自愿用力对健康吞咽时颏下表面肌电活动的影响。
Effect of Volitional Effort on Submental Surface Electromyographic Activity During Healthy Swallowing.
机构信息
The University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand.
School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.
出版信息
Dysphagia. 2022 Apr;37(2):297-306. doi: 10.1007/s00455-021-10278-4. Epub 2021 Mar 9.
The effortful swallowing technique aims to compensate for or rehabilitate impaired swallowing by using maximal volitional effort to behaviorally modify aspects of swallowing physiology. Given that swallowing is a submaximal task, swallowing at submaximal levels has recently been suggested as a more task-specific therapeutic technique. The aim of this study was to investigate differences in muscle activity during minimum, regular, and maximum effort swallowing of different boluses and across different ages, with the goal of characterizing the task specificity of minimum effort and maximum effort swallowing. Forty-three healthy adults (22 female) representing four age groups (20-39, 40-59, 60-79, and 80 + years) participated in the study. They were verbally cued to swallow saliva and 5 mL water boluses using participant-determined minimum, regular, and maximum levels of effort, in randomized order. sEMG peak amplitude and duration of each swallow were measured. Linear mixed effects analyses demonstrated that compared to regular effort swallowing, maximum effort swallowing resulted in increased sEMG amplitude (p < .001) and prolonged duration (p < .001), while minimum effort swallowing resulted in decreased amplitude (p < .001) but no significant difference in duration (p = .06). These effects occurred regardless of age or bolus type. Differences in sEMG activity were smaller between regular and minimum effort swallowing than regular and maximum effort swallowing. Both increasing and decreasing volitional efforts during swallowing translate to significant modulation of muscle activity. However, regular swallowing is more similar to minimal effort swallowing. Results reinforce the concept of swallowing as a submaximal task, and provide insight into the development of sEMG biofeedback techniques for rehabilitation.
费力吞咽技术旨在通过最大的意志努力来补偿或康复受损的吞咽功能,从而对吞咽生理学的各个方面进行行为修正。由于吞咽是一种次最大任务,最近有人建议在次最大水平下进行吞咽,作为一种更具任务特异性的治疗技术。本研究旨在探讨不同大小的吞咽时不同年龄组的肌肉活动差异,以及不同努力程度吞咽时的肌肉活动差异,目的是描述最小努力和最大努力吞咽的任务特异性。43 名健康成年人(22 名女性)代表四个年龄组(20-39 岁、40-59 岁、60-79 岁和 80 岁及以上)参与了这项研究。他们被口头提示用自己确定的最小、正常和最大努力程度吞咽唾液和 5 毫升水,以随机顺序进行。测量了每次吞咽的 sEMG 峰值幅度和持续时间。线性混合效应分析表明,与正常努力吞咽相比,最大努力吞咽导致 sEMG 幅度增加(p<0.001)和持续时间延长(p<0.001),而最小努力吞咽导致幅度降低(p<0.001),但持续时间无显著差异(p=0.06)。这些影响与年龄或吞咽类型无关。正常努力吞咽和最小努力吞咽之间的 sEMG 活动差异小于正常努力吞咽和最大努力吞咽之间的差异。吞咽时增加和减少意志努力都会导致肌肉活动的显著调节。然而,正常吞咽与最小努力吞咽更为相似。结果强化了吞咽是一种次最大任务的概念,并为吞咽肌电生物反馈技术的康复应用提供了深入的见解。