Steele Catriona M, Van Lieshout Pascal H H M
Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
Dysphagia. 2004 Summer;19(3):192-206. doi: 10.1007/s00455-004-0006-5.
Thickened liquids are a commonly recommended intervention for dysphagia. Previous research has documented differences in temporal aspects of bolus transit for paste versus liquid consistencies; however, the influence of liquid viscosity on tongue movements during swallowing remains unstudied. We report an analysis of the influence of bolus consistency on lingual kinematics during swallowing. Electromagnetic midsagittal articulography was used to trace tongue body and dorsum movement during sequential swallows of three bolus consistencies: thin, nectar-thick, and honey-thick liquids. Rheological profiling was conducted to characterize viscosity and density differences among six liquids (two of each consistency). Eight healthy volunteers participated; four were in a younger age cohort (under age 30) and four were over the age of 50. The primary difference observed across the liquids of interest was a previously unreported phenomenon of sip-mass modulation; both flavor and density appeared to influence sip-sizing behaviors. Additionally, significantly greater variability in lingual movement patterns was observed in the older subject group. Systematic variations in lingual kinematics related to bolus consistency were restricted to the variability of downward tongue dorsum movement. Otherwise, the present analysis failed to find empirical evidence of significant modulations in tongue behaviors across the thin to honey-thick consistency range.
浓稠液体是吞咽困难时常用的推荐干预措施。以往研究记录了糊状与液体状食团通过时间方面的差异;然而,液体粘度对吞咽时舌运动的影响仍未得到研究。我们报告了一项关于食团稠度对吞咽时舌运动学影响的分析。采用电磁矢状面关节造影术,在依次吞咽三种食团稠度(稀液体、花蜜状浓稠液体和蜂蜜状浓稠液体)的过程中追踪舌体和舌背的运动。进行流变学分析以表征六种液体(每种稠度两种)之间的粘度和密度差异。八名健康志愿者参与;四名属于较年轻队列(30岁以下),四名年龄超过50岁。在所关注的液体中观察到的主要差异是一种此前未报告的啜饮量调制现象;味道和密度似乎都影响啜饮量大小行为。此外,在老年受试者组中观察到舌运动模式的变异性显著更大。与食团稠度相关的舌运动学系统变化仅限于舌背向下运动的变异性。否则,本分析未能找到在稀到蜂蜜状浓稠度范围内舌行为有显著调制的实证证据。