Abstract:
Resting pressure at the upper oesophageal sphincter (UOS) has been reported to be susceptible to factors such as emotional stress or respiration. This exploratory study investigated the potential for behavioural modulation of UOS resting pressure in healthy adults to increase our understanding of volitional control of UOS pressure, and the potential development of rehabilitation approaches. Six healthy adults were seen one hour daily for two weeks (10 days) and for one post-training session after a training break of two weeks. Manipulation of UOS resting pressure was practised during a protocol of alternating increased and decreased pressure. A high-resolution manometry contour plot was used as a biofeedback modality. Participants were asked to explore how to achieve warmer and cooler colours (pressure increase and decrease, respectively) at the UOS resting pressure band, without changing head position or manipulating activity of other muscles. Performance was analysed prior to training start and following daily training. Participants were able to increase resting pressure following one week of practice; however, there was no evidence for purposeful pressure decrease. The increased resting pressure achieved by participants indicates a capacity for purposeful pressure modulation given intensive biofeedback training. The lack of volitional reduction in pressure may be explained by sustained pressure generation due to the intrinsic muscular characteristics of the UOS and a flooring effect in healthy subjects, in whom physiology mandates a minimum degree of resting pressure to fulfil the barrier function. Distention caused by the presence of the intraluminal catheter cannot be ruled out.
摘要:
据报道,食管上括约肌(UOS)的静息压力易受情绪压力或呼吸等因素的影响。这项探索性研究调查了健康成年人对UOS静息压力的行为调节的潜力,以增加我们对UOS压力的自愿控制的理解。以及康复方法的潜在发展。六个健康成年人每天一小时,持续两周(10天),并在两周的训练休息后进行一次训练。在交替增加和降低压力的方案期间实施UOS静息压力的操纵。高分辨率测压轮廓图被用作生物反馈模式。参与者被要求探索如何实现更温暖和更冷的颜色(压力增加和减少,分别)在UOS静止压力带,不改变头部位置或操纵其他肌肉的活动。在训练开始之前和日常训练之后分析表现。参与者能够在一周的练习后增加静息压力;然而,没有证据表明有目的的压力降低.参与者获得的静息压力增加表明,在进行强化生物反馈训练的情况下,有目的的压力调节能力。由于UOS的内在肌肉特征和健康受试者的地板效应,压力缺乏自愿降低可以通过持续的压力产生来解释。在其中,生理学要求最低程度的静息压力来实现屏障功能。不能排除由腔内导管的存在引起的扩张。