimensions of the pharynx and cervical part of esophagus, that is, swallowing capacity which can result in dysphagia. Degenerative changes in the cervical discs and facet joints are common additional cause of dysphagia in elderly people with disorders of the central control of swallowing (stroke, Parkinson's disease, senile dementia etc). The most important therapeutic options in patients with CD are: medicamentous therapy, physical therapy, manual therapy, kinesiotherapy and surgical treatment. The aim of the conservative therapy in patients with CD is to improve the swallowing capacity (for example, soft tissue techniques, stretching of the

  12. Cannabinoids facilitate the swallowing reflex elicited by the superior laryngeal nerve stimulation in rats.

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    Rahman Md Mostafeezur

    Full Text Available Cannabinoids have been reported to be involved in affecting various biological functions through binding with cannabinoid receptors type 1 (CB1 and 2 (CB2. The present study was designed to investigate whether swallowing, an essential component of feeding behavior, is modulated after the administration of cannabinoid. The swallowing reflex evoked by the repetitive electrical stimulation of the superior laryngeal nerve in rats was recorded before and after the administration of the cannabinoid receptor agonist, WIN 55-212-2 (WIN, with or without CB1 or CB2 antagonist. The onset latency of the first swallow and the time intervals between swallows were analyzed. The onset latency and the intervals between swallows were shorter after the intravenous administration of WIN, and the strength of effect of WIN was dose-dependent. Although the intravenous administration of CB1 antagonist prior to intravenous administration of WIN blocked the effect of WIN, the administration of CB2 antagonist did not block the effect of WIN. The microinjection of the CB1 receptor antagonist directly into the nucleus tractus solitarius (NTS prior to intravenous administration of WIN also blocked the effect of WIN. Immunofluorescence histochemistry was conducted to assess the co-localization of CB1 receptor immunoreactivity to glutamic acid decarboxylase 67 (GAD67 or glutamate in the NTS. CB1 receptor was co-localized more with GAD67 than glutamate in the NTS. These findings suggest that cannabinoids facilitate the swallowing reflex via CB1 receptors. Cannabinoids may attenuate the tonic inhibitory effect of GABA (gamma-aminobuteric acid neurons in the central pattern generator for swallowing.

  13. Effects of coal fly ash on tree swallow reproduction in Watts Bar Reservoir, Tennessee.

    Science.gov (United States)

    Walls, Suzanne J; Meyer, Carolyn B; Iannuzzi, Jacqueline; Schlekat, Tamar H

    2015-01-01

    Coal-fly ash was released in unprecedented amounts (4.1 × 10(6) m(3) ) into the Emory River from the Tennessee Valley Authority Kingston Fossil Plant on Watts Bar Reservoir in Tennessee. Tree swallows were exposed to ash-related constituents at the ash release via their diet of emergent aquatic insects, whose larval forms can accumulate constituents from submerged river sediments. Reproduction of tree swallow colonies was assessed over a 2-year period by evaluating whether 1) ash constituent concentrations were elevated in egg, eggshell, and nestling tissues at colonies near ash-impacted river reaches compared to reference colonies, 2) production of fledglings per nesting female was significantly lower in ash-impacted colonies versus reference colonies, and 3) ash constituent concentrations or diet concentrations were correlated with nest productivity measures (clutch size, hatching success, and nestling survival, and fledglings produced per nest). Of the 26 ash constituents evaluated, 4 (Se, Sr, Cu, and Hg) were significantly elevated in tissues potentially from the ash, and 3 (Se, Sr, and Cu) in tissues or in swallow diet items were weakly correlated to at least one nest-productivity measure or egg weight. Tree swallow hatching success was significantly reduced by 12%, but fledgling production per nest was unaffected due to larger clutch sizes in the impacted than reference colonies. Bioconcentration from the ash to insects in the diet to tree swallow eggs appears to be low. Overall, adverse impacts of the ash on tree swallow reproduction were not observed, but monitoring is continuing to further ensure Se from the residual ash does not adversely affect tree swallow reproduction over time. Integr Environ Assess Manag 2015;11:56-66. © 2014 SETAC.

  14. Task-dependent differences in corticobulbar excitability of the submental motor projections: Implications for neural control of swallowing.

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    Doeltgen, Sebastian H; Ridding, Michael C; Dalrymple-Alford, John; Huckabee, Maggie-Lee

    2011-01-15

    It has been suggested that the primary motor cortex plays a substantial role in the neural circuitry that controls swallowing. Although its role in the voluntary oral phase of swallowing is undisputed, its precise role in motor control of the more reflexive, pharyngeal phase of swallowing is unclear. The contribution of the primary motor cortex to the pharyngeal phase of swallowing was examined using transcranial magnetic stimulation (TMS) to evoke motor evoked potentials (MEPs) in the anterior hyomandibular muscle group during either volitional submental muscle contraction or contraction during the pharyngeal phase of both volitionally, and reflexively, initiated swallowing. For each subject, in all three conditions, TMS was triggered when submental surface EMG (sEMG) reached 75% of the mean maximal submental sEMG amplitude measured during 10 volitional swallows. MEPs recorded during volitional submental muscle contraction were elicited in 22 of the 35 healthy subjects examined (63%). Only 16 of these 22 subjects (45.7%) also displayed MEPs recorded during volitional swallowing, but their MEP amplitudes were larger when triggered by submental muscle contraction than when triggered by volitional swallowing. Additionally, only 7 subjects (of 19 tested) showed MEPs triggered by submental muscle contraction during a reflexively triggered pharyngeal swallow. These differences indicate differing levels of net M1 excitability during execution of the investigated tasks, possibly brought about by task-dependent changes in the balance of excitatory and inhibitory neural activity. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. The evaluation of swallowing in patients with spinocerebellar ataxia and oropharyngeal dysphagia: A comparison study of videofluoroscopic and sonar doppler

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    Abdulmassih, Edna Márcia da Silva

    2013-01-01

    Full Text Available Introduction: Spinocerebellar ataxia (SCA is a degenerative disease that can cause loss of coordination of voluntary muscle movement such as that required for swallowing. Aims: The purposes of this cross-sectional and comparative case study were: (1 to assess the severity of dysphagia through a videofluoroscopic swallow study, and (2 to compare differences in frequency, intensity, and duration of sound waves produced during swallowing in normal and SCA patients by using sonar Doppler. Method: During swallow evaluation using videofluoroscopy, a sonar Doppler transducer was placed on the right side of the neck, at the lateral edge of the trachea, just below the cricoid cartilage to capture the sounds of swallowing in 30 SCA patients and 30 controls. Result: The prevalence in the dynamic evaluation of swallowing videofluoroscopy was by changes in the oral phase of swallowing. The analysis of variance of the averages found in each variable - frequency, intensity and duration of swallowing - shows there was a significant correlation when compared to the healthy individual curve. Conclusion: The study demonstrates the prevalence of oral dysphagia observed in dynamic videofluoroscopic swallow evaluation. In patients with SCA, the mean initial frequency (IF, initial intensity (II, and final intensity (FI were higher and the time (T and peak frequency (PF were lower, demonstrating a pattern of cricopharyngeal opening very close to that found in normal populations.

  16. Voluntary Modulation of Hemodynamic Responses in Swallowing Related Motor Areas: A Near-Infrared Spectroscopy-Based Neurofeedback Study.

    Directory of Open Access Journals (Sweden)

    Silvia Erika Kober

    Full Text Available In the present study, we show for the first time that motor imagery of swallowing, which is defined as the mental imagination of a specific motor act without overt movements by muscular activity, can be successfully used as mental strategy in a neurofeedback training paradigm. Furthermore, we demonstrate its effects on cortical correlates of swallowing function. Therefore, N = 20 healthy young adults were trained to voluntarily increase their hemodynamic response in swallowing related brain areas as assessed with near-infrared spectroscopy (NIRS. During seven training sessions, participants received either feedback of concentration changes in oxygenated hemoglobin (oxy-Hb group, N = 10 or deoxygenated hemoglobin (deoxy-Hb group, N = 10 over the inferior frontal gyrus (IFG during motor imagery of swallowing. Before and after the training, we assessed cortical activation patterns during motor execution and imagery of swallowing. The deoxy-Hb group was able to voluntarily increase deoxy-Hb over the IFG during imagery of swallowing. Furthermore, swallowing related cortical activation patterns were more pronounced during motor execution and imagery after the training compared to the pre-test, indicating cortical reorganization due to neurofeedback training. The oxy-Hb group could neither control oxy-Hb during neurofeedback training nor showed any cortical changes. Hence, successful modulation of deoxy-Hb over swallowing related brain areas led to cortical reorganization and might be useful for future treatments of swallowing dysfunction.

  17. Association between walking speed and age in healthy, free-living individuals using mobile accelerometry--a cross-sectional study.

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    Michaela Schimpl

    Full Text Available CONTEXT: Walking speed is a fundamental parameter of human motion and is increasingly considered as an important indicator of individuals' health status. OBJECTIVE: To evaluate the relationship of gait parameters, and demographic and physical characteristics in healthy men and women. DESIGN, SETTING, AND PARTICIPANTS: Recruitment of a subsample (n = 358 of male and female blood donors taking part in the Cambridge CardioResource study. Collection of demographic data, measurement of physical characteristics (height, weight and blood pressure and assessment of 7-day, free-living activity parameters using accelerometry and a novel algorithm to measure walking speed. Participants were a median (interquartile range[IQR] age of 49 (16 years; 45% women; and had a median (IQR BMI of 26 (5.4. MAIN OUTCOME MEASURE: Walking speed. RESULTS: In this study, the hypothesis that walking speed declines with age was generated using an initial 'open' dataset. This was subsequently validated in a separate 'closed' dataset that showed a decrease of walking speed of -0.0037 m/s per year. This is equivalent to a difference of 1.2 minutes, when walking a distance of 1 km aged 20 compared to 60 years. Associations between walking speed and other participant characteristics (i.e. gender, BMI and blood pressure were non-significant. BMI was negatively correlated with the number of walking and running steps and longest non-stop distance. CONCLUSION: This is the first study using accelerometry which shows an association between walking speed and age in free-living, healthy individuals. Absolute values of gait speed are comparable to published normal ranges in clinical settings. This study highlights the potential use of mobile accelerometry to assess gait parameters which may be indicative of future health outcomes in healthy individuals.

  18. Validation of an Internet-Based Long Version of the International Physical Activity Questionnaire in Danish Adults Using Combined Accelerometry and Heart Rate Monitoring

    DEFF Research Database (Denmark)

    Hansen, Andreas Wolff; Dahl-Petersen, Inger; Helge, Jørn Wulff;

    2014-01-01

    BACKGROUND: The International Physical Activity Questionnaire (IPAQ) is commonly used in surveys but reliability and validity has not been established in the Danish population. METHODS: Among participants in the Danish Health Examination survey 2007-2008, 142 healthy participants (45% men) wore...... a unit that combined accelerometry and heart rate monitoring (Acc+HR) for 7 consecutive days and then completed the IPAQ. Background data were obtained from the survey. Physical activity energy expenditure (PAEE) and time in moderate, vigorous and sedentary intensity level were derived from the IPAQ...

  19. Physical activity measured by accelerometry and its associations with cardiac structure and vascular function in young and middle-aged adults

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Lyass, Asya; Larson, Martin G

    2015-01-01

    BACKGROUND: Physical activity is associated with several health benefits, including lower cardiovascular disease risk. The independent influence of physical activity on cardiac and vascular function in the community, however, has been sparsely investigated. MEASURES AND RESULTS: We related...... relations of usual levels of physical activity and cardiovascular remodeling....... objective measures of moderate- to vigorous-intensity physical activity (MVPA, assessed by accelerometry) to cardiac and vascular indices in 2376 participants of the Framingham Heart Study third generation cohort (54% women, mean age 47 years). Using multivariable regression models, we related MVPA...

  20. Swallowing disorders in nursing home residents: how can the problem be explained?

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    Nogueira D

    2013-02-01

    Full Text Available Dália Nogueira,1 Elizabeth Reis21Speech Therapy Department, Escola Superior de Saúde de Alcoitão, Estoril, Portugal; 2Department of Quantitative Methods, Lisbon University Institute ISCTE/IUL, Lisbon, PortugalBackground: The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes.Methods: The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST. For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test.Results: The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age

  1. Effects of carbonated liquids on oropharyngeal swallowing measures in people with neurogenic dysphagia.

    Science.gov (United States)

    Sdravou, Katerina; Walshe, Margaret; Dagdilelis, Lukas

    2012-06-01

    Aspiration is common in adults with neurogenic dysphagia and pharyngeal delay. This can lead to dehydration, malnutrition, and aspiration pneumonia. Diet modifications aimed at reducing thin liquid aspiration are partially successful or unpalatable or both. Carbonated liquids show some potential in influencing swallowing behavior. However, there is a paucity of evidence to support this intervention. This study compares the effects of carbonated thin liquids (CTL) with that of noncarbonated thin liquids (NCTL) on oropharyngeal swallowing in adults with neurogenic dysphagia and examines the palatability of the CTL stimulus. Seventeen people with pharyngeal delay attended for videofluoroscopy (VFSS). Outcome measures were oral transit time (OTT), pharyngeal transit time (PTT), stage transition duration (STD), initiation of the pharyngeal swallow (IPS), penetration-aspiration scale (PENASP), and pharyngeal retention (PR). A modification of Quartermaster Hedonic Scale (AQHS) was employed to assess palatability of the CTL. CTL vs. NCTL significantly decreased penetration and aspiration on 5-ml (P = 0.028) and 10-ml (P = 0.037) swallows. CTL had no significant effect on OTT, PTT, IPS, and PR for any volume of bolus. Only one participant disliked the CTL stimulus. These findings support the hypothesis that oropharyngeal swallowing can be modulated in response to sensory stimuli. Implications for research and clinical practice are discussed.

  2. The effect of bolus viscosity on swallowing function in neurogenic dysphagia.

    Science.gov (United States)

    Clavé, P; de Kraa, M; Arreola, V; Girvent, M; Farré, R; Palomera, E; Serra-Prat, M

    2006-11-01

    To assess the pathophysiology and treatment of neurogenic dysphagia. 46 patients with brain damage, 46 with neurodegenerative diseases and eight healthy volunteers were studied by videofluoroscopy while swallowing 3-20 mL liquid (20.4 mPa s), nectar (274.4 mPa s) and pudding (3931.2 mPa s) boluses. Volunteers presented a safe and efficacious swallow, short swallow response ( or =0.33 mJ). Brain damage patients presented: (i) 21.6% aspiration of liquids, reduced by nectar (10.5%) and pudding (5.3%) viscosity (P or =806 ms) with a delay in laryngeal closure (> or =245 ms), and weak bolus propulsion forces (neurogenic dysphagia presented high prevalence of videofluoroscopic signs of impaired safety and efficacy of swallow, and were at high risk of respiratory and nutritional complications. Impaired safety is associated with slow oropharyngeal reconfiguration and impaired efficacy with low bolus propulsion. Increasing bolus viscosity greatly improves swallowing function in neurological patients.

  3. In situ coating makes it easier for children to swallow and tolerate tablets and capsules.

    Science.gov (United States)

    El Edelbi, R; Eksborg, S; Lindemalm, S

    2015-09-01

    Getting children to swallow tablets and capsules is a challenge, and factors that influence their ability to swallow include taste, smell and texture. The aim of this study was to explore how well paediatric patients tolerated and accepted the MedCoat(®) in situ coating for tablets and capsules. A nonrandomised intervention study was performed at the Astrid Lindgren Children's Hospital, Karolinska University Hospital, Sweden. We identified 78 paediatric patients, 43 females and 35 males, who had problems swallowing tablets and capsules and evaluated their abilities with questionnaires. The median age of the patients was nine years old, and the range was two to 17 years old. Swallowing ability and palatability was improved by in situ coating. The results showed that 66 of 77 paediatric patients (86%, 95% confidence interval: 76-93%) were able to take the drugs they had been prescribed after in situ coating. Swallowing improved in 87% of cases, and palatability improved in 85% of cases. A study of 77 paediatric patients with a median age of nine years, and a range of two to 17 years, found that 86% were able to take the tablets and capsules they had been prescribed after they were coated with the MedCoat. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  4. Use of computer and respiratory inductance plethysmography for the automated detection of swallowing in the elderly.

    Science.gov (United States)

    Moreau-Gaudry, Alexandre; Sabil, Abdelkebir; Baconnier, Pierre; Benchetrit, Gila; Franco, Alain

    2005-01-01

    Deglutition disorders can occur at any age but are especially prevalent in the elderly. The resulting morbidity and mortality are being recognized as major geriatric health issues, Because of difficulties in studying swallowing in the frail elderly, a new, non-invasive, user-friendly, bedside technique has been developed. Ideally suited to such patients, this tool, an intermediary between purely instrumental and clinical methods, combines respiratory inductance plethysmography (RIP) and the computer to detect swallowing automatically, Based on an automated analysis of the airflow estimated by the RIP-derived signal, this new tool was evaluated according to its capacity to detect clinical swallowing from among the 1643 automatically detected respiratory events, This evaluation used contingency tables and Receiver Operator Characteristic (ROC) curves, Results were all significant (chi2(1,n=1643)>100, p<0.01). Considering its high accuracy in detecting swallowing (area under the ROC curve greater than 0.9), this system would be proposed to study deglutition and then deglutition disorders in the frail elderly, to set up medical supervision and to evaluate the efficiency of a swallowing disorder remedial therapeutic.

  5. On the Physiology of Normal Swallowing as Revealed by Magnetic Resonance Imaging in Real Time

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    Arno Olthoff

    2014-01-01

    Full Text Available The aim of this study was to assess the physiology of normal swallowing using recent advances in real-time magnetic resonance imaging (MRI. Therefore ten young healthy subjects underwent real-time MRI and flexible endoscopic evaluations of swallowing (FEES with thickened pineapple juice as oral contrast bolus. MRI movies were recorded in sagittal, coronal, and axial orientations during successive swallows at about 25 frames per second. Intermeasurement variation was analyzed and comparisons between real-time MRI and FEES were performed. Twelve distinct swallowing events could be quantified by real-time MRI (start time, end time, and duration. These included five valve functions: oro-velar opening, velo-pharyngeal closure, glottal closure, epiglottic retroflexion, and esophageal opening; three bolus transports: oro-velar transit, pharyngeal delay, pharyngeal transit; and four additional events: laryngeal ascent, laryngeal descent, vallecular, and piriform sinus filling and pharyngeal constriction. Repetitive measurements confirmed the general reliability of the MRI method with only two significant differences for the start times of the velo-pharyngeal closure (t(8=-2.4, P≤0.046 and laryngeal ascent (t(8=-2.6, P≤0.031. The duration of the velo-pharyngeal closure was significantly longer in real-time MRI compared to FEES (t(8=-3.3, P≤0.011. Real-time MRI emerges as a simple, robust, and reliable tool for obtaining comprehensive functional and anatomical information about the swallowing process.

  6. Experimental infection of cliff swallows (Petrochelidon pyrrhonota) with varying doses of West Nile virus

    Science.gov (United States)

    Oesterle, P.T.; Nemeth, N.M.; VanDalen, Kaci K.; Sullivan, H.; Bentler, K.T.; Young, G.R.; McLean, R.G.; Clark, L.; Smeraski, C.; Hall, J.S.

    2009-01-01

    Cliff swallows (Petrochelidon pyrrhonota) were inoculated with differing doses of West Nile virus (WNV) to evaluate their potential role as reservoir hosts in nature. Swallows often nest in large colonies in habitats and months associated with high mosquito abundance and early WNV transmission in North America. Additionally, cliff swallow diet consists of insects, including mosquitoes, leading to an additional potential route of WNV infection. The average peak viremia titer among infected cliff swallows was 106.3 plaque-forming units (PFU)/mL serum and the reservoir competence index was 0.34. There was no correlation between dose and probability of becoming infected or viremia peak and duration. Oral shedding was detected from 2 to 14 days post-inoculation with an average peak titer of 1044 PFU/swab. These results suggest that cliff swallows are competent reservoir hosts of WNV and therefore, they may play a role in early seasonal amplification and maintenance of WNV. Copyright ?? 2009 by The American Society of Tropical Medicine and Hygiene.

  7. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough

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    Carlos Shuler Nin

    2013-12-01

    Full Text Available OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough.METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons.RESULTS: The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6% of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6% of the patients, whereas the treatment was ineffective in 1 (8.4%. We observed no complications related to barium swallow, such as contrast aspiration.CONCLUSIONS: Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  8. Surface electromyographic studies of swallowing in normal subjects: a review of 440 adults. Report 3. Qualitative data.

    Science.gov (United States)

    Vaiman, Michael; Eviatar, Ephraim; Segal, Samuel

    2004-12-01

    Surface electromyographic studies were performed on 440 normal adults to describe and evaluate different types of normal swallows clinically useful for ENT department. Study design Prospective observational study of healthy volunteers. EMG recordings were made using stick-on surface electrodes. Rectified and filtered EMG signals were evaluated. Parameters evaluated include the graphic configuration of activity of the orbicularis oris, masseter, submental group, and infrahyoid muscles, the last 2 covered by platysma, during single swallowing and continuous drinking. Four tests were examined: voluntary saliva swallows, voluntary separate swallows as normal, voluntary separate swallows of excessive amount of water (20 mL), drinking of 100 mL of water. Graphic recording of activity of the above-mentioned muscles during swallowing and drinking were evaluated for groups of adults of different ages. There are several types of normal swallows as seen at the surface EMG records. There was no difference between EMG recordings of male and female swallows. Only group of elderly patients (age 70+) shows age-induced differences in recorded swallows. There are two main types of normal swallow: single-share and double-share swallows. The oral phase of swallowing, being under conscious control, is very variable and should not be taken into consideration during evaluation of records. Final oral, pharyngeal, and initial esophageal stages of swallowing can be defined and evaluated at the rectified and filtered surface EMG record. The normal muscle activity during swallows and drinking has several graphic patterns which can be identified and described similar to EKG records when surface EMG is rectified and filtered. The method of EMG recording is quick and simple, and can be used for screening and evaluation purposes in outpatient and inpatient ENT departments. These parameters represent activities required for normal deglutition, and can be used to identify abnormalities in ENT

  9. Effect of the Enveloppe Linguale Nocturne on atypical swallowing: surface electromyography and computerised postural test evaluation.

    Science.gov (United States)

    Ciavarella, D; Mastrovincenzo, M; Sabatucci, A; Parziale, V; Chimenti, C

    2010-09-01

    Swallowing is a neuromuscular mechanism regulated by many nervous reflex arcs. Persistence of child swallowing at the end of dental eruption is called atypical swallowing (AS). This condition is related to a dysfunction of vertical maxillary growth called open bite. The authors treated this malocclusion with the Enveloppe Linguale Nocturne (ELN), or tongue positioner, created by Dr. Bonnet. The aim of this work is to evaluate the effect of ELN on swallowing and the postural variation obtained by its use. Seven patients affected by AS were evaluated. Surface Electromyography (sEMG) testing was performed on each patient with different tongue positions, and swallowing was evaluated with and without the ELN. A surface Electromyograph (Biopack) with 8 channels was used (4 channels for the right muscles and 4 for the left) on 4 groups of muscles: temporals, masseters (MM), submental (SUB) and sternocleidmastoids. On each patient a postural test using a computerised Postural test (Lizard) was also performed. Statistical analysis was done using the Graph pad Instat 3 both for sEMG activity and for computerised postural analysis. All seven subjects had different results in the sEMG and footrest tests. The sEMG test results indicated that muscle activation and swallowing duration varied greatly with the use of ELN, with a reduction of time of swallow act (p = 0.002) and variation in contraction of muscles. Mean MM activation was higher without ELN than in tests performed with the appliance (p = 0.002). Mean SUB activation was higher with than without ELN (p = 0.0033). ELN has a therapeutic effect on posture too. Computerised postural test without device showed in all patients an alteration of barycentre as well as an elevated oscillatory record (A mmq; V mms). With ELN footrest kilogram difference (p = 0.0110), Oscillatory Area (P = 0.0102) and velocity of oscillation (P = 0.0102) presented a great reduction in respect to patients record without ELN. With ELN the tongue

  10. Usefulness of videofluoroscopic swallow study in treacher collins syndrome with cleft palate: a case report.

    Science.gov (United States)

    Hwang, Do-Won; Jung, Kang-Jae; Kim, Seung-Yeon; Kim, Jae-Hyung

    2014-10-01

    A 3-year-old girl had multiple anomalies compatible with Treacher Collins Syndrome (TCS). From the neonatal period, sucking was poor, making tube feeding necessary. Excessive saliva was retained in the oral cavity. Nasal leakage caused by the cleft palate was observed when she spoke. The initial videofluoroscopic swallow study (VFSS) showed a poor posterior bolus transit and nasopharyngeal regurgitation. A delayed swallow reflex and bolus stasis at the vallecular and pyriform sinuses were recognized. Based on the VFSS findings, the patient underwent palatoplasty at 20 months of age. At approximately 23 months of age, a follow-up VFSS was performed; poor posterior bolus transit, nasopharyngeal regurgitation, and delayed swallow reflex were not observed. Finally, the patient was able to eat ground or chopped foods and solid foods orally. We deem VFSS to be helpful in deciding the appropriate management of dysphagia in TCS.

  11. Anatomy and Physiology of Feeding and Swallowing – Normal and Abnormal

    Science.gov (United States)

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2008-01-01

    SYNOPSIS Eating and swallowing are complex behaviors involving volitional and reflexive activities of more than 30 nerves and muscles. They have two crucial biological features: food passage from the oral cavity to stomach and airway protection. The swallowing process is commonly divided into oral, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid. Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus. The goal of dysphagia rehabilitation is to identify and treat abnormalities of feeding and swallowing while maintaining safe and efficient alimentation and hydration. PMID:18940636

  12. Primary closure versus radial forearm flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech.

    Science.gov (United States)

    Hsiao, Hung-Tao; Leu, Yi-Shing; Lin, Chang-Ching

    2002-12-01

    The authors compared the postoperative speech and swallowing function of six patients who underwent free radial forearm flap reconstruction after hemiglossectomy with that of six control patients who underwent primary closure of the defect. Clinical speech pathologic evaluations included the Fletcher time-to-time maximum repetition rate of syllables, multiple rhyme test, and overall quality and intelligibility of the patients' speech. Evaluation of swallowing included the duration of deglutition, bolus volume, and ingestion rate. Speech quality, including intelligibility and articulation, was better in patients with primary closure. However, the bolus volume and ingestion rate in deglutition were better in those with flap reconstruction. These results suggest that the flap adds bulk, thus improving pharyngeal clearance by maintaining the tongue-to-mouth roof contact that is necessary in the swallowing process. The nonfunctional flap, however, hinders articulation by restricting the mobility of the remaining portion of the normal tongue.

  13. Non-invasive monitoring of functionally distinct muscle activations during swallowing.

    Science.gov (United States)

    McKeown, Martin J; Torpey, Dana C; Gehm, Wendy C

    2002-03-01

    Dysphagia is an important consequence of many diseases. As some of the muscles of deglutition tend to be deep to the surface, needle electrodes are typically used, but this limits the number of muscles that can be simultaneously recorded. Since control of swallowing involves central pattern generators (CPGs) which distribute commands to several muscles, monitoring several muscles simultaneously is desirable. Here we describe a novel method, based on computing the independent components (ICs) of the simultaneous sEMG recordings (Muscle Nerve Suppl 9 (2000) 9) to detect the underlying functional muscle activations during swallowing using only surface EMG (sEMG) electrodes. Seven normal subjects repeatedly swallowed liquids of varying consistency while sEMG was recorded from 15 electrodes from the face and throat. Active areas of EMG were excised from the recordings and the ICs of the sEMG were calculated. The ICs demonstrated less swallow-to-swallow variability than the raw sEMG. The ICs, each consisting of a unique temporal waveform and a spatial distribution, provided a means to segregate the complex sequence of muscle activation into rigorously defined separate functional units. The temporal profiles of the ICs and their spatial distribution were consistent with prior needle EMG studies of the cricopharyngeal, superior pharyngeal constrictor, submental and possibly arytenoid muscles. Other components appeared to correspond to EKG artifact contaminating the EMG recordings, laryngeal excursion, tongue movement and activation of the buccal and/or masseter musculature At least two of the components were affected by the consistency of the liquids swallowed. Re-testing one subject a week later demonstrated good intertrial reliability. We propose that the ICs of the sEMG provide a non-invasive means to assess the complex muscle sequence activation of deglutition.

  14. Speech and swallowing following tongue cancer surgery and free flap reconstruction--a systematic review.

    Science.gov (United States)

    Lam, Lisetta; Samman, Nabil

    2013-06-01

    This was a systematic review of the current research on speech and swallowing outcomes and the factors affecting these outcomes after primary resection of tongue cancer and free flap reconstruction. A structured search in various electronic databases and relevant journals was performed. Retrieved articles were critically appraised in three rounds according to the level of evidence, the methodological quality, and the specific domain of speech and swallowing. A total of 21 articles were in the final review and the findings were categorized according to the area of tongue resection. For patients with resection and free flap reconstruction limited to either the oral tongue or the base of tongue (BOT), significant decline in speech and swallowing function was evident in the early postoperative phase, but the majority recovered close to preoperative level after 1 year. Poorer speech and swallowing outcomes were found following resections involving both oral and base of tongue (OBOT) regardless of the type of free flap reconstruction. Results overall were influenced by multiple factors including tumor size, area of resection, method of reconstruction and the use of adjuvant therapy. The use of free flaps in the immediate reconstruction of the tongue after tumor resection should aim at the maintenance of the mobility of the residual tongue and restoration of tongue bulk in order to optimize the recovery of speech and swallowing function. Future research in this field should employ standardized and reliable evaluation of speech and swallowing outcomes using multiple modalities in well-designed cohort studies with longer follow-up. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Speech and swallow rehabilitation in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Clarke, P; Radford, K; Coffey, M; Stewart, M

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The disease itself and the treatment can have far reaching effects on speech and swallow function, which are consistently prioritised by survivors as an area of concern. This paper provides recommendations on the assessments and interventions for speech and swallow rehabilitation in this patient group. Recommendations • All multidisciplinary teams should have rehabilitation patient pathways covering all stages of the patient's journey including multidisciplinary and pre-treatment clinics. (G) • Clinicians treating head and neck cancer patients should consult the National Cancer Rehabilitation Pathway for head and neck cancers. (G) • All head and neck cancer patients should have a pre-treatment assessment of speech and swallowing. (G) • A programme of prophylactic exercises and the teaching of swallowing manoeuvres can reduce impairments, maintain function and enable a speedier recovery. (R) • Continued speech and language therapist input is important in maintaining voice and safe and effective swallow function following head and neck cancer treatment. (R) • Disease recurrence must be ruled out in the management of stricture and/or stenosis. (R) • Continuous radial expansion balloons offer a safe, effective dilation method with advantages over gum elastic bougies. (R) • Site, length and completeness of strictures as well as whether they are in the presence of the larynx or not, need to be assessed when establishing the likelihood of surgically improved outcome. (G) • Primary surgical voice restoration should be offered to all patients undergoing laryngectomy. (R) • Attention to surgical detail and long-term speech and language therapist input is required to optimise speech and swallowing after laryngectomy. (G) • Patients should commence wearing heat and moisture exchange devices as soon as possible after

  16. Nitric Oxide and Histamine Signal Attempts to Swallow: A Component of Learning that Food Is Inedible in "Aplysia"

    Science.gov (United States)

    Katzoff, Ayelet; Miller, Nimrod; Susswein, Abraham J.

    2010-01-01

    Memory that food is inedible in "Aplysia" arises from training requiring three contingent events. Nitric oxide (NO) and histamine are released by a neuron responding to one of these events, attempts to swallow food. Since NO release during training is necessary for subsequent memory and NO substitutes for attempts to swallow, it was suggested that…

  17. Neonatal swallowing assessment and practical recommendations for oral feeding in a girl with a severe congenital myopathy

    NARCIS (Netherlands)

    Engel-Hoek, L. van den; Erasmus, C.E.; Swart, B.J.M. de; Sie, L.T.L.; Groot, I.J.M. de

    2011-01-01

    The investigators report the case of a 6-week-old girl with a cap-like congenital myopathy and frequent coughing during feeding. Neonatal swallowing assessments were performed with surface electromyography of the submental muscle group and nasal airflow during sucking and swallowing. A

  18. Multi-year survival, growth and maturation of invasive swallow-wort juveniles (Vincetoxicum spp.) across a habitat gradient

    Science.gov (United States)

    Vincetoxicum rossicum, pale swallow-wort [PSW], and V. nigrum, black swallow-wort [BSW] are two non-native perennial vines that are increasingly problematic in many regions of the northeastern US and southern Canada. The two species can grow in full sun or shaded forest understories, and infest a v...

  19. Determining Variation in Flight Speed and Pattern of Cliff Swallow Using Video Frame Analysis

    Directory of Open Access Journals (Sweden)

    E Santosh,

    2014-03-01

    Full Text Available Ability to fly faster varies from one species of birds to the other. Take off from their nest, settling on the nest or migratory speed of flight is different from one bird to the other, so is also to Cliff Swallows. Many workers have tried different ways to analyze the flight speed of birds using principles of mechanics and physics. Here we have analyzed take off and settling in speeds of Indian Cliff Swallows by applying Video frame analysis technique with fixed focal length.

  20. A VALIDATION STUDY OF THE FACIAL-ORAL TRACT THERAPY SWALLOWING ASSESSMENT OF SALIVA

    DEFF Research Database (Denmark)

    Mortensen, Jesper; Jensen, Ditte; Kjærsgaard, Annette

    Introduction Facial-Oral Tract Therapy (F.O.T.T.) (1) is an approach that provides both clinical assessment and treatment of oropharyngeal dysphagia. In the F.O.T.T. approach, a prerequisite for the initiation of oral intake is safe swallowing of saliva. A recent randomized controlled trial (2......) showed that patients assessed for initiation of oral intake with an F.O.T.T. based clinical assessment, hereinafter referred to as the Swallowing Assessment of Saliva (SAS), were no more likely to develop aspiration pneumonia that patients who were assessed with an endoscopic evaluation. The objective...

  1. The influence of wearing schemes and supportive telephone calls on adherence in accelerometry measurement: results of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van den Berg N

    2017-03-01

    adherence in this group of participants. Further studies are necessary to examine adherence and the effects of additional SPCs in other samples or settings. Keywords: accelerometry, physical activity assessment, health promotion

  2. Towards Uniform Accelerometry Analysis: A Standardization Methodology to Minimize Measurement Bias Due to Systematic Accelerometer Wear-Time Variation

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    Tarun R. Katapally, Nazeem Muhajarine

    2014-06-01

    Full Text Available Accelerometers are predominantly used to objectively measure the entire range of activity intensities – sedentary behaviour (SED, light physical activity (LPA and moderate to vigorous physical activity (MVPA. However, studies consistently report results without accounting for systematic accelerometer wear-time variation (within and between participants, jeopardizing the validity of these results. This study describes the development of a standardization methodology to understand and minimize measurement bias due to wear-time variation. Accelerometry is generally conducted over seven consecutive days, with participants' data being commonly considered 'valid' only if wear-time is at least 10 hours/day. However, even within ‘valid’ data, there could be systematic wear-time variation. To explore this variation, accelerometer data of Smart Cities, Healthy Kids study (www.smartcitieshealthykids.com were analyzed descriptively and with repeated measures multivariate analysis of variance (MANOVA. Subsequently, a standardization method was developed, where case-specific observed wear-time is controlled to an analyst specified time period. Next, case-specific accelerometer data are interpolated to this controlled wear-time to produce standardized variables. To understand discrepancies owing to wear-time variation, all analyses were conducted pre- and post-standardization. Descriptive analyses revealed systematic wear-time variation, both between and within participants. Pre- and post-standardized descriptive analyses of SED, LPA and MVPA revealed a persistent and often significant trend of wear-time’s influence on activity. SED was consistently higher on weekdays before standardization; however, this trend was reversed post-standardization. Even though MVPA was significantly higher on weekdays both pre- and post-standardization, the magnitude of this difference decreased post-standardization. Multivariable analyses with standardized SED, LPA and

  3. Not So Fast: Swimming Behavior of Sailfish during Predator-Prey Interactions using High-Speed Video and Accelerometry.

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    Marras, Stefano; Noda, Takuji; Steffensen, John F; Svendsen, Morten B S; Krause, Jens; Wilson, Alexander D M; Kurvers, Ralf H J M; Herbert-Read, James; Boswell, Kevin M; Domenici, Paolo

    2015-10-01

    Billfishes are considered among the fastest swimmers in the oceans. Despite early estimates of extremely high speeds, more recent work showed that these predators (e.g., blue marlin) spend most of their time swimming slowly, rarely exceeding 2 m s(-1). Predator-prey interactions provide a context within which one may expect maximal speeds both by predators and prey. Beyond speed, however, an important component determining the outcome of predator-prey encounters is unsteady swimming (i.e., turning and accelerating). Although large predators are faster than their small prey, the latter show higher performance in unsteady swimming. To contrast the evading behaviors of their highly maneuverable prey, sailfish and other large aquatic predators possess morphological adaptations, such as elongated bills, which can be moved more rapidly than the whole body itself, facilitating capture of the prey. Therefore, it is an open question whether such supposedly very fast swimmers do use high-speed bursts when feeding on evasive prey, in addition to using their bill for slashing prey. Here, we measured the swimming behavior of sailfish by using high-frequency accelerometry and high-speed video observations during predator-prey interactions. These measurements allowed analyses of tail beat frequencies to estimate swimming speeds. Our results suggest that sailfish burst at speeds of about 7 m s(-1) and do not exceed swimming speeds of 10 m s(-1) during predator-prey interactions. These speeds are much lower than previous estimates. In addition, the oscillations of the bill during swimming with, and without, extension of the dorsal fin (i.e., the sail) were measured. We suggest that extension of the dorsal fin may allow sailfish to improve the control of the bill and minimize its yaw, hence preventing disturbance of the prey. Therefore, sailfish, like other large predators, may rely mainly on accuracy of movement and the use of the extensions of their bodies, rather than resorting

  4. Swallowing and speech function after intraoral soft tissue reconstruction with lateral upper arm free flap and radial forearm free flap.

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    Hara, I; Gellrich, N-C; Duker, J; Schön, R; Fakler, O; Smelzeisen, R; Honda, T; Satoru, O

    2003-06-01

    Swallowing, speech, and morbidity were assessed postoperatively in 25 patients, 18 of whom had had intraoral defects reconstructed by lateral upper arm free flaps (LUFF) and 7 by radial forearm free flaps (RFFF). Video fluoroscopy was used to assess swallowing, the Freiburger audiometric test to assess speech; and measurement of arm circumference to assess donor site morbidity. A questionnaire was used to evaluate swallowing, speech, and donor site morbidity subjectively. The degree of impairment in swallowing depended on the site of resection. Anterior and posterior resections affected swallowing more than lateral resections. Anterior resection and the use of LUFFs reduced intelligibility. There was no significant difference in impairment between LUFF and RFFF. We conclude that the LUFFs are superior to RFFFs because they can be closed primary and the incidence of donor site morbidity is slight.

  5. Effectiveness of Rehabilitative Balloon Swallowing Treatment on Upper Esophageal Sphincter Relaxation and Pharyngeal Motility for Neurogenic Dysphagia.

    Science.gov (United States)

    Kim, Yong Kyun; Choi, Sung Sik; Choi, Jung Hwa; Yoon, Jeong-Gyu

    2015-08-01

    To investigate the relationship between dysphagia severity and opening of the upper esophageal sphincter (UES), and to assess the effect of balloon size on functional improvement after rehabilitative balloon swallowing treatment in patients with severe dysphagia with cricopharyngeus muscle dysfunction (CPD). We reviewed videofluoroscopic swallowing studies (VFSS) conducted in the Department of Physical Medicine and Rehabilitation, Myongji Hospital from January through December in 2012. All subjects diagnosed with CPD by VFSS further swallowed a 16-Fr Foley catheter filled with barium sulfate suspension for three to five minutes. We measured the maximum diameter of the balloon that a patient could swallow into the esophagus and subsequently conducted a second VFSS. Then, we applied a statistical technique to correlate the balloon diameter with functional improvement after the balloon treatment. Among 283 inpatients who received VFSS, 21 subjects were diagnosed with CPD. It was observed that the degree of UES opening evaluated by swallowing a catheter balloon had inverse linear correlations with pharyngeal transit time and post-swallow pharyngeal remnant. Videofluoroscopy guided iterative balloon swallowing treatment for three to five minutes, significantly improved the swallowing ability in terms of pharyngeal transit time and pharyngeal remnant (p<0.005 and p<0.001, respectively). Correlation was seen between balloon size and reduction in pharyngeal remnants after balloon treatment (Pearson correlation coefficient R=-0.729, p<0.001), whereas there was no definite relationship between balloon size and improvement in pharyngeal transit time (R=-0.078, p=0.738). The maximum size of the balloon that a patient with CPD can swallow possibly indicates the maximum UES opening. The iterative balloon swallowing treatment is safe without the risk of aspiration, and it can be an effective technique to improve both pharyngeal motility and UES relaxation.

  6. SU-E-J-193: Application of Surface Mapping in Detecting Swallowing for Head-&-Neck Cancer

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    Cao, D; Xie, X; Mehta, V; Shepard, D [Swedish Cancer Institute, Seattle, WA (United States)

    2015-06-15

    Purpose: Recent evidence is emerging that long term swallowing function may be improved after radiotherapy for head-&-neck cancer if doses are limited to certain swallowing structures. Immobilization of patients with head-&-neck cancer is typically done with a mask. This mask, however, doesn’t limit patient swallowing. Patient voluntary or involuntary swallowing may introduce significant tumor motion, which can lead to suboptimal delivery. In this study, we have examined the feasibility of using surface mapping technology to detect patient swallowing during treatment and evaluated its magnitude. Methods: The C-RAD Catalyst system was used to detect the patient surface map. A volunteer lying on the couch was used to simulate the patient under treatment. A virtual marker was placed near the throat and was used to monitor the swallowing action. The target motion calculated by the Catalyst system through deformable registration was also collected. Two treatment isocenters, one placed close to the throat and the other placed posterior to the base-of-tongue, were used to check the sensitivity of surface mapping technique. Results: When the patient’s throat is not in the shadow of the patient’s chest, the Catalyst system can clearly identify the swallowing motion. In our tests, the vertical motion of the skin can reach to about 5mm. The calculated target motion can reach up to 1 cm. The magnitude of this calculated target motion is more dramatic when the plan isocenter is closer to the skin surface, which suggests that the Catalyst motion tracking technique is more sensitive to the swallowing motion with a shallower isocenter. Conclusion: Surface mapping can clearly identify patient swallowing during radiation treatment. This information can be used to evaluate the dosimetric impact of the involuntary swallowing. It may also be used to potentially gate head-&-neck radiation treatments. A prospective IRB approved study is currently enrolling patients in our

  7. A combined approach of bedside clinical examination and flexible endoscopic evaluation of swallowing in poststroke dysphagia: A pilot study

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    Sureshkumar Radhakrishnan

    2013-01-01

    Full Text Available Background: As with most neurologic conditions, stroke involves impairment of the swallowing mechanism. This could be a spectrum of issues, the worst of which is aspiration. At the same time, the prolonged presence of a naso-gastric tube (NGT has its own morbidity. Flexible endoscopic evaluation of swallowing (FEES is one reliable method to assess the structural and functional status of the oropharynx and larynx, during the swallowing process. Objective: To study the utility of FEES in decision-making with respect to resumption of oral intake in stroke patients. To document the findings of FEES in stroke patients, and to look for correlations between these and the site of stroke. Materials and Methods: Protocol insertion of naso-gastric tube in all stroke patients, at presentation. Initial assessment by a neurologist and swallowing therapist, depending on cognitive status of the patient. All patients underwent MRI Brain with diffusion weighted sequences. After detailed clinical examination, they underwent swallow exercises under the supervision of a trained swallowing therapist. The decision to remove NGT was taken clinically by the combined decision of neurologist and swallowing therapist. Then all patients underwent FEES by the ENT surgeon. The final decision for NGT removal was taken as per the FEES findings. Result: Sixteen stroke patients underwent the FEES procedure during a period of six months. The oropharyngeal and laryngeal findings varied depending on the area of stroke involvement. Of these, change in decision regarding swallowing rehabilitation or NGT removal was needed in four patients, following the FEES findings. Conclusions: FEES is an easy, efficient and reliable method to evaluate the swallowing status in stroke patients. In combination with good bedside clinical examination and swallow exercises, it can be a good tool in assessing patients with post- stroke dysphagia. Post-stroke rehabilitation and prevention of aspiration

  8. Sensory regulation of swallowing and airway protection: a role for the internal superior laryngeal nerve in humans.

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    Jafari, Samah; Prince, Rebecca A; Kim, Daniel Y; Paydarfar, David

    2003-07-01

    During swallowing, the airway is protected from aspiration of ingested material by brief closure of the larynx and cessation of breathing. Mechanoreceptors innervated by the internal branch of the superior laryngeal nerve (ISLN) are activated by swallowing, and connect to central neurones that generate swallowing, laryngeal closure and respiratory rhythm. This study was designed to evaluate the hypothesis that the ISLN afferent signal is necessary for normal deglutition and airway protection in humans. In 21 healthy adults, we recorded submental electromyograms, videofluoroscopic images of the upper airway, oronasal airflow and respiratory inductance plethysmography. In six subjects we also recorded pressures in the hypopharynx and upper oesophagus. We analysed swallows that followed a brief infusion (4-5 ml) of liquid barium onto the tongue, or a sip (1-18 ml) from a cup. In 16 subjects, the ISLN was anaesthetised by transcutaneous injection of bupivacaine into the paraglottic compartment. Saline injections using the identical procedure were performed in six subjects. Endoscopy was used to evaluate upper airway anatomy, to confirm ISLN anaesthesia, and to visualise vocal cord movement and laryngeal closure. Comparisons of swallowing and breathing were made within subjects (anaesthetic or saline injection vs. control, i.e. no injection) and between subjects (anaesthetic injection vs. saline injection). In the non-anaesthetised condition (saline injection, 174 swallows in six subjects; no injection, 522 swallows in 20 subjects), laryngeal penetration during swallowing was rare (1.4 %) and tracheal aspiration was never observed. During ISLN anaesthesia (16 subjects, 396 swallows), all subjects experienced effortful swallowing and an illusory globus sensation in the throat, and 15 subjects exhibited penetration of fluid into the larynx during swallowing. The incidence of laryngeal penetration in the anaesthetised condition was 43 % (P swallow cycle to evaluate the

  9. Predictive modelling for swallowing dysfunction after primary (chemo)radiation : Results of a prospective observational study

    NARCIS (Netherlands)

    Christianen, Miranda E M C; Schilstra, Cornelis; Beetz, Ivo; Muijs, C.T.; Chouvalova, Olga; Burlage, Fred R.; Doornaert, P.; Koken, P.W.; Leemans, C.R.; Rinkel, R.N.; de Bruijn, M.J.; de Bock, G.H.; Roodenburg, J.L.; van der Laan, B.F.; Slotman, B.J.; Verdonck-de Leeuw, I.M.; Bijl, Hendrik P.; Langendijk, J.A.

    2012-01-01

    Background and purpose: The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop

  10. Oral motor movements and swallowing in patients with myotonic dystrophy type 1.

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    Ercolin, Beatriz; Sassi, Fernanda Chiarion; Mangilli, Laura Davison; Mendonça, Lucia Iracema Zanotto; Limongi, Suelly Cecilia Olivan; de Andrade, Claudia Regina Furquim

    2013-09-01

    Oropharyngeal dysphagia and esophageal motility disorders were found to be the most important causes of aspiration pneumonia in patients with myotonic dystrophy. The purpose of this report was to evaluate clinical characteristics of the oral motor movements and swallowing of individuals with myotonic dystrophy type 1 (DM1) using a standardized clinical protocol and surface electromyography (sEMG). Participants were 40 individuals divided in two groups: G1 composed of 20 adults with DM1 and G2 composed of 20 healthy volunteers paired by age and gender to the individuals in G1. Statistical analysis included one-way ANOVA with two factors for within- and between-group comparisons and Bonferroni correction for multiple comparisons. Patients with DM1 presented deficits in posture, position, and mobility of the oral motor structures, as well as compromised mastication and deglutition. The sEMG data indicated that these patients had longer muscle activations during swallowing events. The longer duration of sEMG in the group of patients with DM1 is possibly related to myotonia and/or incoordination of the muscles involved in the swallowing process or could reflect a physiological adaptation for safe swallowing.

  11. Biomechanical events of swallowing are determined more by bolus consistency than by age or gender

    NARCIS (Netherlands)

    J. Hendriks; Bert de Swart; Alexander Geurts; L. van den Engel-Hoek; B. Gorissen; E. Esser; I. Groot

    2012-01-01

    The biomechanics of swallowing saliva and substances of different consistencies were investigated in healthy children and adults. To this end, the duration and mean amplitude value (MAV) of surface electromyography (sEMG) of the submental muscle group (SMG) activity, the maximum anterior tongue

  12. Biomechanical events of swallowing are determined more by bolus consistency than by age or gender.

    Science.gov (United States)

    van den Engel-Hoek, Lenie; de Groot, Imelda J M; Esser, Eva; Gorissen, Birthe; Hendriks, Jan C M; de Swart, Bert J M; Geurts, Alexander C H

    2012-05-15

    The biomechanics of swallowing saliva and substances of different consistencies were investigated in healthy children and adults. To this end, the duration and mean amplitude value (MAV) of surface electromyography (sEMG) of the submental muscle group (SMG) activity, the maximum anterior tongue pressure (ATP), and the rise and release slopes of ATP were measured while participants (39 female and 39 male participants, age 5-65 years) swallowed saliva, 5 mL water (reference), 5 mL thick liquid, and 5 mL solid food. Mean outcome parameters varied with the consistency of the liquid or food swallowed, with the exception of the rise slope of ATP. Moreover, outcome variables were not substantially affected by age with children of 5 years and older showing similar biomechanical events to those of adults. It is important to gain insight into the biomechanics of swallowing saliva and substances of different consistencies in order to understand the underlying mechanisms of dysphagia children and adults. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Surface Electromyography for Speech and Swallowing Systems: Measurement, Analysis, and Interpretation

    Science.gov (United States)

    Stepp, Cara E.

    2012-01-01

    Purpose: Applying surface electromyography (sEMG) to the study of voice, speech, and swallowing is becoming increasingly popular. An improved understanding of sEMG and building a consensus as to appropriate methodology will improve future research and clinical applications. Method: An updated review of the theory behind recording sEMG for the…

  14. Biomechanical events of swallowing are determined more by bolus consistency than by age or gender.

    NARCIS (Netherlands)

    Engel-Hoek, L. van den; Groot, I.J.M. de; Esser, E.; Gorissen, B.; Hendriks, J.C.M.; Swart, B.J.M. de; Geurts, A.C.H.

    2012-01-01

    The biomechanics of swallowing saliva and substances of different consistencies were investigated in healthy children and adults. To this end, the duration and mean amplitude value (MAV) of surface electromyography (sEMG) of the submental muscle group (SMG) activity, the maximum anterior tongue

  15. Pharyngeal Pressure Generation during Tongue-Hold Swallows across Age Groups

    Science.gov (United States)

    Doeltgen, Sebastian H.; Macrae, Phoebe; Huckabee, Maggie-Lee

    2011-01-01

    Purpose: To compare the effects of the tongue-hold swallowing maneuver on pharyngeal pressure generation in healthy young and elderly research volunteers. Method: Sixty-eight healthy research volunteers (young, n = 34, mean age = 26.8 years, SD = 5.5; elderly, n = 34, mean age = 72.6 years, SD = 4.8; sex equally represented) performed 5…

  16. The mechanics of swallowing and the muscular control of diverse behaviours in gopher snakes.

    Science.gov (United States)

    Moon, B R

    2000-09-01

    Snakes are excellent subjects for studying functional versatility and potential constraints because their movements are constrained to vertebral bending and twisting. In many snakes, swallowing is a kind of inside-out locomotion. During swallowing, vertebral bends push food from the jaws along a substantial length of the body to the stomach. In gopher snakes (Pituophis melanoleucus) and king snakes (Lampropeltis getula), swallowing often begins with lateral bending of the head and neck as the jaws advance unilaterally over the prey. Axial movement then shifts to accordion-like, concertina bending as the prey enters the oesophagus. Once the prey is completely engulfed, concertina bending shifts to undulatory bending that pushes the prey to the stomach. The shift from concertina to undulatory bending reflects a shift from pulling the prey into the throat (or advancing the mouth over the prey) to pushing it along the oesophagus towards the stomach. Undulatory kinematics and muscular activity patterns are similar in swallowing and undulatory locomotion. However, the distinct mechanical demands of internal versus external force exertion result in different duty factors of muscle activity. Feeding and locomotor movements are thus integral functions of the snake axial system.

  17. Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function.

    Science.gov (United States)

    Cabib, Christopher; Ortega, Omar; Kumru, Hatice; Palomeras, Ernest; Vilardell, Natalia; Alvarez-Berdugo, Daniel; Muriana, Desirée; Rofes, Laia; Terré, Rosa; Mearin, Fermín; Clavé, Pere

    2016-09-01

    Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition. The integrity of oropharyngeal-cortical afferent pathways can be assessed by electroencephalography through sensory-evoked potentials by pharyngeal electrical stimulation, while corticopharyngeal efferent pathways can be characterized by electromyography through motor-evoked potentials by transcranial magnetic stimulation. Dysfunction in both cortico-mediated evoked responses is associated with delayed swallow response and aspiration. Studies have reported hemispherical asymmetry on motor control of swallowing and the relevance of impaired oropharyngeal sensitivity on aspiration. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Characterization of poststroke OD is evolving from the assessment of impaired biomechanics to the sensorimotor integration processes involved in deglutition. Treatment is also changing from compensatory strategies to promoting brain plasticity, both to recover swallow function and to improve brain-related swallowing dysfunction. © 2016 New York Academy of Sciences.

  18. Effects of Dining on Tongue Endurance and Swallowing-Related Outcomes

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    Kays, Stephanie A.; Hind, Jacqueline A.; Gangnon, Ronald E.; Robbins, JoAnne

    2010-01-01

    Purpose: The purpose of this study was to test the hypothesis that eating a meal reduces tongue strength and endurance in healthy old and young adults. It was predicted that older adults would show greater declines in tongue endurance while demonstrating higher perceived effort, longer meal durations, and clinical signs of swallowing difficulty.…

  19. Tongue-Pressure and Hyoid Movement Timing in Healthy Liquid Swallowing

    Science.gov (United States)

    Steele, Catriona; Sasse, Caroline; Bressmann, Tim

    2012-01-01

    It was hypothesized that tongue-palate pressure generation might directly facilitate hyoid movement in swallowing through the anatomical connections of the extrinsic tongue muscles. If true, non-invasive measures of tongue-palate pressure timing might serve as a proxy measure of hyoid excursion. The timing relationships between events in the…

  20. The Effects of Age and Preoral Sensorimotor Cues on Anticipatory Mouth Movement During Swallowing

    Science.gov (United States)

    Moon, Jerald B.; Goodman, Shawn S.

    2016-01-01

    Purpose The aim of this study was to investigate the effects of preoral sensorimotor cues on anticipatory swallowing/eating-related mouth movements in older and younger adults. It was hypothesized that these cues are essential to timing anticipatory oral motor patterns, and these movements are delayed in older as compared with younger adults. Method Using a 2 × 2 repeated-measures design, eating-related lip, jaw, and hand movements were recorded from 24 healthy older (ages 70–85 years) and 24 healthy younger (ages 18–30 years) adults under 4 conditions: typical self-feeding, typical assisted feeding (proprioceptive loss), sensory-loss self-feeding (auditory and visual loss/degradation), and sensory-loss assisted feeding (loss/degradation of all cues). Results All participants demonstrated anticipatory mouth opening. The absence of proprioception delayed lip-lowering onset, and sensory loss more negatively affected offset. Given at least 1 preoral sensorimotor cue, older adults initiated movement earlier than younger adults. Conclusions Preoral sensorimotor information influences anticipatory swallowing/eating-related mouth movements, highlighting the importance of these cues. Earlier movement in older adults may be a compensation, facilitating safe swallowing given other age-related declines. Further research is needed to determine if the negative impact of cue removal may be further exacerbated in a nonhealthy system (e.g., presence of dysphagia or disease), potentially increasing swallowing- and eating-related risks. PMID:26540553

  1. A Continent-Wide Migratory Divide in North American Breeding Barn Swallows (Hirundo rustica.

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    Keith A Hobson

    Full Text Available Populations of most North American aerial insectivores have undergone steep population declines over the past 40 years but the relative importance of factors operating on breeding, wintering, or stopover sites remains unknown. We used archival light-level geolocators to track the phenology, movements and winter locations of barn swallows (Hirdundo rustica; n = 27 from populations across North America to determine their migratory connectivity. We identified an east-west continental migratory divide for barn swallows with birds from western regions (Washington State, USA (n = 8 and Saskatchewan, Canada (n = 5 traveling shorter distances to wintering areas ranging from Oregon to northern Colombia than eastern populations (Ontario (n = 3 and New Brunswick (n = 10, Canada which wintered in South America south of the Amazon basin. A single swallow from a stable population in Alabama shared a similar migration route to eastern barn swallows but wintered farther north in northeast Brazil indicating a potential leap frog pattern migratory among eastern birds. Six of 9 (67% birds from the two eastern populations and Alabama underwent a loop migration west of fall migration routes including around the Gulf of Mexico travelling a mean of 2,224 km and 722 km longer on spring migration, respectively. Longer migration distances, including the requirement to cross the Caribbean Sea and Gulf of Mexico and subsequent shorter sedentary wintering periods, may exacerbate declines for populations breeding in northeastern North America.

  2. Development of a system to monitor laryngeal movement during swallowing using a bend sensor.

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    Qiang Li

    Full Text Available BACKGROUND: Swallowing 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. METHODS: Six 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. RESULTS: Seven 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. CONCLUSIONS: The 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.

  3. Tongue pressure during swallowing in adults with down syndrome and its relationship with palatal morphology.

    Science.gov (United States)

    Hashimoto, Megumi; Igari, Kazuko; Hanawa, Soshi; Ito, Ayumi; Takahashi, Atsushi; Ishida, Naoko; Koyama, Shigeto; Ono, Takahiro; Sasaki, Keiichi

    2014-08-01

    In individuals with Down syndrome, hypotonicity of the tongue and an underdeveloped maxilla may lead to poor oral motor coordination, which adversely affects the oral phase of swallowing. This study aimed to evaluate the characteristics of pressure produced by the tongue against the hard palate during swallowing in individuals with Down syndrome. In addition, the relationship between tongue pressure and palatal morphology was examined. We studied nine adults with Down syndrome and ten healthy adults as controls. Tongue pressure while swallowing 5 mL water was recorded by a sensor sheet system with five measuring points attached to the hard palate. Palatal length, depth, width, curvature, and slope were measured by three-dimensional digital maxillary imaging. The order of onset of tongue pressure on the median line of the hard palate was the same in all participants, except for three with Down syndrome. The duration and maximal magnitude of tongue pressure on the median line in nine participants with Down syndrome were significantly shorter and lower than those of controls. In participants with Down syndrome, significant positive correlations were observed between the duration of tongue pressure at the mid-median part of the hard palate and palatal depth and width, and between the duration and maximal magnitude of tongue pressure at the posterior-median part and palatal length. These findings suggest that impaired tongue activity, poor tongue control, and constrained tongue motion due to a short and narrow palate contribute to swallowing difficulty in individuals with Down syndrome.

  4. Swallowing therapy and progressive resistance training in head and neck cancer patients undergoing radiotherapy treatment

    DEFF Research Database (Denmark)

    Fredslund Hajdu, Sara Vinther; Wessel, Irene; Johansen, Christoffer

    2017-01-01

    is randomly assigned to either (1) twice weekly PRT and three times weekly swallowing exercises by physio- and occupational therapists, respectively, as well as daily home exercises throughout radiotherapy or (2) standard care. Inclusion criteria are patients with cancer in the larynx, pharynx, oral cavity...

  5. Swallowing and Dysphagia Rehabilitation: Translating Principles of Neural Plasticity into Clinically Oriented Evidence

    Science.gov (United States)

    Robbins, JoAnne; Butler, Susan G.; Daniels, Stephanie K.; Gross, Roxann Diez; Langmore, Susan; Lazarus, Cathy L.; Martin-Harris, Bonnie; McCabe, Daniel; Musson, Nan; Rosenbek, John

    2008-01-01

    Purpose: This review presents the state of swallowing rehabilitation science as it relates to evidence for neural plastic changes in the brain. The case is made for essential collaboration between clinical and basic scientists to expand the positive influences of dysphagia rehabilitation in synergy with growth in technology and knowledge. The…

  6. A study of brain networks associated with swallowing using graph-theoretical approaches.

    Directory of Open Access Journals (Sweden)

    Bo Luan

    Full Text Available Functional connectivity between brain regions during swallowing tasks is still not well understood. Understanding these complex interactions is of great interest from both a scientific and a clinical perspective. In this study, functional magnetic resonance imaging (fMRI was utilized to study brain functional networks during voluntary saliva swallowing in twenty-two adult healthy subjects (all females, [Formula: see text] years of age. To construct these functional connections, we computed mean partial correlation matrices over ninety brain regions for each participant. Two regions were determined to be functionally connected if their correlation was above a certain threshold. These correlation matrices were then analyzed using graph-theoretical approaches. In particular, we considered several network measures for the whole brain and for swallowing-related brain regions. The results have shown that significant pairwise functional connections were, mostly, either local and intra-hemispheric or symmetrically inter-hemispheric. Furthermore, we showed that all human brain functional network, although varying in some degree, had typical small-world properties as compared to regular networks and random networks. These properties allow information transfer within the network at a relatively high efficiency. Swallowing-related brain regions also had higher values for some of the network measures in comparison to when these measures were calculated for the whole brain. The current results warrant further investigation of graph-theoretical approaches as a potential tool for understanding the neural basis of dysphagia.

  7. The location and tracking of swallowed dental appliances: the role of radiology.

    Science.gov (United States)

    Absi, E G; Buckley, J G

    1995-05-01

    Two cases of swallowing mishaps, one involving a spoon-denture and the other an orthodontic partial arch wire, are reported. The former was recovered following interventional radiology, the latter by proctoscopy. The role of radiographic investigation and possible measures to prevent such potential life-threatening emergencies are discussed.

  8. Sequential evolution of cortical activity and effective connectivity of swallowing using fMRI.

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    Mihai, Paul Glad; Otto, Mareile; Platz, Thomas; Eickhoff, Simon B; Lotze, Martin

    2014-12-01

    Swallowing consists of a hierarchical sequence of primary motor and somatosensory processes. The temporal interplay of different phases is complex and clinical disturbances frequent. Of interest was the temporal interaction of the swallowing network. Time resolution optimized functional magnetic resonance imaging was used to describe the temporal sequence of representation sites of swallowing and their functional connectivity. Sixteen young healthy volunteers were investigated who swallowed 2 ml of water 20 times per run with a repetition time for functional imaging of 514 ms. After applying the general linear model approach to identify activation magnitude in preselected regions of interest repeated measures analysis of variance (rmANOVA) was used to detect relevant effects on lateralization, time, and onset. Furthermore, dynamic causal modeling (DCM) was applied to uncover where the input enters the model and the way in which the cortical regions are connected. The temporal analysis revealed a successive activation starting at the premotor cortex, supplementary motor area (SMA), and bilateral thalamus, followed by the primary sensorimotor cortex, the posterior insula, and cerebellum and culminating with activation in the pons shortly before subsiding. The rmANOVA revealed that activation was lateralized initially to the left hemisphere and gradually moved to the right hemisphere over time. The group random effects DCM analysis resulted in a most likely model that consisted of inputs to SMA and M1S1, bidirectionally connected, and a one-way connection from M1S1 to the posterior insula.

  9. Functional results of speech and swallowing after oral microvascular free flap reconstruction.

    Science.gov (United States)

    Archontaki, Maria; Athanasiou, Athanasios; Stavrianos, Spyros D; Korkolis, Dimitris P; Faratzis, Gregory; Papadopoulou, Flora; Kokkalis, Georgios; Rapidis, Alexander D

    2010-11-01

    To study speech and swallowing in patients who underwent microvascular free flap reconstruction after major surgery of the oral cavity. Twenty patients, 17 men and 3 women, with a mean age of 58.5 years (range 27-79 years) were included in the study. Squamous cell carcinoma was the most common malignancy. Swallowing assessment was performed through videofluoroscopy, using three consistencies of barium meal. The recorded swallows were assessed for the ability to hold the bolus during the oral phase, lip seal, tongue movement, residue in the floor of the mouth, laryngeal penetration and aspiration. Speech function regarding intelligibility and articulation was objectively assessed. Fifteen out of 20 patients (75%) had a good lip seal. Fourteen patients (73.6%) had adequate control of bolus, while in 89.4% the neotongue motility was satisfactory. Vallecular residue was noted in 25% of patients, laryngeal penetration in two (10%), while three patients (15%) continued to have significant aspiration, which necessitated continuous feeding through a gastrostomy. Postoperative speech intelligibility and articulation was satisfactory in 75 and 62.5% of the patients, respectively. Microvascular free flap reconstruction of major defects after oral resections rehabilitates the functions of swallowing and speech in acceptable levels, improving quality of life in these patients.

  10. Associations between voice quality and swallowing function in patients treated for oral or oropharyngeal cancer

    NARCIS (Netherlands)

    de Bruijn, Marieke J.; Rinkel, Rico N. P. M.; Cnossen, Ingrid C.; Witte, Birgit I.; Langendijk, Johannes A.; Leemans, C. Ren; Verdonck-de Leeuw, Irma M.

    2013-01-01

    The purpose of this study was to investigate associations between voice quality and swallowing function in patients treated for oral or oropharyngeal cancer. Recordings of speech and videofluoroscopy of 51 patients after treatment for oral or oropharyngeal cancer were analysed. Acoustic voice parame

  11. Exposure and effects of perfluoroalkyl substances in tree swallows nesting in Minnesota and Wisconsin, USA

    Science.gov (United States)

    The exposure and effects of perfluoroalkyl substances (PFASs) were studied at eight locations in Minnesota and Wisconsin between 2007 and 2011 using tree swallows (Tachycineta bicolor) as sentinel species. These eight sites covered a range of possible exposure pathways and ecolog...

  12. Tongue pressure during swallowing is decreased in patients with Duchenne muscular dystrophy.

    Science.gov (United States)

    Hamanaka-Kondoh, Sato; Kondoh, Jugo; Tamine, Ken-Ichi; Hori, Kazuhiro; Fujiwara, Shigehiro; Maeda, Yoshinobu; Matsumura, Tsuyoshi; Yasui, Kumiko; Fujimura, Harutoshi; Sakoda, Saburo; Ono, Takahiro

    2014-06-01

    Although dysphagia is a life-threatening problem in patients with Duchenne muscular dystrophy (DMD), the pathophysiology of oral stage dysphagia is yet to be understood. The present study investigated the tongue motor deficit during swallowing in patients with DMD and its relationship with disease-specific palatal morphology. Tongue pressure during swallowing water was recorded in 11 male patients with DMD and 11 age- and sex-matched healthy subjects using an intra-oral sensor with five measuring points, and the state of tongue pressure production was compared between the groups. Palatal morphology was assessed by a non-contact three-dimensional scanner on maxillary plaster models. In patients with DMD, the normal sequential order of tongue-palate contact was lost and the maximal magnitude and integrated value of tongue pressure on the mid-anterior part of palate were smaller than those in healthy subjects. The width of the palate in patients was greater than that in healthy subjects and the depth of the palate in patients had a negative correlation with tongue pressure magnitude on the median palate. Our results suggested that the deteriorated tongue motor kinetics prevented tongue movement during swallowing that was appropriate for the depth of the palate and affects the state of tongue pressure production during swallowing.

  13. Endoscopic Removal of an Inadvertently Swallowed Toothbrush in the Emergency Department

    OpenAIRE

    Martyn Harvey; Grant Cave; Gaynor Prince

    2012-01-01

    A 16-year-old girl inadvertently swallowed a toothbrush during attempted manual induction of emesis. The 20 cm toothbrush was successfully removed via overtube facilitated endoscopy using a retractable snare while the patient was sedated in the emergency department.

  14. Endoscopic Removal of an Inadvertently Swallowed Toothbrush in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Martyn Harvey

    2012-01-01

    Full Text Available A 16-year-old girl inadvertently swallowed a toothbrush during attempted manual induction of emesis. The 20 cm toothbrush was successfully removed via overtube facilitated endoscopy using a retractable snare while the patient was sedated in the emergency department.

  15. Differential retention of emulsion components in the mouth after swallowing: ATR FTIR measurements of oral coatings

    NARCIS (Netherlands)

    Jongh, H.de; Janssen, A.; Weenen, H.

    2006-01-01

    ATR FT-IR spectroscopy was used to investigate the coating that stays behind in the moutii after swallowing mayonnaise samples. Typically, the oil content was found to decrease to an average of 26% (range: 12-40%) of me t=0 value after 2 min, to <13% after 4 min and had practically disappeared from

  16. Surface Electromyography for Speech and Swallowing Systems: Measurement, Analysis, and Interpretation

    Science.gov (United States)

    Stepp, Cara E.

    2012-01-01

    Purpose: Applying surface electromyography (sEMG) to the study of voice, speech, and swallowing is becoming increasingly popular. An improved understanding of sEMG and building a consensus as to appropriate methodology will improve future research and clinical applications. Method: An updated review of the theory behind recording sEMG for the…

  17. Speech and Swallowing Data in Individual Patients Who Underwent Glossectomy after Prosthetic Rehabilitation

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    Viviane de Carvalho

    2016-01-01

    Full Text Available Maintaining oral function in patients undergoing glossectomy boosts interventions such as prosthetic rehabilitation. However, current literature still fails in the presentation of results of prosthetic rehabilitation in relation to speech or swallowing. The objective of this research is to evaluate the effectiveness of prosthetic rehabilitation on voice, speech, and swallowing in patients undergoing glossectomy by performing a systematic literature review and meta-analysis of individual cases. Studies were identified by relevant electronic database and included all dates available. The criteria used were sample with any n; resection due to malignant tumors, restricted to tongue and/or floor of mouth; type of prosthetic rehabilitation; and description of the oral functions outcomes with prosthesis. For the meta-analysis of individual data, associations between the variables of interest and the type of prosthesis were evaluated. Thirty-three of 471 articles met the selection criteria. Results on speech and/or voice and swallowing were reported in 27 and 28 articles, respectively. There were improvement of speech intelligibility and swallowing in 96 patients and in 73 patients, respectively, with prosthesis. Based on the available evidences, this article showed that prosthetic rehabilitation was able to improve oral functions and can be a strategy used with surgical reconstruction in selected cases.

  18. Effects of club soda and ginger brew on linguapalatal pressures in healthy swallowing.

    Science.gov (United States)

    Krival, Kate; Bates, Crystal

    2012-06-01

    Oral chemesthesis is the detection of chemicals that activate temperature and pain receptors in the oral mucosa. Presentation of orally chemesthetic input has been theorized to stimulate a faster, stronger swallow. We measured differences in peak linguapalatal swallowing pressures, pressure durations, and pressure adjustments in response to two volumes of water and carbonation (in Schweppes® Club Soda) and carbonation + gingerol (in Reed's Extra Ginger Brew) in 20 young adult women. There was a main effect of stimulus on linguapalatal swallowing pressure, F(6,74) = 6.247, p = 0.000, hp(2) = 0.536 (Reed's Extra Ginger Brew > Schweppes Club Soda > water). Rising and releasing linguapalatal pressure durations were greater for carbonation + gingerol and carbonation than for water. Our results add to the evidence that orally chemesthetic beverages influence greater neuromotor activity compared to water during the oral stage of swallowing. Our findings also suggest that there may be some benefit to the cumulative addition of chemosensory agents in a beverage. Clinically, this provides a theoretical basis for considering the use of these or chemically similar beverages as facilitating stimuli in patients who aspirate thin liquids.

  19. Development of a System to Monitor Laryngeal Movement during Swallowing Using a Bend Sensor

    Science.gov (United States)

    Li, Qiang; Hori, Kazuhiro; Minagi, Yoshitomo; Ono, Takahiro; Chen, Yong-jin; Kondo, Jyugo; Fujiwara, Shigehiro; Tamine, Kenichi; Hayashi, Hirokazu; Inoue, Makoto; Maeda, Yoshinobu

    2013-01-01

    Background Swallowing 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. Methods Six 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. Results Seven 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. Conclusions The 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. PMID:23940652

  20. Building a three-dimensional model of the upper gastrointestinal tract for computer simulations of swallowing.

    Science.gov (United States)

    Gastelum, Alfonso; Mata, Lucely; Brito-de-la-Fuente, Edmundo; Delmas, Patrice; Vicente, William; Salinas-Vázquez, Martín; Ascanio, Gabriel; Marquez, Jorge

    2016-03-01

    We aimed to provide realistic three-dimensional (3D) models to be used in numerical simulations of peristaltic flow in patients exhibiting difficulty in swallowing, also known as dysphagia. To this end, a 3D model of the upper gastrointestinal tract was built from the color cryosection images of the Visible Human Project dataset. Regional color heterogeneities were corrected by centering local histograms of the image difference between slices. A voxel-based model was generated by stacking contours from the color images. A triangle mesh was built, smoothed and simplified. Visualization tools were developed for browsing the model at different stages and for virtual endoscopy navigation. As result, a computer model of the esophagus and the stomach was obtained, mainly for modeling swallowing disorders. A central-axis curve was also obtained for virtual navigation and to replicate conditions relevant to swallowing disorders modeling. We show renderings of the model and discuss its use for simulating swallowing as a function of bolus rheological properties. The information obtained from simulation studies with our model could be useful for physicians in selecting the correct nutritional emulsions for patients with dysphagia.

  1. An Energy Efficient MAC Protocol for Multi-Hop Swallowable Body Sensor Networks

    Directory of Open Access Journals (Sweden)

    Lin Lin

    2014-10-01

    Full Text Available Swallowable body sensor networks (BSNs are composed of sensors which are swallowed by patients and send the collected data to the outside coordinator. These sensors are energy constraint and the batteries are difficult to be replaced. The medium access control (MAC protocol plays an important role in energy management. This paper investigates an energy efficient MAC protocol design for swallowable BSNs. Multi-hop communication is analyzed and proved more energy efficient than single-hop communication within the human body when the circuitry power is low. Based on this result, a centrally controlled time slotting schedule is proposed. The major workload is shifted from the sensors to the coordinator. The coordinator collects the path-loss map and calculates the schedules, including routing, slot assignment and transmission power. Sensor nodes follow the schedules to send data in a multi-hop way. The proposed protocol is compared with the IEEE 802.15.6 protocol in terms of energy consumption. The results show that it is more energy efficient than IEEE 802.15.6 for swallowable BSN scenarios.

  2. Physical activity in German adolescents measured by accelerometry and activity diary: introducing a comprehensive approach for data management and preliminary results.

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    Rebecca Pfitzner

    Full Text Available INTRODUCTION: Surveillance of physical activity (PA is increasingly based on accelerometry. However, data management guidelines are lacking. We propose an approach for combining accelerometry and diary based PA information for assessment of PA in adolescents and provide an example of this approach using data from German adolescents. METHODS: The 15-year-old participants comprised a subsample the GINIplus birth cohort (n = 328, 42.4% male. Data on PA was obtained from hip-worn accelerometers (ActiGraph GT3X for seven consecutive days, combined with a prospective activity diary. Major aspects of data management were validity of wear time, handling of non-wear time and diary comments. After data cleaning, PA and percentage of adolescents meeting the recommendations for moderate-to-vigorous activity (MVPA per day were determined. RESULTS: From the 2224 recorded days 493 days (25% were invalid, mainly due to uncertainties relating to non-wear time (322 days. Ultimately, 269 of 328 subjects (82% with valid data for at least three weekdays and one weekend day were included in the analysis. Mean MVPA per day was 39.1 minutes (SD ±25.0, with boys being more active than girls (41.8±21.5 minutes vs. 37.1±27.8 minutes, p<0.001. Accordingly, 24.7% of boys and 17.2% of girls (p<0.01 met the WHO recommendations for PA. School sport accounted for only 6% of weekly MVPA. In fact, most MVPA was performed during leisure time, with the majority of adolescents engaging in ball sports (25.4% and endurance sports (19.7%. Girls also frequently reported dancing and gymnastics (23%. CONCLUSION: For assessment of PA in adolescents, collecting both accelerometry and diary-based information is recommended. The diary is vital for the identification of invalid data and non-compliant participants. Preliminary results suggest that four out of five German adolescents do not meet WHO recommendations for PA and that school sport contributes only little to MVPA.

  3. Suppression of jaw-opening and trigemino-hypoglossal reflexes during swallowing in the cat.

    Science.gov (United States)

    Ono, T; Ishiwata, Y; Kuroda, T; Nakamura, Y

    1999-11-01

    Jaw-opening and trigemino-hypoglossal reflexes can be evoked by innocuous as well as noxious afferents from intra-oral structures. It has been reported that the amplitude of the jaw-opening reflex evoked by weak electrical stimulation of the upper lip is subject not only to tonic suppression but also to phase-linked modulation during mastication. In this study, we investigated whether the jaw-opening and trigemino-hypoglossal reflexes are modulated during swallowing. Data were obtained from 8 chloralose-anesthetized cats. Reflexes were monitored by electromyographic activities recorded from the anterior digastric, genioglossus, and styloglossus muscles and, after paralysis, by the efferent discharge in the digastric and hypoglossal nerves. Swallowing was elicited either by water dropped on the tongue or by repetitive stimulation of the superior laryngeal nerve. Jaw-opening and trigemino-hypoglossal reflexes were evoked by stimulation of the lingual nerve, and the evoked afferent volley was recorded from the Gasserian ganglion so that the threshold of the lingual nerve could be determined. The following results were obtained: (1) The jaw-opening and trigemino-hypoglossal reflexes evoked by stimulation of the low-threshold, but not high-threshold, lingual afferents were remarkably suppressed during swallowing; and (2) both the jaw-opening and trigemino-hypoglossal reflexes evoked by low-threshold lingual afferents were suppressed during fictive swallowing after the animals were paralyzed. We conclude that the jaw-opening and trigemino-hypoglossal reflexes evoked by low-threshold lingual afferents are suppressed during swallowing by a central motor program.

  4. Cortical processing of swallowing in ALS patients with progressive dysphagia--a magnetoencephalographic study.

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    Inga K Teismann

    Full Text Available Amyotrophic lateral sclerosis (ALS is a rare disease causing degeneration of the upper and lower motor neuron. Involvement of the bulbar motor neurons often results in fast progressive dysphagia. While cortical compensation of dysphagia has been previously shown in stroke patients, this topic has not been addressed in patients suffering from ALS. In the present study, we investigated cortical activation during deglutition in two groups of ALS patients with either moderate or severe dysphagia. Whole-head MEG was employed on fourteen patients with sporadic ALS using a self-paced swallowing paradigm. Data were analyzed by means of time-frequency analysis and synthetic aperture magnetometry (SAM. Group analysis of individual SAM data was performed using a permutation test. We found a reduction of cortical swallowing related activation in ALS patients compared to healthy controls. Additionally a disease-related shift of hemispheric lateralization was observed. While healthy subjects showed bilateral cortical activation, the right sensorimotor cortex was predominantly involved in ALS patients. Both effects were even stronger in the group of patients with severe dysphagia. Our results suggest that bilateral degeneration of the upper motor neuron in the primary motor areas also impairs further adjusted motor areas, which leads to a strong reduction of 'swallowing related' cortical activation. While both hemispheres are affected by the degeneration a relatively stronger activation is seen in the right hemisphere. This right hemispheric lateralization of volitional swallowing observed in this study may be the only sign of cortical plasticity in dysphagic ALS patients. It may demonstrate compensational mechanisms in the right hemisphere which is known to predominantly coordinate the pharyngeal phase of deglutition. These results add new aspects to our understanding of the pathophysiology of dysphagia in ALS patients and beyond. The compensational

  5. Role of the retrotrapezoid nucleus/parafacial respiratory group in coughing and swallowing in guinea pigs

    Science.gov (United States)

    Shiba, Keisuke; Mukudai, Shigeyuki; Umezaki, Toshiro; Sakaguchi, Hirofumi; Hisa, Yasuo

    2015-01-01

    The retrotrapezoid/parafacial respiratory group (RTN/pFRG) located ventral to the facial nucleus plays a key role in regulating breathing, especially enhanced expiratory activity during hypercapnic conditions. To clarify the roles of the RTN/pFRG region in evoking coughing, during which reflexive enhanced expiration is produced, and in swallowing, during which the expiratory activity is consistently halted, we recorded extracellular activity from RTN/pFRG neurons during these fictive behaviors in decerebrate, paralyzed, and artificially ventilated guinea pigs. The activity of the majority of recorded respiratory neurons was changed in synchrony with coughing and swallowing. To further evaluate the contribution of RTN/pFRG neurons to these nonrespiratory behaviors, the motor output patterns during breathing, coughing, and swallowing were compared before and after brain stem transection at the caudal margin of RTN/pFRG region. In addition, the effects of transection at its rostral margin were also investigated to evaluate pontine contribution to these behaviors. During respiration, transection at the rostral margin attenuated the postinspiratory activity of the recurrent laryngeal nerve. Meanwhile, the late expiratory activity of the abdominal nerve was abolished after caudal transection. The caudal transection also decreased the amplitude of the coughing-related abdominal nerve discharge but did not abolish the activity. Swallowing could be elicited even after the caudal end transection. These findings raise the prospect that the RTN/pFRG contributes to expiratory regulation during normal respiration, although this region is not an essential element of the neuronal networks involved in coughing and swallowing. PMID:26203106

  6. Altered Cortical Swallowing Processing in Patients with Functional Dysphagia: A Preliminary Study

    Science.gov (United States)

    Wollbrink, Andreas; Warnecke, Tobias; Winkels, Martin; Pantev, Christo; Dziewas, Rainer

    2014-01-01

    Objective Current neuroimaging research on functional disturbances provides growing evidence for objective neuronal correlates of allegedly psychogenic symptoms, thereby shifting the disease concept from a psychological towards a neurobiological model. Functional dysphagia is such a rare condition, whose pathogenetic mechanism is largely unknown. In the absence of any organic reason for a patient's persistent swallowing complaints, sensorimotor processing abnormalities involving central neural pathways constitute a potential etiology. Methods In this pilot study we measured cortical swallow-related activation in 5 patients diagnosed with functional dysphagia and a matched group of healthy subjects applying magnetoencephalography. Source localization of cortical activation was done with synthetic aperture magnetometry. To test for significant differences in cortical swallowing processing between groups, a non-parametric permutation test was afterwards performed on individual source localization maps. Results Swallowing task performance was comparable between groups. In relation to control subjects, in whom activation was symmetrically distributed in rostro-medial parts of the sensorimotor cortices of both hemispheres, patients showed prominent activation of the right insula, dorsolateral prefrontal cortex and lateral premotor, motor as well as inferolateral parietal cortex. Furthermore, activation was markedly reduced in the left medial primary sensory cortex as well as right medial sensorimotor cortex and adjacent supplementary motor area (pdysphagia - a condition with assumed normal brain function - seems to be associated with distinctive changes of the swallow-related cortical activation pattern. Alterations may reflect exaggerated activation of a widely distributed vigilance, self-monitoring and salience rating network that interferes with down-stream deglutition sensorimotor control. PMID:24586948

  7. Cliff swallows Petrochelidon pyrrhonota as bioindicators of environmental mercury, Cache Creek Watershed, California

    Science.gov (United States)

    Hothem, Roger L.; Trejo, Bonnie S.; Bauer, Marissa L.; Crayon, John J.

    2008-01-01

    To evaluate mercury (Hg) and other element exposure in cliff swallows (Petrochelidon pyrrhonota), eggs were collected from 16 sites within the mining-impacted Cache Creek watershed, Colusa, Lake, and Yolo counties, California, USA, in 1997-1998. Nestlings were collected from seven sites in 1998. Geometric mean total Hg (THg) concentrations ranged from 0.013 to 0.208 ??g/g wet weight (ww) in cliff swallow eggs and from 0.047 to 0.347 ??g/g ww in nestlings. Mercury detected in eggs generally followed the spatial distribution of Hg in the watershed based on proximity to both anthropogenic and natural sources. Mean Hg concentrations in samples of eggs and nestlings collected from sites near Hg sources were up to five and seven times higher, respectively, than in samples from reference sites within the watershed. Concentrations of other detected elements, including aluminum, beryllium, boron, calcium, manganese, strontium, and vanadium, were more frequently elevated at sites near Hg sources. Overall, Hg concentrations in eggs from Cache Creek were lower than those reported in eggs of tree swallows (Tachycineta bicolor) from highly contaminated locations in North America. Total Hg concentrations were lower in all Cache Creek egg samples than adverse effects levels established for other species. Total Hg concentrations in bullfrogs (Rana catesbeiana) and foothill yellow-legged frogs (Rana boylii) collected from 10 of the study sites were both positively correlated with THg concentrations in cliff swallow eggs. Our data suggest that cliff swallows are reliable bioindicators of environmental Hg. ?? Springer Science+Business Media, LLC 2007.

  8. Spatiotemporal Patterns in Nest Box Occupancy by Tree Swallows Across North America

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    David Vleck

    2012-06-01

    Full Text Available Data from the North American Breeding Bird Survey (BBS suggest that populations of aerial insectivorous birds are declining, particularly in northeastern regions of the continent, and particularly since the mid-1980s. Species that use nest boxes, such as Tree Swallows (Tachycineta bicolor, may provide researchers with large data sets that better reveal finer-scale geographical patterns in population trends. We analyzed trends in occupancy rates for ca. 40,000 Tree Swallow nest-box-years from 16 sites across North America. The earliest site has been studied intensively since 1969 and the latest site since 2004. Nest box occupancy rates declined significantly at five of six (83% sites east of -78° W longitude, whereas occupancy rates increased significantly at four of ten sites (40% west of -78° W longitude. Decreasing box occupancy trends from the northeast were broadly consistent with aspects of a previous analysis of BBS data for Tree Swallows, but our finding of instances of increases in other parts of the continent are novel. Several questions remain, particularly with respect to causes of these broad-scale geographic changes in population densities of Tree Swallows. The broad geographic patterns are consistent with a hypothesis of widespread changes in climate on wintering, migratory, or breeding areas that in turn may differentially affect populations of aerial insects, but other explanations are possible. It is also unclear whether these changes in occupancy rates reflect an increase or decrease in overall populations of Tree Swallows. Regardless, important conservation steps will be to unravel causes of changing populations of aerial insectivores in North America.

  9. Submental sEMG and hyoid movement during Mendelsohn maneuver, effortful swallow, and expiratory muscle strength training.

    Science.gov (United States)

    Wheeler-Hegland, Karen M; Rosenbek, John C; Sapienza, Christine M

    2008-10-01

    This study investigated the concurrent biomechanical and electromyographic properties of 2 swallow-specific tasks (effortful swallow and Mendelsohn maneuver) and 1 swallow-nonspecific (expiratory muscle strength training [EMST]) swallow therapy task in order to examine the differential effects of each on hyoid motion and associated submental activation in healthy adults, with the overall goal of characterizing task-specific and overload properties of each task. Twenty-five healthy male and female adults (M = 25 years of age) participated in this prospective, experimental study with 1 participant group. Each participant completed all study tasks (including normal swallow, Mendelsohn maneuver swallow, effortful swallow, and EMST task) in random order during concurrent videofluoroscopy and surface electromyography recording. Results revealed significant differences in the trajectory of hyoid motion as measured by overall displacement and angle of elevation of the hyoid bone. As well, timing of hyoid movement and amplitude differences existed between tasks with regard to the activation of the submental musculature. Study results demonstrated differential effects of the 3 experimental tasks on the principles of task specificity and overload. These principles are important in the development of effective rehabilitative programs. Subsequent direction for future research is suggested.

  10. Esophageal Acid Clearance During Random Swallowing Is Faster in Patients with Barrett’s Esophagus Than in Healthy Controls

    Science.gov (United States)

    Lottrup, Christian; Krarup, Anne L; Gregersen, Hans; Ejstrud, Per; Drewes, Asbjørn M

    2016-01-01

    Background/Aims Impaired esophageal acid clearance may be a contributing factor in the pathogenesis of Barrett’s esophagus. However, few studies have measured acid clearance as such in these patients. In this explorative, cross-sectional study, we aimed to compare esophageal acid clearance and swallowing rate in patients with Barrett’s esophagus to that in healthy controls. Methods A total of 26 patients with histology-confirmed Barrett’s esophagus and 12 healthy controls underwent (1) upper endoscopy, (2) an acid clearance test using a pH-impedance probe under controlled conditions including controlled and random swallowing, and (3) an ambulatory pH-impedance measurement. Results Compared with controls and when swallowing randomly, patients cleared acid 46% faster (P = 0.008). Furthermore, patients swallowed 60% more frequently (mean swallows/minute: 1.90 ± 0.74 vs 1.19 ± 0.58; P = 0.005), and acid clearance time decreased with greater random swallowing rate (P 0.3). Conclusions More frequent swallowing and thus faster acid clearance in Barrett’s esophagus may constitute a protective reflex due to impaired mucosal integrity and possibly acid hypersensitivity. Despite these reinforced mechanisms, acid clearance ability seems to be overthrown by repeated, retrograde acid reflux, thus resulting in increased esophageal acid exposure and consequently mucosal changes. PMID:27557545

  11. Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding.

    Science.gov (United States)

    Goldfield, Eugene C; Richardson, Michael J; Lee, Kimberly G; Margetts, Stacey

    2006-10-01

    This prospective study compared the coordination of sucking, swallowing, and breathing and its relationship to oxygen saturation in infants during breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, infants began bottle-feedings of expressed human milk using one of two systems: a soft-walled bottle and nipple (system 1, Playtex) or a hard-walled bottle and nipple (system 2, Avent). Infants' sucking, swallowing, breathing, and oxygenation were measured during breast-feeding and bottle-feeding, and coordination of these activities during breast-feeding and bottle-feeding were compared. During breast-feeding, swallowing occurred nonrandomly between breaths and did not interfere with breathing. The same distribution of swallowing occurred in infants fed with system 1, while swallowing occurred randomly in infants fed with system 2. Swallowing significantly increased during bottle-feeding among infants using system 2, but decreased among infants using system 1. Infants using system 2 also had a greater instability in the coordination of sucking, swallowing, and breathing and more perturbation of breathing. Oxygen saturation was significantly higher in infants fed with system 1 compared with system 2. These results suggest that the overall feeding pattern and oxygenation of system 1 are closer to the physiologic norm than system 2.

  12. Correlation varies with different time lags between the motions of the hyoid bone, epiglottis, and larynx during swallowing.

    Science.gov (United States)

    Seo, Han Gil; Oh, Byung-Mo; Leigh, Ja-Ho; Han, Tai Ryoon

    2014-10-01

    Although coordination and timing of swallowing have often been investigated by using discrete timing events such as the onset, peak, and duration of specific motions, the sequence and duration of swallowing events cannot represent the coordination of the swallowing mechanism quantitatively. This study aimed to apply a cross-correlation analysis of the motions of the hyolaryngeal structures during swallowing as an objective method for measuring the coordination and timing of the motions. Forty healthy subjects swallowed 2 and 5 ml of diluted barium solution (35 %) and 5 ml of curd yogurt under videofluoroscopy. Hyolaryngeal motions in videofluoroscopic images were digitized using the motion analysis system. The time series of the horizontal and vertical hyoid motion, the laryngeal elevation, and the angle of the epiglottic tilt were analyzed using cross-correlation at each 1/60-s time lag. The results showed high and consistent cross-correlations between hyolaryngeal motions during swallowing in most of the subjects regardless of age and bolus type. The horizontal hyoid motion and laryngeal elevation were more strongly correlated with the epiglottic tilt than the vertical hyoid motion, which might suggest the mechanism of the epiglottic tilt during swallowing. The bolus volume and viscosity affected the correlation coefficients and time lags between the hyolaryngeal motions, particularly those related to the epiglottic tilt. The results suggest that cross-correlation analysis may be used for measuring the coordination and timing of swallowing. Further studies using cross-correlation analysis of additional physiological factors related to swallowing or pathological conditions are warranted.

  13. Biomarkers of exposure and effects of environmental contaminants on swallows nesting along the Rio Grande, Texas, USA

    Science.gov (United States)

    Mora, M.A.; Musquiz, D.; Bickham, J.W.; MacKenzie, D.S.; Hooper, M.J.; Szabo, J.K.; Matson, C.W.

    2006-01-01

    We collected adult cave swallows (Petrochelidon fulva) and cliff swallows (P. pyrrhonota) during the breeding seasons in 1999 and 2000 from eight locations along the Rio Grande from Brownsville to El Paso (unless otherwise specified, all locations are Texas, USA) and an out-of-basin reference location. Body mass, spleen mass, hepatosomatic index (HSI), gonadosomatic index (GSI), thyroxine (T4) in plasma, DNA damage measured as the half-peak coefficient of variation of DNA content (HPCV) in blood cells, as well as acetylcholinesterase and butyrylcholinesterase in brain were compared with concentrations of organochlorines, metals, and metalloids in carcasses to determine potential effects of contaminants on swallows during the breeding season. Concentrations of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p???-DDE) were significantly greater in swallows from El Paso than in those from most locations, except for Pharr and Llano Grande. All swallows from these three locations had p,p???-DDE concentrations of 3 ??g/g wet weight or greater. Swallows from El Paso either had or shared the highest concentrations of p,p???-DDE, polychlorinated biphenyls, and 13 inorganic elements. Swallows from El Paso exhibited greater spleen mass and HPCV values as well as lower T4 values compared with those from other locations. Thyroxine was a potential biomarker of contaminant exposure in swallows of the Rio Grande, because it was negatively correlated with p,p???-DDE and Se. Spleen mass was positively correlated with selenium and HSI and negatively correlated with body mass, GSI, Mn, and Ni. Overall, the present study suggests that insectivorous birds living in areas of high agricultural and industrial activity along the Rio Grande bioaccumulate environmental contaminants. These contaminants, particularly p,p???-DDE, may be among multiple factors that impact endocrine and hematopoietic function in Rio Grande swallows. ?? 2006 SETAC.

  14. Central orexin inhibits reflex swallowing elicited by the superior laryngeal nerve via caudal brainstem in the rat.

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    Kobashi, Motoi; Mizutani, Satoshi; Fujita, Masako; Mitoh, Yoshihiro; Shimatani, Yuichi; Matsuo, Ryuji

    2014-05-10

    We examined the effects of orexins on the reflex swallowing using anesthetized rats. Orexins were administered into the fourth ventricle. Swallowing was induced by repeated electrical stimulation of the central cut end of the superior laryngeal nerve (SLN) and was identified by the electromyogram lead penetrated the mylohyoid muscle through bipolar electrodes. The frequency of swallowing during the electrical stimulation of the SLN decreased after the administration of orexin-A in a dose-dependent manner. The latency of the first swallowing tended to be extended after the administration of orexin-A. The administration of orexin-B did not affect swallowing frequency. Pre-administration of SB334867, an orexin-1 receptor antagonist, attenuated the degree of inhibition of swallowing frequency induced by the administration of orexin-A. To identify the effective site of orexin-A, the effect of a microinjection of orexin-A into the dorsal vagal complex (DVC) was evaluated. Orexin-A was injected into one of the lateral DVC, the intermediate DVC, or the medial DVC. Microinjection of orexin-A into the medial DVC but not the other two sites decreased swallowing frequency. Pre-injection of SB334867 into the medial DVC disrupted the inhibitory response induced by fourth ventricular administration of orexin-A. The electrical lesion of the commissural part of the NTS, but not ablation of the AP, abolished the inhibition of reflex swallowing induced by fourth ventricular administration of orexin-A. These results suggest that orexin-A inhibits reflex swallowing via orexin-1 receptors situated in the commissural part of the NTS and/or its vicinity.

  15. 'Pharyngocise': Randomized Controlled Trial of Preventative Exercises to Maintain Muscle Structure and Swallowing Function During Head-and-Neck Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Carnaby-Mann, Giselle, E-mail: gmann@phhp.ufl.edu [Department of Behavioral Science and Community Health, University of Florida, Gainesville, FL (United States); Crary, Michael A. [Department of Speech Language and Hearing Sciences, University of Florida, Gainesville, FL (United States); Schmalfuss, Ilona [Department of Radiology, North Florida/South Georgia Veterans Health System, Gainesville, FL (Georgia); Amdur, Robert [Department of Radiation Oncology, University of Florida, Gainesville, FL (United States)

    2012-05-01

    Purpose: Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the 'usual care.' Methods and Materials: A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise). The intervention arms were treated daily during chemoradiotherapy. The primary outcome measure was muscle size and composition (determined by T{sub 2}-weighted magnetic resonance imaging). The secondary outcomes included functional swallowing ability, dietary intake, chemosensory function, salivation, nutritional status, and the occurrence of dysphagia-related complications. Results: The swallowing musculature (genioglossus, hyoglossuss, and mylohyoid) demonstrated less structural deterioration in the active treatment arm. The functional swallowing, mouth opening, chemosensory acuity, and salivation rate deteriorated less in the pharyngocise group. Conclusion: Patients completing a program of swallowing exercises during cancer treatment demonstrated superior muscle maintenance and functional swallowing ability.

  16. Effects of carbonated liquid on swallowing dysfunction in dementia with Lewy bodies and Parkinson’s disease dementia

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    Larsson V

    2017-08-01

    Full Text Available Victoria Larsson,1 Gustav Torisson,1,2 Margareta Bülow,3 Elisabet Londos1 1Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 2Department of Infectious Diseases, 3Diagnostic Centre of Imaging and Functional Medicine, Skåne University Hospital, Malmö, Sweden Background: Swallowing dysfunction is an increasingly recognized problem in patients with dementia with Lewy bodies (DLB and Parkinson’s disease dementia (PDD, which can result in aspiration pneumonia and death. Few studies have examined potential ways of improving swallowing function in this fragile patient group. The aim of this study was to evaluate swallowing dysfunction and carbonated liquid using videofluoroscopy in DLB and PDD patients. Methods: A total of 48 patients with DLB and PDD were referred for a clinical examination with videofluoroscopy. Descriptive overall assessments were provided at the time of the examination regarding swallowing function and the effects of different modifications, including carbonated thin liquid (CTL. Additionally, a repeated measures quantitative retrospective analysis has been performed comparing 1 thin liquids; 2 thickened liquids and 3 CTLs, with regard to the quantitative variables 1 pharyngeal transit time (PTT; 2 pharyngeal retention and 3 tracheal penetration. Results: In all, 40/48 (83% of the patients had a swallowing dysfunction, which was confirmed on videofluoroscopy, with 34/40 (85% patients having a pharyngeal-type dysfunction. A total of 14/40 (35% patients with an objective swallowing impairment did not have any subjective swallowing symptoms. Out of the patients with swallowing dysfunction, 87% had an overall improved swallowing function with carbonated liquid. PTT for carbonated liquid (median 633 ms, interquartile range [IQR] 516–786 ms was quicker than for thin liquid (760 ms, IQR 613–940 ms, P=0.014 and thickened liquid (880.0 ms, IQR 600–1,500 ms, P<0.001. No significant effect

  17. Associations between multiple accelerometry-assessed physical activity parameters and selected health outcomes in elderly people--results from the KORA-age study.

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    Sandra Ortlieb

    Full Text Available INTRODUCTION: Accelerometry is an important method for extending our knowledge about intensity, duration, frequency and patterns of physical activity needed to promote health. This study has used accelerometry to detect associations between intensity levels and related activity patterns with multimorbidity and disability. Moreover, the proportion of people meeting the physical activity recommendations for older people was assessed. METHODS: Physical activity was measured in 168 subjects (78 males; 65-89 years of age, using triaxial GT3X accelerometers for ten consecutive days. The associations between physical activity parameters and multimorbidity or disability was examined using multiple logistic regression models, which were adjusted for gender, age, education, smoking, alcohol consumption, lung function, nutrition and multimorbidity or disability. RESULTS: 35.7% of the participants met the physical activity recommendations of at least 150 minutes of moderate to vigorous activity per week. Only 11.9% reached these 150 minutes, when only bouts of at least 10 minutes were counted. Differences in moderate to vigorous activity between people with and without multimorbidity or disability were more obvious when shorter bouts instead of only longer bouts were included. Univariate analyses showed an inverse relationship between physical activity and multimorbidity or disability for light and moderate to vigorous physical activity. A higher proportion of long activity bouts spent sedentarily was associated with higher risk for multimorbidity, whereas a high proportion of long bouts in light activity seemed to prevent disability. After adjustment for covariates, there were no significant associations, anymore. CONCLUSIONS: The accumulated time in moderate to vigorous physical activity seems to have a stronger relationship with health and functioning when shorter activity bouts and not only longer bouts were counted. We could not detect an association

  18. Associations between Multiple Accelerometry-Assessed Physical Activity Parameters and Selected Health Outcomes in Elderly People – Results from the KORA-Age Study

    Science.gov (United States)

    Ortlieb, Sandra; Gorzelniak, Lukas; Nowak, Dennis; Strobl, Ralf; Grill, Eva; Thorand, Barbara; Peters, Annette; Kuhn, Klaus A.; Karrasch, Stefan; Horsch, Alexander; Schulz, Holger

    2014-01-01

    Introduction Accelerometry is an important method for extending our knowledge about intensity, duration, frequency and patterns of physical activity needed to promote health. This study has used accelerometry to detect associations between intensity levels and related activity patterns with multimorbidity and disability. Moreover, the proportion of people meeting the physical activity recommendations for older people was assessed. Methods Physical activity was measured in 168 subjects (78 males; 65–89 years of age), using triaxial GT3X accelerometers for ten consecutive days. The associations between physical activity parameters and multimorbidity or disability was examined using multiple logistic regression models, which were adjusted for gender, age, education, smoking, alcohol consumption, lung function, nutrition and multimorbidity or disability. Results 35.7% of the participants met the physical activity recommendations of at least 150 minutes of moderate to vigorous activity per week. Only 11.9% reached these 150 minutes, when only bouts of at least 10 minutes were counted. Differences in moderate to vigorous activity between people with and without multimorbidity or disability were more obvious when shorter bouts instead of only longer bouts were included. Univariate analyses showed an inverse relationship between physical activity and multimorbidity or disability for light and moderate to vigorous physical activity. A higher proportion of long activity bouts spent sedentarily was associated with higher risk for multimorbidity, whereas a high proportion of long bouts in light activity seemed to prevent disability. After adjustment for covariates, there were no significant associations, anymore. Conclusions The accumulated time in moderate to vigorous physical activity seems to have a stronger relationship with health and functioning when shorter activity bouts and not only longer bouts were counted. We could not detect an association of the intensity

  19. Study protocol of physical activity and sedentary behaviour measurement among schoolchildren by accelerometry - Cross-sectional survey as part of the ENERGY-project

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    te Velde Saskia J

    2011-03-01

    Full Text Available Abstract Background Physical activity and sedentary behaviour among children should be measured accurately in order to investigate their relationship with health. Accelerometry provides objective and accurate measurement of body movement, which can be converted to meaningful behavioural outcomes. The aim of this study was to evaluate the best evidence for the decisions on data collection and data processing with accelerometers among children resulting in a standardized protocol for use in the participating countries. Methods/Design This cross-sectional accelerometer study was conducted as part of the European ENERGY-project that aimed to produce an obesity prevention intervention among schoolchildren. Five countries, namely Belgium, Greece, Hungary, Switzerland and the Netherlands participated in the accelerometer study. We used three different Actigraph models-Actitrainers (triaxial, GT3Xs and GT1Ms. Children wore the device for six consecutive days including two weekend days. We selected an epoch length of 15 seconds. Accelerometers were placed at children's waist at the right side of the body in an elastic belt. In total, 1082 children participated in the study (mean age = 11.7 ± 0.75 y, 51% girls. Non-wearing time was calculated as periods of more than 20 minutes of consecutive zero counts. The minimum daily wearing time was set to 10 hours for weekdays and 8 hours for weekend days. The inclusion criterion for further analysis was having at least three valid weekdays and one valid weekend day. We selected a cut-point (count per minute (cpm of 5200 cpm for vigorous physical activity. We also created time filters for school-time during data cleaning in order to explore school-time physical activity and sedentary behaviour patterns in particular. Discussion This paper describes the decisions for data collection and processing. Use of standardized protocols would ease future use of accelerometry and the comparability of results between studies.

  20. Nocturnal sleep-related variables from 24-h free-living waist-worn accelerometry: International Study of Childhood Obesity, Lifestyle and the Environment

    Science.gov (United States)

    Tudor-Locke, C; Mire, E F; Barreira, T V; Schuna, J M; Chaput, J-P; Fogelholm, M; Hu, G; Kurpad, A; Kuriyan, R; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tremblay, M S; Zhao, P; Church, T S; Katzmarzyk, P T

    2015-01-01

    Objectives: We describe the process of identifying and defining nocturnal sleep-related variables (for example, movement/non-movement indicators of sleep efficiency, waking episodes, midpoint and so on) using the unique 24-h waist-worn free-living accelerometer data collected in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Methods: Seven consecutive days of 24-h waist-worn accelerometer (GT3X+, ActiGraph LLC) data were collected from over 500 children at each site. An expert subgroup of the research team with accelerometry expertize, frontline data collectors and data managers met on several occasions to categorize and operationally define nocturnal accelerometer signal data patterns. The iterative process was informed by the raw data drawn from a sub set of the US data, and culminated in a refined and replicable delineated definition for each identified nocturnal sleep-related variable. Ultimately based on 6318 participants from all 12 ISCOLE sites with valid total sleep episode time (TSET), we report average clock times for nocturnal sleep onset, offset and midpoint in addition to sleep period time, TSET and restful sleep efficiency (among other derived variables). Results: Nocturnal sleep onset occurred at 2218 hours and nocturnal sleep offset at 0707 hours. The mean midpoint was 0243 hours. The sleep period time of 529.6 min (8.8 h) was typically accumulated in a single episode, making the average TSET very similar in duration (529.0 min). The mean restful sleep efficiency ranged from 86.8% (based on absolute non-movement of 0 counts per minute) to 96.0% (based on relative non-movement of <100 counts per minute). Conclusions: These variables extend the potential of field-based 24-h waist-worn accelerometry to distinguish and categorize the underlying robust patterns of movement/non-movement signals conveying magnitude, duration, frequency and periodicity during the nocturnal sleep period. PMID:27152185

  1. Comparison of uniaxial and triaxial accelerometry in the assessment of physical activity among adolescents under free-living conditions: the HELENA study

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    Vanhelst Jérémy

    2012-03-01

    Full Text Available Abstract Background Different types of devices are available and the choice about which to use depends on various factors: cost, physical characteristics, performance, and the validity and intra- and interinstrument reliability. Given the large number of studies that have used uniaxial or triaxial devices, it is of interest to know whether the different devices give similar information about PA levels and patterns. The aim of this study was to compare physical activity (PA levels and patterns obtained simultaneously by triaxial accelerometry and uniaxial accelerometry in adolescents in free-living conditions. Methods Sixty-two participants, aged 13-16 years, were recruited in this ancillary study, which is a part of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA. All participants wore a uniaxial accelerometer (ActiGraph GT1M®, Pensacola, FL and a triaxial accelerometer (RT3®, Stayhealthy, Monrovia, CA simultaneously for 7 days. The patterns were calculated by converting accelerometer data output as a percentage of time spent at sedentary, light, moderate, and vigorous PA per day. Analysis of output data from the two accelerometers were assessed by two different tests: Equivalence Test and Bland & Altman method. Results The concordance correlation coefficient between the data from the triaxial accelerometer and uniaxial accelerometer at each intensity level was superior to 0.95. The ANOVA test showed a significant difference for the first three lower intensities while no significant difference was found for vigorous intensity. The difference between data obtained with the triaxial accelerometer and the uniaxial monitor never exceeded 2.1% and decreased as PA level increased. The Bland & Altman method showed good agreement between data obtained between the both accelerometers (p Conclusions Uniaxial and triaxial accelerometers do not differ in their measurement of PA in population studies, and either could be used in such

  2. Detection of walking periods and number of steps in older adults and patients with Parkinson's disease: accuracy of a pedometer and an accelerometry-based method.

    Science.gov (United States)

    Dijkstra, Baukje; Zijlstra, Wiebren; Scherder, Erik; Kamsma, Yvo

    2008-07-01

    The aim of this study was to examine if walking periods and number of steps can accurately be detected by a single small body-fixed device in older adults and patients with Parkinson's disease (PD). Results of an accelerometry-based method (DynaPort MicroMod) and a pedometer (Yamax Digi-Walker SW-200) worn on each hip were evaluated against video observation. Twenty older adults and 32 PD patients walked straight-line trajectories at different speeds, of different lengths and while doing secondary tasks in an indoor hallway. Accuracy of the instruments was expressed as absolute percentage error (older adults versus PD patients). Based on the video observation, a total of 236.8 min of gait duration and 24,713 steps were assessed. The DynaPort method predominantly overestimated gait duration (10.7 versus 11.1%) and underestimated the number of steps (7.4 versus 6.9%). Accuracy decreased significantly as walking distance decreased. Number of steps were also mainly underestimated by the pedometers, the left Yamax (6.8 versus 11.1%) being more accurate than the right Yamax (11.1 versus 16.3%). Step counting of both pedometers was significantly less accurate for short trajectories (3 or 5 m) and as walking pace decreased. It is concluded that the Yamax pedometer can be reliably used for this study population when walking at sufficiently high gait speeds (>1.0 m/s). The accelerometry-based method is less speed-dependent and proved to be more appropriate in the PD patients for walking trajectories of 5 m or more.

  3. Differences in Trunk Accelerometry Between Frail and Nonfrail Elderly Persons in Sit-to-Stand and Stand-to-Sit Transitions Based on a Mobile Inertial Sensor.

    Science.gov (United States)

    Galán-Mercant, Alejandro; Cuesta-Vargas, Antonio I

    2013-08-16

    Clinical frailty syndrome is a common geriatric syndrome, which is characterized by physiological reserve decreases and increased vulnerability. The changes associated to ageing and frailties are associated to changes in gait characteristics and the basic functional capacities. Traditional clinical evaluation of Sit-to-Stand (Si-St) and Stand-to-Sit (St-Si) transition is based on visual observation of joint angle motion to describe alterations in coordination and movement pattern. The latest generation smartphones often include inertial sensors with subunits such as accelerometers and gyroscopes, which can detect acceleration. Firstly, to describe the variability of the accelerations, angular velocity, and displacement of the trunk during the Sit-to-Stand and Stand-to-Sit transitions in two groups of frail and physically active elderly persons, through instrumentation with the iPhone 4 smartphone. Secondly, we want to analyze the differences between the two study groups. A cross-sectional study that involved 30 subjects over 65 years, 14 frail and 16 fit subjects. The participants were classified with frail syndrome by the Fried criteria. Linear acceleration was measured along three orthogonal axes using the iPhone 4 accelerometer. Each subject performed up to three successive Si-St and St-Si postural transitions using a standard chair with armrest. Significant differences were found between the two groups of frail and fit elderly persons in the accelerometry and angular displacement variables obtained in the kinematic readings of the trunk during both transitions. The inertial sensor fitted in the iPhone 4 is able to study and analyze the kinematics of the Si-St and St-Si transitions in frail and physically active elderly persons. The accelerometry values for the frail elderly are lower than for the physically active elderly, while variability in the readings for the frail elderly is also lower than for the control group.

  4. Improving swallowing outcomes in patients with head and neck cancer using a theory-based pretreatment swallowing intervention package: protocol for a randomised feasibility study

    Science.gov (United States)

    Smith, Christina H; Barratt, Helen; Taylor, Stuart A

    2017-01-01

    Introduction The incidence of head and neck cancer (HNC) in the UK is rising, with an average of 31 people diagnosed daily. Patients affected by HNC suffer significant short-term and long-term post-treatment morbidity as a result of dysphagia, which affects daily functioning and quality of life (QOL). Pretreatment swallowing exercises may provide additional benefit over standard rehabilitation in managing dysphagia after primary HNC treatments, but uncertainty about their effectiveness persists. This study was preceded by an intervention development phase to produce an optimised swallowing intervention package (SIP). The aim of the current study is to assess the feasibility of this new intervention and research processes within a National Health Service (NHS) setting. Method and analysis A two-arm non-blinded randomised controlled feasibility study will be carried out at one tertiary referral NHS centre providing specialist services in HNC. Patients newly diagnosed with stage III and IV disease undergoing planned surgery and/or chemoradiation treatments will be eligible. The SIP will be delivered pre treatment, and a range of swallowing-related and QOL measures will be collected at baseline, 1, 3 and 6 months post-treatment. Outcomes will test the feasibility of a future randomised controlled trial (RCT), detailing rate of recruitment and patient acceptance to participation and randomisation. Salient information relating to protocol implementation will be collated and study material such as the case report form will be tested. A range of candidate outcome measures will be examined for suitability in a larger RCT. Ethics and dissemination Ethical approval was obtained from an NHS Research Ethics Committee. Findings will be published open access in a peer-reviewed journal, and presented at relevant conferences and research meetings. Trial registration number ISRCTN40215425; Pre-results. PMID:28348190

  5. Impaired swallowing mechanics of post radiation therapy head and neck cancer patients: A retrospective videofluoroscopic study

    Institute of Scientific and Technical Information of China (English)

    William G Pearson Jr; Alisa A Davidoff; Zachary M Smith; Dorothy E Adams; Susan E Langmore

    2016-01-01

    AIM: To determine swallowing outcomes and hyolaryngeal mechanics associated with post radiation therapy head and neck cancer(rt HNC) patients using videofluoroscopic swallow studies. METHODS: In this retrospective cohort study, video-fluoroscopic images of rt HNC patients(n = 21) were compared with age and gender matched controls(n = 21). Penetration-aspiration of the bolus and bolus residue were measured as swallowing outcome variables. Timing and displacement measurements of the anterior and posterior muscular slings elevating the hyolaryngeal complex were acquired. Coordinate data of anatomical landmarks mapping the action of the anterior muscles(suprahyoid muscles) and posterior muscles(long pharyngeal muscles) were used to calculate the distance measurements, and slice numbers were used to calculate time intervals. Canonical variate analysis with post-hoc discriminant function analysis was performed on coordinate data to determine multivariate mechanics of swallowing associated with treatment. Pharyngeal constriction ratio(PCR) was also measured to determine if weak pharyngeal constriction is associated with post radiation therapy.RESULTS: The rt HNC group was characterized by poor swallowing outcomes compared to the control group in regards to: Penetration-aspiration scale(P < 0.0001), normalized residue ratio scale(NRRS) for the valleculae(P = 0.002) and NRRS for the piriform sinuses(P = 0.003). Timing and distance measurements of the anterior muscular sling were not significantly different in the two groups, whereas for the PMS time of displacement was abbreviated(P = 0.002) and distance of excursion was reduced(P = 0.02) in the rt HNC group. A canonical variate analysis shows a significant reduction in pharyngeal mechanics in the rt HNC group(P < 0.0001). The PCR was significantly higher in the test group than the control group(P = 0.0001) indicating reduced efficiency in pharyngeal clearance. CONCLUSION: Using videofluoroscopy, this study shows rt HNC

  6. Preliminary Evaluation of the Pathomechanisms of Dysphagia After Occipitospinal Fusion: Kinematic Analysis by Videofluoroscopic Swallowing Study.

    Science.gov (United States)

    Kaneyama, Shuichi; Sumi, Masatoshi; Takabatake, Masato; Kasahara, Koichi; Kanemura, Aritetsu; Koh, Akihiro; Hirata, Hiroaki

    2016-12-01

    Kinematic analysis of swallowing function using videofluoroscopic swallowing study (VFSS). The aims of this study were to analyze swallowing process in the patients who underwent occipitospinal fusion (OSF) and elucidate the pathomechanism of dysphagia after OSF. Although several hypotheses about the pathomechanisms of dysphagia after OSF were suggested, there has been little tangible evidence to support these hypotheses since these hypotheses were based on the analysis of static radiogram or CT. Considering that swallowing is a compositive motion of oropharyngeal structures, the etiology of postoperative dysphagia should be investigated through kinematic approaches. Each four patients with or without postoperative dysphagia (group D and N, respectively) participated in this study. For VFSS, all patients were monitored to swallow 5-mL diluted barium solution by fluoroscopy, and then dynamic passing pattern of the barium solution was analyzed. Additionally, O-C2 angle (O-C2A) was measured for the assessment of craniocervical alignment. O-C2A in group D was -7.5 degrees, which was relatively smaller than 10.3 degrees in group N (P = 0.07). In group D, all cases presented smooth medium passing without any obstruction at the upper cervical level regardless of O-C2A, whereas the obstruction to the passage of medium was detected at the apex of mid-lower cervical ocurvature, where the anterior protrusion of mid-lower cervical spine compressed directly the pharyngeal space. In group N, all cases showed smooth passing of medium through the whole process of swallowing. This study presented that postoperative dysphagia did not occur at the upper cervical level even though there was smaller angle of O-C2A and demonstrated the narrowing of the oropharyngeal space towing to direct compression by the anterior protrusion of mid-lower cervical spine was the etiology of dysphagia after OSF. Therefore, surgeon should pay attention to the alignment of mid-cervical spine as well as

  7. Sex steroid hormones in barn swallow (Hirundo rustica) populations at a dioxin contaminated site in northeast Louisiana

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This study compares the gonadal sex steroid hormone levels (i.e., estradiol, total estrogen, and testosterone) in Louisiana barn swallows (Hirundo rustica) that were...

  8. [Aural Stimulation with Capsaicin Ointment Improved the Swallowing Function in Patients with Dysphagia: Evaluation by the SMRC Scale].

    Science.gov (United States)

    Kondo, Eiji; Jinnouchi, Osamu; Ohnishi, Hiroki; Kawata, Ikuji; Takeda, Noriaki

    2015-11-01

    Cough and swallowing reflexes are important airway-protective mechanisms against aspiration. Angiotensin-converting enzyme (ACE) inhibitors, one of the side effects of which is cough, have been reported to reduce the incidence of aspiration pneumonia in hypertensive patients with stroke. ACE inhibitors have also been reported to improve the swallowing function in post-stroke patients. On the other hand, stimulation of the Arnold nerve, the auricular branch of the vagus, triggers the cough reflex (Arnold's ear-cough reflex). Capsaicin, an agonist of Transient Receptor Potential Vanilloid 1 (TRPV1), has been shown to activate the peripheral sensory C-fibers. Stimulation of the sensory branches of the vagus in the laryngotracheal mucosa with capsaicin induces the cough reflex and has been reported to improve the swallowing function in patients with dysphagia. In our previous study, we showed that aural stimulation of the Arnold nerve with 0.025% capsaicin ointment improved the swallowing function, as evaluated by the endoscopic swallowing score, in 26 patients with dysphagia. In the present study, the video images of swallowing recorded in the previous study were re-evaluated using the SMRC scale by an independent otolaryngologist who was blinded to the information about the patients and the endoscopic swallowing score. The SMRC scale is used to evaluate four aspects of the swallowing function: 1) Sensory: the initiation of the swallowing reflex as assessed by the white-out timing; 2) Motion: the ability to hold blue-dyed water in the oral cavity and induce laryngeal elevation; 3) Reflex: glottal closure and the cough reflex induced by touching the epiglottis or arytenoid with the endoscope; 4) Clearance: pharyngeal clearance of the blue-dyed water after swallowing. Accordingly, we demonstrated that a single application of capsaicin ointment to the external auditory canal of patients with dysphagia significantly improved the R, but not the S, M or C scores, and this

  9. Speech-Language and swallowing manifestations and rehabilitation in an 11-year-old girl with MELAS syndrome.

    Science.gov (United States)

    Vandana, V P; Bindu, Parayil Sankaran; Sonam, Kothari; Taly, Arun B; Gayathri, N; Madhu, N; Sinha, S

    2015-01-01

    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a rare mitochondrial disease. The available studies on MELAS syndrome are limited to evaluation of radiological, audiological, genetic, and neurological findings. Among the various neurological manifestations, speech-language and swallowing manifestations are less discussed in the literature. This report describes the speech-language and swallowing function in an 11-year-old girl with MELAS syndrome. The intervention over a period of 6 months is discussed.

  10. Relationship between Class III malocclusion and hyoid bone displacement during swallowing: a cine-magnetic resonance imaging study

    OpenAIRE

    Gokce, Sila Mermut; Gokce, Hasan Suat; Gorgulu, Serkan; Karacay, Seniz; Akca, Eralp; Olmez, Huseyin

    2012-01-01

    Objective The displacement of the hyoid bone (HB) is a critical biomechanical component of the swallowing function. The aim of this study was to evaluate the swallowing-induced vertical and horizontal displacements of the HB in subjects with 2 different magnitudes of skeletal Class III malocclusion, by means of real-time, balanced turbo-field-echo (B-TFE) cine-magnetic resonance imaging. Methods The study population comprised 19 patients with mild skeletal Class III malocclusion, 16 with seve...

  11. Effectiveness of Chin-tuck Maneuver to Facilitate Swallowing in Neurologic Dysphagia.

    Science.gov (United States)

    Saconato, Mariana; Chiari, Brasilia Maria; Lederman, Henrique Manoel; Gonçalves, Maria Inês Rebelo

    2016-01-01

    Introduction The chin-tuck maneuver is the most frequently employed postural maneuver in the treatment of neurogenic oropharyngeal dysphagia caused by encephalic vascular strokes and degenerative diseases. Objective The purpose of this study was to investigate the effectiveness of this maneuver in patients with neurogenic dysphagia and factors that could interfere in it. Methods In this retrospective cohort, we analyzed the medical files and videofluoroscopy exams of 35 patients (19 male - 54% and 16 female - 46%; age range between 20 and 89 years old; mean = 69 years). Results The results suggest that the effectiveness of chin-tuck maneuver is related to the overall degree of dysphagia: the more severe the dysphagia, the less effective the maneuver. Conclusion Chin-tuck maneuver should benefit dysphagic patients with delay in the swallowing trigger, reduced laryngeal elevation, and difficulties to swallow liquids, but is not the best compensatory strategy for patients with severe dysphagia.

  12. Effects of reflux laryngitis on non-nutritive swallowing in newborn lambs.

    Science.gov (United States)

    Brisebois, Simon; Samson, Nathalie; Fortier, Pierre-Hugues; Doueik, Alexandre A; Carreau, Anne-Marie; Praud, Jean-Paul

    2014-08-15

    Reflux laryngitis in infants may be involved not only in laryngeal disorders, but also in disorders of cardiorespiratory control through its impact on laryngeal function. Our objective was to study the effect of reflux laryngitis on non-nutritive swallowing (NNS) and NNS-breathing coordination. Two groups of six newborn lambs, randomized into laryngitis and control groups, were surgically instrumented for recording states of alertness, swallowing and cardiorespiratory variables without sedation. A mild to moderate reflux laryngitis was induced in lambs from the experimental group. A significant decrease in the number of NNS bursts and apneas was observed in the laryngitis group in active sleep (p=0.03). In addition, lower heart and respiratory rates, as well as prolonged apnea duration (plaryngitis group. We conclude that a mild to moderate reflux laryngitis alters NNS burst frequency and autonomous control of cardiac activity and respiration in lambs.

  13. Music therapy protocol development to enhance swallowing training for stroke patients with dysphagia.

    Science.gov (United States)

    Kim, Soo Ji

    2010-01-01

    Considering the devastating condition of dysphagia, it is necessary to provide intensive therapeutic regimen based on interdisciplinary approach. In this aspect, music-enhanced swallowing protocol was developed through a pilot study. Then, the modified protocol from a pilot study was examined with 8 stroke patients in a local hospital. The protocol was designed to improve oral motor control, laryngeal elevation, breathing, and swallowing functions. The dependent variables measured included reflex, respiration, and laryngeal functions using the Frenchay Dysarthria assessment. Results from the initial to the midevaluation showed that pitch in the laryngeal category were statistically significant after 6th sessions. After the 12th session, when the final evaluation was compared with the initial assessment, additional categories revealed statistically significant changes. It is recommended that this study should be replicated with a control group and a larger sample using either FEES or video fluoroscopy for scientific data to further substantiate music therapy outcomes in stroke rehabilitation.

  14. Multimodal signalling in the North American barn swallow: a phenotype network approach

    Science.gov (United States)

    Wilkins, Matthew R.; Shizuka, Daizaburo; Joseph, Maxwell B.; Hubbard, Joanna K.; Safran, Rebecca J.

    2015-01-01

    Complex signals, involving multiple components within and across modalities, are common in animal communication. However, decomposing complex signals into traits and their interactions remains a fundamental challenge for studies of phenotype evolution. We apply a novel phenotype network approach for studying complex signal evolution in the North American barn swallow (Hirundo rustica erythrogaster). We integrate model testing with correlation-based phenotype networks to infer the contributions of female mate choice and male–male competition to the evolution of barn swallow communication. Overall, the best predictors of mate choice were distinct from those for competition, while moderate functional overlap suggests males and females use some of the same traits to assess potential mates and rivals. We interpret model results in the context of a network of traits, and suggest this approach allows researchers a more nuanced view of trait clustering patterns that informs new hypotheses about the evolution of communication systems. PMID:26423842

  15. Multimodal signalling in the North American barn swallow: a phenotype network approach.

    Science.gov (United States)

    Wilkins, Matthew R; Shizuka, Daizaburo; Joseph, Maxwell B; Hubbard, Joanna K; Safran, Rebecca J

    2015-10-01

    Complex signals, involving multiple components within and across modalities, are common in animal communication. However, decomposing complex signals into traits and their interactions remains a fundamental challenge for studies of phenotype evolution. We apply a novel phenotype network approach for studying complex signal evolution in the North American barn swallow (Hirundo rustica erythrogaster). We integrate model testing with correlation-based phenotype networks to infer the contributions of female mate choice and male-male competition to the evolution of barn swallow communication. Overall, the best predictors of mate choice were distinct from those for competition, while moderate functional overlap suggests males and females use some of the same traits to assess potential mates and rivals. We interpret model results in the context of a network of traits, and suggest this approach allows researchers a more nuanced view of trait clustering patterns that informs new hypotheses about the evolution of communication systems.

  16. Geographic variation in sexual selection and implications for speciation in the Barn Swallow

    Institute of Scientific and Technical Information of China (English)

    Elizabeth; SC; Scordato; Rebecca; J; Safran

    2015-01-01

    Barn Swallows(Hirundo rustica), a group of passerine birds comprised of six closely related subspecies, are well known throughout their nearly worldwide distribution, in part because of their close association with human settlements.A tractable species for both individual-based and population-level studies, Barn Swallows are a prominent model system in evolutionary, ecological, and behavioral research. Here we review work on sexual selection and population divergence in this species complex, focusing on comparative studies among populations and subspecies.We summarize variation in the targets of mate choice and in the information conveyed by sexually selected traits, and conclude that the benefits advertised by different traits may vary geographically. Finally, we consider the role of sexual selection as a driver of population divergence in this widespread and phenotypically variable species complex.

  17. Tools and early management of language and swallowing disorders in acute stroke patients.

    Science.gov (United States)

    Flamand-Roze, Constance; Cauquil-Michon, Cécile; Denier, Christian

    2012-02-01

    The role of the stroke units in improving morbidity, mortality, and recovery from stroke is clearly demonstrated. However, acute management of language disorders in these specialized units remains controversial, and management of swallowing disorders is usually nonstandardized. The recent validation of a scale for rapid screening of language disorders (LAST [Language Screening Test]) in acute stroke patients should allow optimization of their detection and early management. Swallowing disorders should be screened and managed using a standardized protocol. Following early initial evaluation repeated on a daily basis, they justify tailored rehabilitation sessions, adaptation of food textures, team formation, and families' information. The use of these protocols implies the cooperation and coordination of the medical and paramedical teams and the daily presence of speech therapists. These aspects are crucial for patients in the stroke units to achieve full benefits from the management proposed in this paper, leading to diminution of complications and better long-term functional prognosis.

  18. Effect of visual biofeedback to acquire supraglottic swallow in healthy individuals: a randomized-controlled trial.

    Science.gov (United States)

    Imada, Miho; Kagaya, Hitoshi; Ishiguro, Yuriko; Kato, Miho; Inamoto, Yoko; Tanaka, Takashi; Shibata, Seiko; Saitoh, Eiichi

    2016-06-01

    The aim of this study is to evaluate the effect of visual biofeedback therapy in acquiring supraglottic swallow (SGS) in a randomized-controlled trial with healthy individuals. Eighteen individuals (mean age, 26 years) who could not close or keep closed the vocal folds before and during the swallow in SGS were allocated randomly to either a visual biofeedback group (eight individuals) or a nonbiofeedback group (10 individuals). A videoendoscope was inserted intranasally and an SGS exercise, using 4 ml of green-colored water, was performed 30 times per day up to 5 days. When the participant failed to perform SGS, the result was provided only to the participants in the visual biofeedback group. The median length of time until acquiring SGS was 1.5 days in the visual biofeedback group and 3.5 days in the nonbiofeedback group (P=0.040). We concluded that visual biofeedback effectively enabled participants to acquire SGS earlier.

  19. Videofluoroscopy and oropharyngeal manometry for evaluation of swallowing in elderly patients.

    Science.gov (United States)

    Reginelli, Alfonso; D'Amora, Marilina; Del Vecchio, Lucia; Monaco, Luigi; Barillari, Maria Rosaria; Di Martino, Natale; Barillari, Umberto; Motta, Gaetano; Cappabianca, Salvatore; Grassi, Roberto

    2016-09-01

    Presbyphagia represents the physiological aging evolution of the swallowing function. It is related to the natural changes of the anatomical structures involved in the swallowing process. These age-related modifications can be asymptomatic in the early stages of life, but in the late stages, they could lead to dysphagia, aspiration pneumonia, dehydration, or malnutrition, reducing the quality of life. Videofluoromanometry (VFM) is the combined study of videofluoroscopy (VFS) and oropharyngeal manometry that allows simultaneous identification of functional and morphological features of the presbyphagia, also in asymptomatic otherwise healthy elderly adults. This study retrospectively evaluated the effectiveness of the VFM and the role of a multidisciplinary team of specialists in the analysis of a large cohort of old patients with presbyphagia, with the objective of achieving early diagnosis of the disease and the best therapy to delay the development of complications such as aspiration pneumonia, malnutrition, and dehydration. Copyright © 2016. Published by Elsevier Ltd.

  20. The influence of taste on swallowing apnea, oral preparation time, and duration and amplitude of submental muscle contraction.

    Science.gov (United States)

    Leow, L P; Huckabee, M-L; Sharma, S; Tooley, T P

    2007-02-01

    Prior research has documented a modulating effect of taste on swallowing. We hypothesized that presentation of tastant stimuli would be a significant variable in swallowing-respiratory coordination, duration of oral bolus preparation, and submental muscle contraction. Twenty-three healthy females were presented with 1-cm(3) gelatin samples flavored with 4 tastants of increasing intensities. Visual analogue scale ratings of perceived intensity of each were used to identify relative equivalent concentrations across the 4 tastants. Data were then collected during ingestion of 5 trials of the 4 equivalent tastants using measurements of nasal airflow and submental surface electromyography (sEMG) to record biomechanical measures. Chi-square analysis failed to identify a statistically significant influence of taste on the phase location of swallowing apnea. Repeated measures analysis of variance demonstrated significant taste effects for oral preparation time, submental sEMG amplitude, and duration (P Swallow duration for sour, salty, and bitter tastants were longer than sweet and neutral tastants. Sour tastants resulted in the greatest amplitude of submental muscle contraction during swallowing. This study supports existing research that found that sour substances were swallowed with more effort when compared with other tastes.

  1. Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Intensive Swallowing Rehabilitation for Chronic Stroke Dysphagia: A Case Series Study

    Science.gov (United States)

    Momosaki, Ryo; Abo, Masahiro; Kakuda, Wataru

    2014-01-01

    The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS) combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56–80 years; interval between onset of stroke and treatment: 24–37 months) with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS), Modified Mann Assessment of Swallowing Ability (MMASA), Functional Oral Intake Scale (FOIS), laryngeal elevation delay time (LEDT) and Repetitive Saliva-Swallowing Test (RSST) on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients. PMID:24803904

  2. Videofluoroscopy of the oral phase of swallowing in eight to twelve years old children with dental malocclusion.

    Science.gov (United States)

    Junqueira, Patricia; Costa, Milton Melciades

    2013-11-01

    The objective of this study was to describe the oral phase of swallowing in individuals with dental malocclusion and to generate data that would contribute to the rehabilitation of those patients. The study was based on the evaluation of the swallowing system through videofluoroscopy on thirty-four children of both genders, aged eight to twelve years old who present with Angle Class II and III dental malocclusions. Thirteen children of similar age and gender presenting normal dental occlusion formed the control group. The results indicated that the oral phase of swallowing is different between individuals with normal occlusion and malocclusion. Dental occlusion types Angle Class II and III did not present a swallowing pattern, independently of the amount of liquid ingested. The swallowing appeared effective in the oral phase of individuals with dental malocclusion, even though adaptations were identified. The outcome, in the absence of a single pattern and the efficiency of the adapted swallowing demonstrates, first a need for additional research investigating orofacial myofunctional treatment for patients with malocclusion and second how such analyses should focus on contributing positively to the rehabilitation of these patients.

  3. Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Intensive Swallowing Rehabilitation for Chronic Stroke Dysphagia: A Case Series Study

    Directory of Open Access Journals (Sweden)

    Ryo Momosaki

    2014-03-01

    Full Text Available The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56-80 years; interval between onset of stroke and treatment: 24-37 months with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS, Modified Mann Assessment of Swallowing Ability (MMASA, Functional Oral Intake Scale (FOIS, laryngeal elevation delay time (LEDT and Repetitive Saliva-Swallowing Test (RSST on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients.

  4. Benefit from the Chin-Down Maneuver in the Swallowing Performance and Self-Perception of Parkinson's Disease Patients

    Science.gov (United States)

    Jotz, Geraldo Pereira

    2017-01-01

    Aims. To verify the effectiveness of the maneuver application in swallowing therapy with PD. Materials and Method. We performed an open-label trial, with three groups compounds by PD individuals: the experimental group, control group, and orientation group. The study included PD patients with dysphagia. A cognitive screening, through a questionnaire about depression and quality of life, was conducted. Swallowing assessment was performed through (1) fiberoptic endoscopic evaluation of swallowing (FEES); (2) clinical evaluation and Functional Oral Intake Scale (FOIS); and (3) assessment of the quality life related to swallowing (SWALQOL). A therapeutic program, which consisted of chin-down postural maneuver and orientations on feeding, was applied. Both groups (EG and OG) received on-month therapeutic program. Results. A significant improvement in swallowing, evaluated by clinical assessment, was observed in solid (p < 0.001) and liquid (p = 0.022) consistencies in EG when compared to OG and CG. Patients in EG presented improvement in QoL, with the significant difference in comparison with the other groups, about domain frequency of symptoms (p = 0.029) in SWALQOL questionnaire. Conclusion. The postural maneuver chin-down improved swallowing performance and self-perception, but not the laryngeal signs. This trial is registered with registration number NCT02973698. PMID:28203475

  5. Visualization of swallowing using real-time TrueFISP MR fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Barkhausen, Joerg; Goyen, Mathias; Lauenstein, Thomas; Debatin, Joerg F. [Department of Diagnostic Radiology, University Hospital Essen (Germany); Winterfeld, F. von; Arweiler-Harbeck, Diana [Department of Otorhinolaryngology, University Hospital Essen (Germany)

    2002-01-01

    The aim of this study was to evaluate the ability of different real-time true fast imaging with steady precession (TrueFISP) sequences regarding their ability to depict the swallowing process and delineate oropharyngeal pathologies in patients with dysphagia. Real-time TrueFISP visualization of swallowing was performed in 8 volunteers and 6 patients with dysphagia using a 1.5 T scanner (Magnetom Sonata, Siemens, Erlangen Germany) equipped with high-performance gradients (amplitude 40 mT/m). Image quality of four different real-time TrueFISP sequences (TR 2.2-3.0 ms, TE 1.1-1.5 ms, matrix 63 x 128-135 x 256, field of view 250 mm{sup 2}, acquisition time per image 139-405 ms) was evaluated. Water, yoghurt, and semolina pudding were assessed as oral contrast agents. Functional exploration of the oropharyngeal apparatus was best possible using the fastest real-time TrueFISP sequence (TR 2.2 ms, TE 1.1 ms, matrix 63 x 128). Increased acquisition time resulted in blurring of anatomical structures. As the image contrast of TrueFISP sequences depends on T2/T1 properties, all tested foodstuff were well suited as oral contrast agents, but image quality was best using semolina pudding. Real-time visualization of swallowing is possible using real-time TrueFISP sequences in conjunction with oral contrast agents. For the functional exploration of swallowing high temporal resolution is more crucial than spatial resolution. (orig.)

  6. Piecemeal deglutition and dysphagia limit in normal subjects and in patients with swallowing disorders.

    Science.gov (United States)

    Ertekin, C; Aydoğdu, I; Yüceyar, N

    1996-11-01

    Before the advanced evaluation of deglutition and selection of a treatment method, objective screening methods are necessary for patients with dysphagia. In this study a new electroclinical test was established to evaluate patients with dysphagia. This test is based on determining piecemeal deglutition; which is a physiological phenomenon occurring when a bolus of a large volume is divided into two or more parts which are swallowed successively. The combined electrophysiological and mechanical method used to record laryngeal movements detected by a piezoelectric transducer, and activities of the related submental integrated EMG (SM-EMG)-and sometimes the cricopharyngeal muscle of the upper oesophageal sphincter (CP-EMG)-were performed during swallowing. Thirty normal subjects and 66 patients with overt dysphagia of neurogenic origin were investigated after detailed clinical evaluation. Twenty patients with a potential risk of dysphagia, but who were normal clinically at the time of investigation, were also evaluated to determine the specificity of the test. All subjects were instructed to swallow doses of water, gradually increasing in quantity from 1 ml to 20 ml, and any recurrence of the signals related to swallowing within the eight seconds was accepted as a sign of dysphagia limit. In normal subjects as well as in the patients without dysphagia, piecemeal deglutition was never seen with less than 20 ml water. This volume was therefore accepted as the lower limit of piecemeal deglutition. In patients with dysphagia, dysphagia limits were significantly lower than those of normal subjects. The method is a highly specific and sensitive test for the objective evaluation of oropharyngeal dysphagia even in patients with suspected dysphagia of neurogenic origin. It can also be safely and simply applied in any EMG laboratory.

  7. The effect of head and neck positions on oropharyngeal swallowing: a clinical and electrophysiologic study.

    Science.gov (United States)

    Ertekin, C; Keskin, A; Kiylioglu, N; Kirazli, Y; On, A Y; Tarlaci, S; Aydoğdu, I

    2001-09-01

    To determine the clinical usefulness of an electrophysiologic method for evaluating dysphagia and to identify the effects of various head and neck positions on oropharyngeal swallowing. Experimental, with control group. An electromyography laboratory. Patients with neurogenic dysphagia (n = 51) and healthy controls (n = 24). Patients were divided into 2 groups: those patients with unilateral lower cranial lesions (n = 9) and those without laterality in the function of the oropharyngeal muscles (n = 42). Subjects were instructed to swallow doses of water, gradually increasing in quantity from 1 to 25 mL under 5 conditions: neutral, chin up, chin tucked, head rotated right, and head rotated left. Change in dysphagia limit through specified head and neck postures. Oropharyngeal swallowing was evaluated by laryngeal movements that were detected by a piezoelectric sensor and electromyography of the submental muscle complex. Laryngeal sensor signals occurring within 8 seconds of a swallow were accepted as a sign of the dysphagia limit. In the control group, dysphagia limit did not change significantly with changes in head and neck postures, except for the chin-up posture (p Dysphagia limit improved significantly (p dysphagia limit occurred in 50% of patients in chin-tuck position, but in the chin-up position, 55% of the patients experienced a significant (p dysphagia limit. The electrophysiologic method of measuring dysphagia limit confirms neurogenic dysphagia and its severity in the neutral head position. Changes in head and neck positions do not significantly alter dysphagia limit in unimpaired subjects except for the chin-up position. Although the results obtained were not compared with other techniques (eg, videofluoroscopy), this simple electrophysiologic method for describing dysphagia limit may have a place in the evaluation of dysphagia and its variability in various head and neck positions.

  8. Electromyography and Mechanomyography Signals During Swallowing in Healthy Adults and Head and Neck Cancer Survivors.

    Science.gov (United States)

    Constantinescu, Gabriela; Hodgetts, William; Scott, Dylan; Kuffel, Kristina; King, Ben; Brodt, Chris; Rieger, Jana

    2017-02-01

    Surface electromyography (sEMG) is used as an adjuvant to dysphagia therapy to demonstrate the activity of submental muscles during swallowing exercises. Mechanomyography (MMG) has been suggested as a potential superior alternative to sEMG; however, this advantage is not confirmed for signal acquired from submental muscles. This study compared the signal-to-noise ratio (SNR) obtained from sEMG and MMG sensors during swallowing tasks, in healthy participants and those with a history of head and neck cancer (HNC), a population with altered anatomy and a high incidence of dysphagia. Twenty-two healthy adults and 10 adults with a history of HNC participated in this study. sEMG and MMG signals were acquired during dry, thin liquid, effortful, and Mendelsohn maneuver swallows. SNR was compared between the two sensors using repeated measures ANOVAs and subsequent planned pairwise comparisons. Test-retest measures were collected on 20 % of participants. In healthy participants, MMG SNR was higher than that of sEMG for dry [t(21) = -3.02, p = 0.007] and thin liquid swallows [t(21) = -4.24, p sEMG also showed much better test-retest reliability than MMG. Biofeedback provided as an adjuvant to dysphagia therapy in patients with HNC should employ sEMG technology, as this sensor type yielded better SNR and overall test-retest reliability. Poor MMG test-retest reliability was noted in both healthy and HNC participants and may have been related to differences in sensor application.

  9. Piecemeal deglutition and dysphagia limit in normal subjects and in patients with swallowing disorders.

    OpenAIRE

    1996-01-01

    OBJECTIVE: Before the advanced evaluation of deglutition and selection of a treatment method, objective screening methods are necessary for patients with dysphagia. In this study a new electroclinical test was established to evaluate patients with dysphagia. METHODS: This test is based on determining piecemeal deglutition; which is a physiological phenomenon occurring when a bolus of a large volume is divided into two or more parts which are swallowed successively. The combined electrophysiol...

  10. Characteristics of belching, swallowing, and gastroesophageal reflux in belching patients based on Rome III criteria.

    Science.gov (United States)

    Li, Jianbo; Xiao, Yinglian; Peng, Sui; Lin, Jinkun; Chen, Minhu

    2013-08-01

    Belching is a common disorder with undetermined pathogenesis. With the combined multichannel intraluminal impedance pH monitoring, two different models of belching have been defined: gastric belching (GB) and supragastric belching (SB). The aim of this study was to assess whether SB was associated with air swallowing as compared with GB or healthy volunteers based on Rome III criteria. Consecutive patients who presented with troublesome repetitive belching were recruited. Both upper endoscopy and multichannel intraluminal impedance pH monitoring were performed. Patients were divided into two groups: SB and GB groups according to the percentage of the predominant belching types. Twenty volunteers were enrolled as healthy controls. The number of air swallowing, regular swallowing, and gastroesophageal reflux profile was compared among the three groups. Thirty-seven patients were included in the study: 25 in the SB group and 12 in GB group. SB patients presented more belching events than GB patients (P 0.05). No significant difference was found among the three groups in regard with the reflux parameters (P > 0.05). The number of gas-containing reflux episodes were 33.0 (20.0, 48.0), 39.5 (29.5, 47.5), and 30.5 (27.0, 41.8) among SB, GB, and healthy volunteers (P = 0.383), respectively. SB patients presented with more belching events compared with GB patients. However, air swallowing and reflux profile were similar among the SB, GB patients, and normal controls. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  11. Murray secretion scale and fiberoptic endoscopic evaluation of swallowing in predicting aspiration in dysphagic patients.

    Science.gov (United States)

    Kuo, Chia-Wei; Allen, Clint Tanner; Huang, Chu-Chun; Lee, Chia-Jung

    2017-06-01

    The objective of this retrospective review is to evaluate the ability of the Murray secretion scale to predict aspiration as determined by fiberoptic endoscopic evaluation of swallowing. Patients with dysphagia undergoing a fiberoptic endoscopic evaluation of swallowing study between January 2013 and November 2015 from a single, tertiary care institution were retrospectively reviewed. The Murray secretion scale and penetration aspiration scale on fiberoptic endoscopic evaluation of swallowing examination were determined. Spearman's correlation analysis, sensitivity, specificity, predictive values, and relative risk evaluating the relationship between the Murray secretion scale and aspiration on fiberoptic endoscopic evaluation of swallowing were calculated. Subgroups of head and neck cancer patients, penetration group, and aspiration group were also analyzed. The mean age of the cases (N = 212) was 62.4 years. Eighty percent were male. There was a strong correlation between Murray secretion scale grade and penetration aspiration scale score (r = 0.785, p Murray secretion scale grade 2 or higher in predicting aspiration were 74 and 90%, respectively. Individuals with a Murray secretion scale grade of 2 or higher were 13.6 times more likely to aspirate than patients with a lower Murray secretion scale grade. All subgroups showed similar trend. Determination of a Murray secretion scale grade, determined by flexible nasopharyngoscopy, may predict patients at high risk for aspiration. In clinical scenarios where more complete assessments of aspiration risk are immediately impossible or impractical, the Murray secretion scale grade may add valuable information to assist in clinical decision-making in patients with dysphagia.

  12. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats

    OpenAIRE

    Anne Abysique; Catherine Tardivel; Jean-Denis Troadec; Bernadette Félix

    2015-01-01

    International audience; Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolu...

  13. Quantitative analysis of oropharyngeal swallowing in Neuronal Ceroid Lipofuscinosis with gastrostomy: case report

    OpenAIRE

    André Vinicius Marcondes Natel Sales; Paula Cristina Cola; Adriana Gomes Jorge; Fernanda Matias Peres; Rarissa Rúbia Dallaqua dos Santos; Célia Maria Giacheti; Roberta Gonçalves da Silva

    2013-01-01

    The presence of oropharyngeal dysphagia in the pediatric population with genetic diseases it is still poorly studied. The aim of this study was to analyze the oral total transit time and pharyngeal transit time, in an individual with neuronal ceroid lipofucinosis (NCL) with severe oropharyngeal dysphagia. Individual with NCL, 3 years old, 2 years with gastrostomy and no oral feeding, weighting loss, but without pulmonary complications. Oropharyngeal swallowing was studied by videofluoroscopy ...

  14. Quality of Life in Swallowing Disorders after Nonsurgical Treatment for Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Silveira, Marta Halina

    2014-12-01

    Full Text Available Introduction Radiotherapy or chemoradiotherapy can result in severe swallowing disorders with potential risk for aspiration and can negatively impact the patient's quality of life (QOL. Objective To assess swallowing-related QOL in patients who underwent radiotherapy/chemoradiotherapy for head and neck cancer. Methods We interviewed 110 patients (85 men and 25 women who had undergone exclusive radiotherapy (25.5% or concomitant chemoradiotherapy (74.5% from 6 to 12 months before the study. The Quality of Life in Swallowing Disorders (SWAL-QOL questionnaire was employed to evaluate dysphagia-related QOL. Results The QOL was reduced in all domains for all patients. The scores were worse among men. There was a relationship between oral cavity as the primary cancer site and the fatigue domain and also between advanced cancer stage and the impact of food selection, communication, and social function domains. Chemoradiotherapy association, the presence of nasogastric tube and tracheotomy, and the persistence of alcoholism and smoking had also a negative effect on the QOL. Conclusions According to the SWAL-QOL questionnaire, the dysphagia-related impact on QOL was observed 6 to 12 months after the treatment ended.

  15. Membrane potential and mechanical responses of the opossum esophagus to vagal stimulation and swallowing.

    Science.gov (United States)

    Rattan, S; Gidda, J S; Goyal, R K

    1983-10-01

    Studies were performed in anesthetized opossums. The electrical changes, recorded using a suction electrode applied to the outside of the esophagus, and mechanical activity, recorded by an intraluminal catheter, were monitored from 5 cm above the lower esophageal sphincter. Swallowing was associated with membrane hyperpolarization followed by depolarization and spike burst. Electrical stimulation of the decentralized vagus also caused a prompt hyperpolarization followed by an overshoot depolarization. Single pulses of stimulation caused primarily hyperpolarization. The amplitude and duration of hyperpolarization increased with increasing frequencies of vagal stimulation. Spike burst occurred as the membrane potential was recovering from the peak hyperpolarization and moving toward peak depolarization. The latency of onset of spike burst decreased with increasing frequency of vagal stimulation. The muscle contraction occurred after a latency. The latency of contractions, like the latency of spike burst, decreased with increased frequency of vagal stimulation. These studies show that (a) membrane hyperpolarization is present during the latent period of contraction associated with swallowing, suggesting that swallow-induced esophageal response may be mediated by vagal inhibitory pathway to the esophagus and (b) spike bursts can be temporally dissociated from depolarization by changing the vagal stimulation frequency, suggesting that spike burst and depolarization may be mediated by different excitatory mechanisms.

  16. Polychlorinated biphenyl exposure and effects in tree swallows (Tachycineta bicolor) residing at eight locations

    Science.gov (United States)

    Yorks, A.L.; Rattner, B.A.; Melancon, M.J.

    1998-01-01

    Twelve-day-old Tree Swallow nestlings were studied at eight sites exhibiting a range of polychlorinated biphenyl (PCB) contamination. In addition to determining PCB concentrations in eggs, nestlings, and food items, hepatic cytochromes P450-associated monooxygenase activity quantified as a biomarker of exposure. Nestlings from several of the sites exhibited elevated PCB concentrations and P450 induction compared to a reference site, Furthermore, cytochromes P450 were correlated with PCB concentrations in nestling. Our findings indicate that likely routes of exposure include the direct materna! deposition of PCBs into the egg and the delivery of contaminated emerging aquatic insects to nestlings. We also examined reproductive and morphological parameters to determine if PCB exposure was adversely affecting swallows at these sites. Hatching success did not differ among sites. There were no dramatic effects on gross and histological gonadal morphology of nestlings, and there was complete concordance between phenotypic sex (gonadal morphology) and genotypic sex (as determined by PCR amplification of the sex chromosome). However, where nestling PCB exposure was substantial, clutch size and body weight differed from a reference site. Despite evidence of PCB exposure, only modest effects were observed in nestling swallows.

  17. Assessment of swallowing in preterm newborns fed by bottle and cup.

    Science.gov (United States)

    López, Claudia Peyres; Chiari, Brasília Maria; Goulart, Ana Lúcia; Furkim, Ana Maria; Guedes, Zelita Caldeira Ferreira

    2014-01-01

    To compare the swallowing performance of premature infants using a cup and a bottle during the first offer of food by mouth. This study was carried out with preterm newborns who presented low weight at birth and no neurological illnesses, genetic syndromes or congenital malformations. The newborns were assessed by videofluoroscopy while using a cup and a bottle, when they reached a post-conceptual age of ≥34 weeks, weight ≥ 1,500 g and showed signs of readiness for oral feeding. All children were fed exclusively by gavage during the period prior to the study. This study included 20 preterm newborns, with average birth weight of 1,356 g and gestational age of 31.3 weeks. The majority of the bottle-fed newborns (68%) presented strong and rhythmic suction and 63% showed good sucking/swallowing/breathing coordination. The same percentage of newborns fed by cup (68%) could not perform the sipping movement and only 32% could suck a minimal amount of liquid contrast. There were no signs of laryngeal penetration and tracheal aspiration in both procedures. At the first oral feeding, preterm newborns showed better swallowing performance with a bottle in comparison to using a cup.

  18. Coordination of tongue activity during swallowing in mouth-breathing children.

    Science.gov (United States)

    Knösel, Michael; Klein, Sabine; Bleckmann, Annalen; Engelke, Wilfried

    2012-09-01

    Habitual mouth breathing is often accompanied by habitual anterior tongue thrust, instead of a lip closure, in order to create the anterior seal necessary for the initiation of physiological deglutition. We tested the null hypothesis of no significant influence of oral maneuver and the use of oral screens on tongue coordination and position during deglutition in 29 subjects (age = 6-16; mean = 9.69 years; 13/16 female/male) with habitual open-mouth posture using intraoral polysensography. The target parameters for swallowing were swallowing-associated nasal airflow interruption (NAI) and coordination of tongue-palate contact during NAI. Conventional myofunctional maneuvers could be facilitated and made more efficient, in terms of increasing the numbers of favorable early tongue-palate contacts typical of somatic swallowing, if accompanied by the application of an oral screen. Habitual open-mouth breathing does not necessarily coincide with distinctively pronounced proportions of late tongue-palate contact.

  19. A new hybrid optimization method inspired from swarm intelligence: Fuzzy adaptive swallow swarm optimization algorithm (FASSO

    Directory of Open Access Journals (Sweden)

    Mehdi Neshat

    2015-11-01

    Full Text Available In this article, the objective was to present effective and optimal strategies aimed at improving the Swallow Swarm Optimization (SSO method. The SSO is one of the best optimization methods based on swarm intelligence which is inspired by the intelligent behaviors of swallows. It has been able to offer a relatively strong method for solving optimization problems. However, despite its many advantages, the SSO suffers from two shortcomings. Firstly, partic