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Abstract：
BACKGROUND: Oropharyngeal dysphagia is common after a stroke. Understanding the physiology of swallowing and its coordination with respiration in stroke recovery is crucially important.
METHODS: A non-invasive swallowing assessment method was used to detect oropharyngeal swallowing and respiration coordination simultaneously during the swallowing process. This system detected movement of the larynx, submental muscle activity, and nasal airflow. Six different sizes of water boluses (maximum of 20 mL) were swallowed and assessed for each subject.
RESULTS: We recruited 59 healthy participants and 38 first ever unilateral stroke patients completed baseline and follow-up assessments at 3, 6, and 9 months poststroke. The results showed that oropharyngeal swallowing parameters in unilateral stroke deviate from normal patterns. For respiration coordination, the unilateral stroke group had longer swallowing apnea duration but similar frequencies of pre- and postswallowing respiratory phase patterns compared with the healthy controls. The probability of piece-meal deglutition was higher in the stroke group than in the control group. Additionally, there were gradually decreasing piece-meal deglutition probabilities among the stroke patients at follow-up, and none differed statistically from those of the controls at 6 months poststroke.
CONCLUSIONS: The non-invasive swallowing and respiration assessment method applied in this study detected the changes manifested in swallowing and respiration during the subacute phase of recovery in 6 months after a unilateral stroke. The study results serve as a baseline for further research and help advance dysphagia research methodologies. These assessments may be combined with bedside evaluations for clinical application.
METHODS: A non-invasive swallowing assessment method was used to detect oropharyngeal swallowing and respiration coordination simultaneously during the swallowing process. This system detected movement of the larynx, submental muscle activity, and nasal airflow. Six different sizes of water boluses (maximum of 20 mL) were swallowed and assessed for each subject.
RESULTS: We recruited 59 healthy participants and 38 first ever unilateral stroke patients completed baseline and follow-up assessments at 3, 6, and 9 months poststroke. The results showed that oropharyngeal swallowing parameters in unilateral stroke deviate from normal patterns. For respiration coordination, the unilateral stroke group had longer swallowing apnea duration but similar frequencies of pre- and postswallowing respiratory phase patterns compared with the healthy controls. The probability of piece-meal deglutition was higher in the stroke group than in the control group. Additionally, there were gradually decreasing piece-meal deglutition probabilities among the stroke patients at follow-up, and none differed statistically from those of the controls at 6 months poststroke.
CONCLUSIONS: The non-invasive swallowing and respiration assessment method applied in this study detected the changes manifested in swallowing and respiration during the subacute phase of recovery in 6 months after a unilateral stroke. The study results serve as a baseline for further research and help advance dysphagia research methodologies. These assessments may be combined with bedside evaluations for clinical application.
摘要：
背景：中风后口咽吞咽困难很常见。了解吞咽的生理学及其在中风恢复中与呼吸的协调至关重要。
方法：采用无创吞咽评估方法，在吞咽过程中同时检测口咽吞咽和呼吸协调。这个系统检测到喉部的运动，下肌活动,和鼻腔气流。吞下六种不同大小的水团(最大20mL),并对每个受试者进行评估。
结果：我们招募了59名健康参与者和38名首次单侧卒中患者在卒中后3、6和9个月完成了基线和随访评估。结果表明，单侧中风口咽吞咽参数偏离正常模式。对于呼吸协调，与健康对照组相比,单侧卒中组的吞咽呼吸暂停持续时间较长,但吞咽前后呼吸时相模式的频率相似.卒中组发生点餐吞咽的概率高于对照组。此外,在随访时，中风患者的膳食吞咽概率逐渐降低，卒中后6个月与对照组无统计学差异。
结论：本研究中应用的非侵入性吞咽和呼吸评估方法检测了单侧中风后6个月亚急性恢复期吞咽和呼吸的变化。研究结果作为进一步研究的基线，并有助于推进吞咽困难的研究方法。这些评估可以与临床应用的床旁评估相结合。
方法：采用无创吞咽评估方法，在吞咽过程中同时检测口咽吞咽和呼吸协调。这个系统检测到喉部的运动，下肌活动,和鼻腔气流。吞下六种不同大小的水团(最大20mL),并对每个受试者进行评估。
结果：我们招募了59名健康参与者和38名首次单侧卒中患者在卒中后3、6和9个月完成了基线和随访评估。结果表明，单侧中风口咽吞咽参数偏离正常模式。对于呼吸协调，与健康对照组相比,单侧卒中组的吞咽呼吸暂停持续时间较长,但吞咽前后呼吸时相模式的频率相似.卒中组发生点餐吞咽的概率高于对照组。此外,在随访时，中风患者的膳食吞咽概率逐渐降低，卒中后6个月与对照组无统计学差异。
结论：本研究中应用的非侵入性吞咽和呼吸评估方法检测了单侧中风后6个月亚急性恢复期吞咽和呼吸的变化。研究结果作为进一步研究的基线，并有助于推进吞咽困难的研究方法。这些评估可以与临床应用的床旁评估相结合。
