University of Pittsburgh, PA.
University of Wisconsin-Madison.
J Speech Lang Hear Res. 2021 Jan 14;64(1):75-90. doi: 10.1044/2020_JSLHR-20-00048. Epub 2020 Dec 17.
Purpose During videofluoroscopic examination of swallowing, patients commonly are instructed to hold a bolus in their mouth until they hear a verbal instruction to swallow, which usually consists of the word and is commonly referred to as the command swallow condition. The language-induced motor facilitation theory suggests that linguistic processes associated with the verbal command to swallow should facilitate the voluntary component of swallowing. As such, the purpose of the study was to examine the linguistic influences of the verbal command on swallowing. Method Twenty healthy young adult participants held a 5-ml liquid bolus in their mouth and swallowed the bolus after hearing one of five acoustic stimuli presented randomly: congruent action word (), incongruent action word (), congruent pseudoword (), incongruent pseudoword (), and nonverbal stimulus (1000-Hz pure tone). Suprahyoid muscle activity during swallowing was measured via surface electromyography (sEMG). Results The onset and peak sEMG latencies following the congruent action word were shorter than latencies following the pure tone and pseudowords but were not different from the incongruent action word. The lack of difference between and did not negate the positive impact of real words on timing. In contrast to expectations, sEMG activity duration and rise time were longer following the word than the pure tone and pseudowords but were not different from . No differences were observed for peak suprahyoid muscle activity amplitude and fall times. Conclusions Language facilitation was observed in swallowing. The clinical utility of the information obtained in the study may depend on the purposes for using the command swallow and the type of patient being assessed. However, linguistic processing under the command swallow condition may alter swallow behaviors and suggests that linguistic inducement could be useful as a compensatory technique for patients with difficulty initiating oropharyngeal swallows.
目的 在吞咽的荧光透视检查过程中,患者通常被指示将一口食物含在口中,直到听到吞咽的口头指令,该指令通常由单词 组成,通常称为命令吞咽条件。语言诱导运动促进理论表明,与吞咽口头指令相关的语言过程应该促进吞咽的自愿成分。因此,本研究的目的是检查口头命令对吞咽的语言影响。
方法 20 名健康的年轻成年参与者将 5 毫升液体含在口中,然后随机听到五种声学刺激中的一种后吞咽:一致的动作词 ()、不一致的动作词 ()、一致的伪词 ()、不一致的伪词 ()和非语言刺激 (1000Hz 纯音)。通过表面肌电图 (sEMG) 测量吞咽时舌骨上肌的活动。
结果 与纯音和伪词相比,在听到一致的动作词 后,sEMG 的起始和峰值潜伏期较短,但与纯音和伪词相比,与不一致的动作词 没有差异。 与 之间的差异并不否定实义词对时间的积极影响。与预期相反,sEMG 活动持续时间和上升时间在听到 字后比纯音和伪词长,但与 字没有差异。没有观察到峰值舌骨上肌活动幅度和下降时间的差异。
结论 在吞咽中观察到语言促进作用。研究中获得的信息的临床应用可能取决于使用命令吞咽的目的和评估的患者类型。然而,在命令吞咽条件下进行语言处理可能会改变吞咽行为,并表明语言诱导可能对难以开始口咽吞咽的患者有用作为一种补偿技术。