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不同舌位和舌长度的含舌吞咽过程中的舌压力产生及颏下表面肌电活动

Tongue Pressure Production and Submental Surface Electromyogram Activities During Tongue-Hold Swallow with Different Holding Positions and Tongue Length.

作者信息

Fujiwara Shigehiro, Fujiu-Kurachi Masako, Hori Kazuhiro, Maeda Yoshinobu, Ono Takahiro

机构信息

Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 5274, 2-bancho, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.

Graduate School of Rehabilitation, Niigata University of Rehabilitation, Murakami, Japan.

出版信息

Dysphagia. 2018 Aug;33(4):403-413. doi: 10.1007/s00455-017-9865-4. Epub 2017 Nov 24.

Abstract

Our previous study regarding the tongue-hold swallow (THS) demonstrated that the tongue-to-palate contact during THS could be influenced by the maximum tongue protrusion length (MTPL) of individual subjects, resulting in two different patterns of pressure generation. The present study further analyzed the influence of MTPL on the tongue pressure production along with submental surface electromyography (sEMG) during THS, in order to establish an index to better control THS effects. Tongue pressure using a sensor sheet system and concurrent submental sEMG activities were measured during swallowing tasks in 18 healthy young adults. Task conditions comprised THS at two different degrees of tongue protrusion and dry swallow. Tongue pressures and sEMG activities were compared among three task conditions, and correlations of MTPL with tongue pressure were also investigated. Additionally, a ROC curve was used to find a cut-off value for MTPL to predict changes (increases and decreases) in tongue pressure during THS. The duration and the amount of submental muscle activity increased concurrently during THS. Two trends were shown on the change in tongue pressure at the posterior-circumferential part of the hard palate during THS compared to dry swallow; the maximal magnitude and the integrated value of tongue pressure increased in some subjects, while these values decreased in others. Thirty-two millimeters was found to be the cut-off value of MTPL, which distinguishes increase/decrease pattern of tongue pressure with sensitivities of 60.0-85.7%. The present finding suggests that more reliable THS effects should be attainable using MTPL to set the tongue-hold position.

摘要

我们之前关于舌持吞咽(THS)的研究表明,THS过程中舌与上颚的接触可能会受到个体受试者最大舌前伸长度(MTPL)的影响,从而导致两种不同的压力产生模式。本研究进一步分析了MTPL对THS过程中舌压力产生的影响以及颏下表面肌电图(sEMG),以便建立一个指标来更好地控制THS的效果。在18名健康年轻成年人的吞咽任务中,使用传感器片系统测量舌压力,并同步测量颏下sEMG活动。任务条件包括两种不同舌前伸程度的THS和干吞咽。比较了三种任务条件下的舌压力和sEMG活动,并研究了MTPL与舌压力的相关性。此外,使用ROC曲线来寻找MTPL的临界值,以预测THS过程中舌压力的变化(增加和减少)。在THS过程中,颏下肌肉活动的持续时间和量同时增加。与干吞咽相比,THS过程中硬腭后圆周部分的舌压力变化呈现出两种趋势;一些受试者的舌压力最大值和积分值增加,而另一些受试者的这些值则下降。发现32毫米是MTPL的临界值,它以60.0 - 85.7%的敏感性区分舌压力的增加/减少模式。目前的研究结果表明,使用MTPL来设定舌持位置应该能够获得更可靠的THS效果。

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