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Kinematics and coordinative dynamics in normal human swallowing.

机译:正常人吞咽的运动学和协调动力学。

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摘要

The tongue functions as the primary articulator during deglutition, responsible both for controlled bolus transfer from the mouth to the pharynx, and for initiation of the pharyngeal phase of swallowing. Several authors have proposed that swallowing behaviours are modifiable, and vary across tasks. These assumptions form the basis for many clinical intervention strategies in dysphagia management. This research sought empirical evidence of systematic modulation in oral motor behaviours in swallowing, related to manipulations of task (rate) and bolus characteristics.; Electromagnetic midsagittal articulography (EMMA) was used to trace tongue and jaw movements during swallowing. Eight healthy subjects, in two age-defined cohorts (under 30; over 50) participated. A data corpus of approximately 4400 swallows was collected.; Analysis of a discrete water swallow reference task (chapter 2) demonstrates the validity of the EMMA method for characterizing tongue behaviours during swallowing, and shows stability in swallowing behaviours across sessions. A comparison of discrete and sequential swallows (chapter 3) failed to find evidence of frequency-dependent scaling in movement amplitudes. Rather, subjects showed economy of effort (fewer movement oscillations per swallow) and simplification of the motor pattern (reduced variability in tongue and jaw movements) as the rate of repeated swallowing increased. Similarly, higher frequencies of swallowing were associated with reduced variability in coordinative relationships between different segments of the tongue and the jaw (chapter 6).; With respect to the influence of bolus consistency on swallowing behaviours, a previously unreported phenomenon of bolus density-related modulation in sip-size is described. Limited evidence of bolus consistency influences on the spatio-temporal characteristics of tongue behaviours during swallowing was observed (chapters 4, 5).; Age-cohort differences were evident throughout this investigation. Older subjects produced a higher number of movement oscillations per swallow and showed greater variability in oral motor behaviour for swallowing. Scaling of tongue movement amplitudes to bolus size was observed only in younger subjects.; In the concluding chapter, the potential for using EMMA to elucidate future research questions regarding oral motor modulation in swallowing is explored. A coordinative dynamics model is proposed to account for reported variations in the timing of pharyngeal swallow initiation across boluses of different consistency.
机译:舌头在脱水过程中起主要发音器的作用,既负责从口腔到咽部的快速推注转移,也负责咽下咽部的吞咽。几位作者提出吞咽行为是可修改的,并且随任务而异。这些假设构成吞咽困难管理中许多临床干预策略的基础。这项研究寻求经验性证据,证明吞咽中口腔运动行为的系统调节与任务(速率)和推注特性的操纵有关。电磁中矢状关节造影(EMMA)用于追踪吞咽过程中舌头和颌骨的运动。参加了两个年龄组(30岁以下; 50岁以上)的健康受试者。收集了大约4400个燕子的数据集。对不连续的吞咽参考任务(第2章)的分析证明了EMMA方法在吞咽过程中表征舌头行为的有效性,并显示了整个疗程中吞咽行为的稳定性。比较离散的和连续的吞咽(第3章)无法找到运动幅度随频率变化的比例的证据。相反,随着重复吞咽率的增加,受试者表现出努力的经济性(每次吞咽的动作振动更少)和运动模式的简化(减少了舌头和颌骨运动的变异性)。同样,较高的吞咽频率与减少舌头和颌骨不同部分之间协调关系的变异性有关(第6章)。关于大剂量稠度对吞咽行为的影响,描述了以前未报道的小剂量的大剂量密度相关调制现象。推注一致性对吞咽期间舌头行为的时空特征影响的证据有限(第4、5章)。在整个调查过程中,年龄组差异明显。年龄较大的受试者每次吞咽会产生更多的运动振荡,并且吞咽的口腔运动行为表现出较大的变异性。仅在年轻受试者中观察到舌头运动幅度到推注大小的比例。在最后一章中,探讨了使用EMMA阐明有关吞咽中口腔运动调节的未来研究问题的潜力。提出了一个协调动力学模型,以解释所报告的咽咽开始时间跨不同稠度的变化。

著录项

  • 作者

    Steele, Catriona Margaret.;

  • 作者单位

    University of Toronto (Canada).;

  • 授予单位 University of Toronto (Canada).;
  • 学科 Health Sciences Speech Pathology.; Biology Animal Physiology.
  • 学位 Ph.D.
  • 年度 2003
  • 页码 280 p.
  • 总页数 280
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;生理学;
  • 关键词

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