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Ziegler W, Staiger A, Schölderle T. Profiles of Dysarthria: Clinical Assessment and Treatment. Brain Sci 2023; 14:11. [PMID: 38248226 PMCID: PMC10813547 DOI: 10.3390/brainsci14010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024] Open
Abstract
In recent decades, we have witnessed a wealth of theoretical work and proof-of-principle studies on dysarthria, including descriptions and classifications of dysarthric speech patterns, new and refined assessment methods, and innovative experimental intervention trials [...].
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Affiliation(s)
- Wolfram Ziegler
- Clinical Neuropsychology Research Group (EKN), Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, 80799 Munich, Germany; (A.S.); (T.S.)
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Sawada T, Okawara H, Nakashima D, Iwabuchi S, Matsumoto M, Nakamura M, Nagura T. Effects of alternating heat and cold stimulation at different cooling rates using a wearable thermo device on shoulder muscle stiffness: a cross-over study. BMC Musculoskelet Disord 2022; 23:669. [PMID: 35831832 PMCID: PMC9281090 DOI: 10.1186/s12891-022-05623-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background A small, wearable thermo device that uses Peltier elements for programmed heat and cold stimulation has been developed recently and is expected to be applied in conventional contrast bath therapy. This study was aimed to examine improvements in trapezius muscle hardness and subjective symptoms resulting from alternating heat and cold stimulation, with different rates of cooling. Methods This cross-over study included four conditions. Twenty healthy young male individuals (age, 22.3 ± 4.5 years) participated in this study. These four interventions targeted the unilateral trapezius muscle of the dominant arm after a 15-min typing task. Specifically, heat and cold stimulations were applied at different ratios (the heating/cooling rate of 3:1, 3:2, and 3:3) or not applied. Each intervention was separated by at least one week. Skin temperature at the stimulation area was recorded using a data logger. Outcome measures included muscle hardness (measured using a portable tester) and subjective symptoms (muscle stiffness and fatigue). Each item was assessed at three time points: baseline, after typing, and after the intervention. Results Two-way analysis of variance with repeated measures found an interaction effect for muscle hardness between four conditions (3:1, 3:2, 3:3, and no) and three time points (p < 0.05). Only in the 3:1 condition were the post-intervention values lower than those after typing (p < 0.01). There was also an interaction effect for subjective muscle stiffness (p < 0.05); the values after the intervention in the 3:1 condition were lower than those after intervention in the no stimulation condition (p < 0.01). There was no significant relationship between changes in muscle hardness and changes in subjective symptoms in the 3:1 condition. Conclusions Our results demonstrate that alternating heat and cold stimulations with a different cooling rate could affect the degree of improvement in muscle hardness and subjective symptoms. In particular, the 3:1 condition has the possibility to improved muscle hardness within the condition and subjective muscle stiffness between conditions. Trial registration UMIN000040620. Registered 1 June 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046359 Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05623-z.
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Affiliation(s)
- Tomonori Sawada
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Hiroki Okawara
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Daisuke Nakashima
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan. .,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
| | - Shuhei Iwabuchi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takeo Nagura
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Kumar A, Munirji L, Nayif S, Almotairy N, Grigoriadis J, Grigoriadis A, Trulsson M. Motor Performance and Skill Acquisition in Oral Motor Training With Exergames: A Pilot Study. Front Aging Neurosci 2022; 14:730072. [PMID: 35309890 PMCID: PMC8924593 DOI: 10.3389/fnagi.2022.730072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To investigate the effects of oral-motor training with exergames on motor performance and motor skill acquisition in two different age groups. Methods Thirty-two healthy participants were recruited in the current pilot study and divided equally into two groups (Gen Z and Baby Boomers) according to their age. A pair of electromyographic (EMG) electrodes were placed on the participants’ masseter muscles. The EMG device communicated via Bluetooth with a mobile video game in response to the electromyographic activity of the masseter muscles during clenching. During the experimental session, participants were asked to play a video game in five blocks of 5 min each, with a 3-min break between each time block. The goal of the game was to collect as many coins (game points) as possible and to dodge/avoid upcoming obstacles (game life). Motor performance was assessed by performance scores and the number of game lives. Skill acquisition was measured by task efficiency (ratio of performance scores and number of game lives) across time blocks. Results The results of the study showed significantly lower performance scores (p < 0.001), a higher number of game lives (p < 0.001), and lower task efficiency in the Baby Boomer group compared to the Gen Z group. Specifically, the results showed that there was a significant difference in task efficiency between the first and second, third and fourth, fourth- and fifth-time blocks in the Gen Z group (p < 0.002). However, there was only a significant difference between first- and second-time blocks in the Baby Boomer group (p = 1.012), suggesting that skill acquisition in the Baby Boomer group did not change significantly over the course of the time blocks. Conclusion The study showed higher motor performance and superior motor skill acquisition with novel exergame training in the Gen Z group compared to the Baby Boomer group. The results of the study indicate that there is an improvement in oral motor skills with short-term training, yet the differences in oral motor skills between the two groups are still evident. The Baby Boomer group, unlike the Gen Z group, did not show robust improvement in task efficiency over the course of the series.
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Affiliation(s)
- Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- *Correspondence: Abhishek Kumar,
| | - Linda Munirji
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sam Nayif
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Nabeel Almotairy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | - Joannis Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Anastasios Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Mats Trulsson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Sawada T, Okawara H, Nakashima D, Iwabuchi S, Matsumoto M, Nakamura M, Nagura T. Effects of alternating heat and cold stimulation using a wearable thermo-device on subjective and objective shoulder stiffness. J Physiol Anthropol 2022; 41:1. [PMID: 34980256 PMCID: PMC8722412 DOI: 10.1186/s40101-021-00275-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 12/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Technological innovations have allowed the use of miniature apparatus that can easily control and program heat and cold stimulations using Peltier elements. The wearable thermo-device has a potential to be applied to conventional contrast bath therapy. This study aimed to examine the effects of alternating heat and cold stimulation (HC) using a wearable thermo-device on subjective and objective improvement of shoulder stiffness. METHODS Twenty healthy young male individuals (20.3 ± 0.6 years) participated in this study. The interventions were randomly conducted under four conditions, including HC, heat stimulation, cold stimulation, and no stimulation on their bilateral trapezius muscle, after a 30-min typing task. Each intervention was administered at least 1 week apart. The analyzed limb was the dominant arm. Muscle hardness was assessed using a portable muscle hardness meter, as well as the skin temperature over the stimulated area. After each condition, the participants were asked for feedback regarding subjective improvement in refreshed feelings, muscle stiffness, and muscle fatigue using an 11-point numerical rating scale. RESULTS With regard to muscle hardness, only the HC condition significantly decreased from 1.43 N to 1.37 N (d = 0.44, p < 0.05). Additionally, reduced muscle hardness in HC condition was associated with the degree of skin cooling during the intervention (cold max: r = 0.634, p < 0.01; cold change: r = -0.548, p < 0.05). Subjective improvement in refreshed feelings, muscle stiffness, and muscle fatigue was determined in the HC and heat stimulation conditions compared with the no stimulation condition (p < 0.01 and p < 0.05, respectively). Moreover, the HC condition showed significantly greater improvements in muscle stiffness and fatigue compared to the cold stimulation condition (p < 0.05). CONCLUSIONS The current study demonstrated that HC promoted not only better subjective symptoms, such as muscle stiffness and fatigue, but also lesser muscle hardness. Furthermore, an association was observed between the degree of skin temperature cooling and reduced muscle hardness during HC. Further investigations on the ratio and intensity of cooling should be conducted in the future to establish the optimal HC protocol for muscle stiffness or fatigue. TRIAL REGISTRATION UMIN000040620 . Registered 1 June 2020.
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Affiliation(s)
- Tomonori Sawada
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Hiroki Okawara
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Daisuke Nakashima
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan. .,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
| | - Shuhei Iwabuchi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takeo Nagura
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Izumi M, Akifusa S. Tongue cleaning in the elderly and its role in the respiratory and swallowing functions: Benefits and medical perspectives. J Oral Rehabil 2021; 48:1395-1403. [PMID: 34612518 DOI: 10.1111/joor.13266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
Abstract
Oral dysfunction, including oral uncleanness and decline in tongue motor function, tongue pressure and swallowing function, precedes frailty. The tongue's dorsum is a reservoir of oral microbiota, desquamated epithelial mucosa and leukocytes due to the multi-papillate anatomy, and leads to tongue coating. The tongue coating is frequently found in older adults because of hyposalivation, immunity's hypoactivity, diminished motor function and compromised tongue's pressure with age. Anaerobe-driven volatile sulphur compounds in tongue coating are a major cause of intra-oral malodor. Dysbiosis of the tongue-coating microbiome rather than the amount of microorganisms is associated with a risk of aspiration pneumonia. Daily tongue cleaning with a brush or scraper is an easy way to control tongue coating deposits and quality. Using mouth wash or rinse-containing germicides is also a way to control the microbiota of tongue coating. The tongue function is closely related to swallowing. Tongue and suprahyoid muscles are linked with respiratory muscles through the endothoracic fascia. The mechanical stimulation during the cleaning of the tongue may stimulate the respiratory muscles. An intervention trial revealed that tongue cleaning by mucosal brush improves tongue pressure, swallowing and respiratory function in old residents of nursing homes, suggesting a rehabilitative effect of tongue cleaning on the swallowing and respiratory functions, preventing aspiration pneumonia. This narrative review assesses the tongue-cleaning benefits for respiratory and swallowing functions and the possibility of preventing aspiration pneumonia.
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Affiliation(s)
- Maya Izumi
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | - Sumio Akifusa
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
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Schimmel M, Aarab G, Baad-Hansen L, Lobbezoo F, Svensson P. A conceptual model of oro-facial health with an emphasis on function. J Oral Rehabil 2021; 48:1283-1294. [PMID: 34462948 PMCID: PMC9292770 DOI: 10.1111/joor.13250] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/14/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022]
Abstract
The individual inclination to lead an autonomous life until death is associated with requirements that may be of physiological, psychosocial and environmental nature. We aim to describe a conceptual oro‐facial health model with an emphasis on oro‐facial function, taking the domains of quality of life and patient‐centred values into account. In the context of oro‐facial function, the requirements of life are met when the oro‐facial system is in a fit state. ‘Fitness of the oro‐facial system, that is oro‐facial health, is a state that is characterised by an absence of, or positive coping with physical disease, mental disease, pain and negative environmental and social factors. It will allow natural oro‐facial functions such as sensing, tasting, touching, biting, chewing, swallowing, speaking, yawning, kissing and facial expression’. In the presented conceptual model of oro‐facial health, it is postulated that each individual has present and future potentials related to biological prerequisites and resources that are developed by an individual through the course of life. These potentials form the oro‐facial functional capacity. When the individual potentials together do not meet the requirements of life anymore, dysfunction and disease result. The oro‐facial system is subject to physiological ageing processes, which will inevitably lead to a decrease in the oro‐facial functional capacity. Furthermore, comorbid medical conditions might hamper oro‐facial function and, alongside with the ageing process, may lead to a state of oral hypofunction. Currently, there is a lack of widespread, validated, easy‐to‐use instruments that help to distinguish between states of oro‐facial fitness as opposed to oral hypofunction. Clearly, research is needed to establish adequate, validated instruments alongside with functional rehabilitation procedures.
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Affiliation(s)
- Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lene Baad-Hansen
- Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Peter Svensson
- Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.,Faculty of Odontology, Malmø University, Sweden
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Jafar MR, Nagesh DS. Literature review on assistive devices available for quadriplegic people: Indian context. Disabil Rehabil Assist Technol 2021; 18:1-13. [PMID: 34176416 DOI: 10.1080/17483107.2021.1938708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/01/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This literature review aims to find the current state of the art in self-help devices (SHD) available for people with quadriplegia. MATERIALS AND METHODS We searched original articles, technical and case studies, conference articles, and literature reviews published between 2014 to 2019 with the keywords ("Self-help devices" OR "Assistive Devices" OR "Assistive Product" OR "Assistive Technology") AND "Quadriplegia" in Science Direct, Pubmed, IEEE Xplore digital library and Web of Science. RESULTS Total 222 articles were found. After removing duplicates and screening these articles based on their title and abstracts 80 articles remained. After this, we reviewed the full text, and articles unrelated to SHD development or about the patients who require mechanical ventilation or where the upper limb is functional (C2 or above and T2 or below injuries) were discarded. After the exclusion of articles using the above-mentioned criterion 75 articles were used for further review. CONCLUSION The abandonment rate of SHD currently available in the literature is very high. The major requirement of the people was independence and improved quality of life. The situation in India is very bad as compared to the developed countries. The people with spinal cord injury in India are uneducated and very poor, with an average income of 3000 ₹ (41$). They require SHDs and training specially designed for them, keeping their needs in mind.Implications for rehabilitationPeople with quadriplegia are totally dependent on caregivers. Assistive devices not only help these people to do day-to-day tasks but also provides them self-confidence.Even though there are a lot of self-help devices currently available, still they are not able to fulfil the requirements of people with quadriplegia, hence there is a very high abandonment rate of such devices.This study provides an evidence that developing devices after understanding the functional and non-functional requirements of these subjects will decrease the abandonment rate and increase the effectiveness of the device.The results of this study can be used for planning and developing assistive devices which are more focussed on fulfilling the requirements of people with quadriplegia.
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Affiliation(s)
- Mohd Rizwan Jafar
- Department of Mechanical Engineering, Delhi Technological University, Delhi, India
| | - D S Nagesh
- Department of Mechanical Engineering, Delhi Technological University, Delhi, India
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Furlan RMMM, Santana GA, Motta AR, Casas EBDL. An instrument for tongue performance assessment in activities associated with digital games: content and construct validity. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212359621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to analyze the content and construct validity of an instrument for tongue performance assessment in activities associated with digital games. Methods: to analyze content validity, ten speech-language pathologists answered a questionnaire in which each item of the instrument and the set of items were judged as to its representativeness. The content validity index and the modified Kappa statistics were calculated. To analyze construct validity, 20 participants, with age between 8 and 13 years, (10 children with weak tongues and 10 children with normal tongue strength) performed a game activity with the T-Station, involving 12 targets with 2 N of strength and 5 s of time for sustained contraction for each target. The performance was compared, for each item of the instrument, between groups. Results: most of the items obtained satisfactory score according to the speech-language pathologist’s evaluation. Children with reduced tongue force had a poorer performance than those with normal tongue force, with a statistically significant difference in three items of the instrument. Conclusion: the instrument proved to be valid as a method for evaluating performance in activities associated with the T-Station.
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Virtual Reality-Based Cognitive-Motor Rehabilitation in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Study on Motivation and Cognitive Function. Healthcare (Basel) 2020; 8:healthcare8030335. [PMID: 32932997 PMCID: PMC7551774 DOI: 10.3390/healthcare8030335] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/03/2022] Open
Abstract
The purpose of this study was to investigate the effects of virtual reality-based cognitive–motor rehabilitation (VRCMR) on the rehabilitation motivation and cognitive function in older adults. This study enrolled 40 older adults with mild cognitive impairment (MCI), living in the community. The subjects were randomly assigned to a VRCMR group (n = 20) or a conventional cognitive rehabilitation (CCR) group (n = 20). The VRCMR group underwent VRCMR using MOTOcog, a computer recognition program, whereas the CCR group underwent conventional cognitive rehabilitation, which included puzzles, wood blocks, card play, stick construction activity, and maze activity. Both interventions were performed 30 min per day, 5 days/week, for 6 weeks. This study performed a cognitive assessment using the Montreal Cognitive Assessment (MoCA) scale, Trail Making Test A and B (TMT-A/B), and Digit Span Test forward and backward (DST-forward/backward). In addition, a 0-to-10 numeric rating self-report scale was used to assess interest and motivation during the rehabilitation training. After the intervention, the VRCMR group showed a significantly greater improvement in the MoCA (p = 0.045), TMT-A (p = 0.039), TMT-B (p = 0.040), and DST-forward (p = 0.011) scores compared to the CCR group, but not in the DST-backward score (p = 0.424). In addition, subjects in the experimental group had significantly higher interest (p = 0.03) and motivation (p = 0.03) than those in the control group. Cohen’s d effect size was 0.4, 0.3, 0.35, 0.4, and 0.5 for the MoCA, TMT-A, TMT-B, DST-forward, and DST-backward tests, respectively. This study demonstrates that VRCMR enhances motivation for rehabilitation and cognitive function in older adults with MCI better than CCR.
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Amaral MS, Furlan RMMM, de Las Casas EB, Motta AR. The influence of tongue mobility on children's performance in computer games that depend on lingual movements. J Oral Rehabil 2020; 47:1233-1241. [PMID: 33464606 DOI: 10.1111/joor.13050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/01/2020] [Accepted: 06/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alteration in tongue mobility requires rehabilitation work through oral motor exercises. These exercises can be integrated with computer games to increase the patient's motivation during treatment. OBJECTIVE To investigate the influence of tongue mobility on children's motor performance in a computer game reliant on lingual movements. METHODS A cross-sectional descriptive observational study was carried out with 16 children with altered tongue mobility and 16 children with normal tongue mobility. The subjects were between 8 and 12 years of age. They underwent a clinical evaluation of the tongue and performed an activity using an intra-oral joystick controlled by the tongue to play a simple computer game. The game consisted of targets appearing on the screen that the participants had to reach by moving the joystick control rod. Afterward, the participants answered a feedback questionnaire. Motor performance in the game, measured by the number of reached targets and by the time to reach the targets, was compared between groups and across directions of tongue movement and order of appearance of the targets. RESULTS The group with altered tongue mobility presented a higher time to reach the target in the downward direction and in the first and last 12 targets and a lower number of targets reached in the left direction, upward direction, and in the first 12 targets than the control group. The direction of the movement influenced tongue performance in both groups. CONCLUSION Children with altered tongue mobility exhibited a worse performance than those with normal tongue mobility.
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Affiliation(s)
- Mariana S Amaral
- Graduate Program in Speech Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Renata M M M Furlan
- Department of Speech Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Estevam B de Las Casas
- Department of Structural Engineering, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Andréa R Motta
- Department of Speech Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Furlan RMMM, Santana GA, Amaral MS, Motta AR, de Las Casas EB. The influence of tongue strength on children's performance in computer games reliant on lingual force generation. J Oral Rehabil 2020; 47:872-879. [PMID: 32080882 DOI: 10.1111/joor.12951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 01/14/2020] [Accepted: 02/15/2020] [Indexed: 11/30/2022]
Abstract
Oral motor exercises, for recovering tongue strength, can be integrated with computer games to increase motivation, especially for treatments in children. The aim of this study was to investigate the influence of tongue strength on motor performance in computer games reliant on lingual force generation. An observational study was carried out at a speech-language pathology outpatient university clinic. Twenty participants (10 with normal tongue strength and 10 with reduced tongue strength) aged 8-13 years used an intra-oral joystick controlled by the tongue to play six computer games during which they had to reach targets that appeared on the screen. Motor performance was measured by the number of attempts to score and the time during which the target force was maintained. Tongue motor performance was compared between groups and across directions of tongue movement, resistance force levels, order of target appearance, continuous force application time on the target, age and sex. Children with normal tongue strength had a lower number of attempts to score (P = .014) and maintained the target force for longer periods (P = .002) than those with reduced tongue strength. The performance was better for both groups (a) in the downward direction compared with the performance in other directions, (b) in games with the lowest resistive force level (0.5 N) compared to those with other levels of resistive force and (c) in the second and third rounds compared with the first round. There were no gender-related differences in performance. Older participants performed better than younger participants. Tongue strength, direction of movement, force to reach the target, time of continuous force application, order of target appearance and age influenced tongue motor performance.
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Affiliation(s)
| | - Guilherme André Santana
- Graduate Program in Structural Engineering, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana Souza Amaral
- Graduate Program in Speech Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Andréa Rodrigues Motta
- Department of Speech Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Hwang N, Kim M, Lee G, Yoon T, Park J, Jung Y. Effect of tongue‐strengthening training combined with a tablet personal computer game in healthy adults. J Oral Rehabil 2020; 47:606-612. [DOI: 10.1111/joor.12944] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/14/2020] [Accepted: 02/09/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Na‐Kyoung Hwang
- Department of Occupational Therapy Seoul North Municipal Hospital Seoul Korea
| | - Min‐Ji Kim
- Division of Health Sciences Department of Dental HygieneDongSeo University Busan Korea
| | - Gihyoun Lee
- Department of Physical and Rehabilitation Medicine Center for Prevention and Rehabilitation Heart Vascular Stroke Institute Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea
| | - Taehyung Yoon
- Division of Health Sciences Department of Occupational Therapy Dongseo University Seoul Korea
| | - Ji‐Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry Dongseo University Busan Korea
| | - YoungJin Jung
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry Dongseo University Busan Korea
- Division of Health Sciences Department of Radiological Science DongSeo University Busan Korea
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Park JS, Lee G, Choi JB, Hwang NK, Jung YJ. Game-based hand resistance exercise versus traditional manual hand exercises for improving hand strength, motor function, and compliance in stroke patients: A multi-center randomized controlled study. NeuroRehabilitation 2020; 45:221-227. [PMID: 31498145 DOI: 10.3233/nre-192829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Game-based exercise is effective for improving strength and motor function in stroke patients undergoing rehabilitation, and it creates fun and motivation for exercise. OBJECTIVE We investigated the effect of game-based exercise on hand strength, motor function, and compliance in stroke patients. METHODS Fifty stroke patients were randomly divided into experimental and control groups. The experimental group performed a game-based hand resistance exercise. This exercise was divided into isotonic and isometric types and was performed 30 min/day, 5 days/week, for 6 weeks with 70% of the 1-repetition maximum. In contrast, the control group was given a traditional manual exercise by the occupational therapist, and the type of exercise and time involved were the same as those in the experimental group. The primary outcome measure was hand strength test measured using a dynamometer. Secondary outcome measures were manual function tests (MFT) and hand function tests using box and block test (BBT). Subject-based reports of motivation, fun, pain/fatigue evaluated on 0 to 10 numeric rating scales were compared between groups. RESULTS After training, hand strength, MFT and BBT was improved in the experimental group compared to the control group (P < 0.001, both). Subject-based reports of motivation and fun was significantly greater in the experimental group than the control group (P < 0.001, both), except to pain/fatigue (P = 0.728). CONCLUSIONS In conclusion, we demonstrated that game-based exercise is more effective than manual exercise in improving muscle strength, motor function, and compliance in stroke patients.
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Affiliation(s)
- Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan, South Korea
| | - Gihyoun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong-Bae Choi
- Department of Occupational Therapy, Kyunghee Medical Center, Seoul, South Korea
| | - Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, Seoul, Republic of Korea
| | - Young-Jin Jung
- Department of Radiological Science at Health Sciences Division, DongSeo University, Busan, South Korea
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Park JS, Jung YJ, Kim HH, Lee G. A Novel Method Using Kinesiology Taping for the Activation of Suprahyoid Muscles in Healthy Adults: A Preliminary Research. Dysphagia 2019; 35:636-642. [PMID: 31620860 DOI: 10.1007/s00455-019-10071-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/01/2019] [Indexed: 01/27/2023]
Abstract
The suprahyoid muscles play a major role in safe swallowing in the pharyngeal phase. Therefore, it is clinically important to design a therapeutic approach for strengthening the suprahyoid muscles for safe and normal swallowing. This study aimed to investigate the activation of suprahyoid muscles by resistance training using kinesiology taping (KT). We enrolled 23 healthy adults. All participants performed saliva swallowing five times at 5 s intervals in three conditions (without KT, 50% stretch with KT, and 80% stretch with KT). KT in the I and reverse V shapes was pulled vertically from the hyolaryngeal complex to the sternum and medially from the superior surface of the clavicle, respectively. Another KT horizontally covered the hyolaryngeal complex to enhance the movement restriction of the hyolaryngeal complex during swallowing. Activation of the suprahyoid muscles during swallowing in the two conditions was measured using surface electromyography. In addition, a 0-10 numerical rating self-report scale was used to evaluate the required effort and the resistance felt during swallowing. Both KT 50% and 80% were significantly higher in surface electromyography (sEMG) mean value, peak value, required effort, and resistance felt during swallowing compared to normal swallowing (p < 0.05). In addition, KT 80% was significantly higher in sEMG value, peak value, required effort, and resistance felt during swallowing than KT 50% (p < 0.05). This study demonstrated that KT applied to the area under the hyolaryngeal complex improves activation of the suprahyoid muscle during swallowing. Therefore, KT applied as resistance during swallowing is considered to have therapeutic potential in dysphagia rehabilitation.
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Affiliation(s)
- Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, 47 Jurye-ro, Sasang-gu, Busan, 47011, Republic of Korea
| | - Young-Jin Jung
- Department of Radiological Science, Health Sciences Division, DongSeo University, V318, 47 Jurye-ro, Sasang-gu, Busan, 47011, Republic of Korea.
| | - Hwan-Hee Kim
- Department of Occupational Therapy, Semyung University, 66 Semyeong-ro, Jecheon-si, Chungcheongbuk-do, 27136, Republic of Korea
| | - Gihyoun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
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Furlan RMMM, Santana GA, Bischof WF, Motta AR, Las Casas EB. A new method for tongue rehabilitation with computer games: Pilot study. J Oral Rehabil 2019; 46:518-525. [DOI: 10.1111/joor.12775] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 12/19/2018] [Accepted: 01/30/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Guilherme André Santana
- Graduate Program in Structural Engineering Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Walter F. Bischof
- Department of Computing Science University of Alberta Edmonton Alberta Canada
| | - Andréa Rodrigues Motta
- Department of Speech Language Pathology and Audiology Universidade Federal de Minas Gerais Belo Horizonte Brazil
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Fougeront N, Fleiter B. Temporomandibular disorder and comorbid neck pain: facts and hypotheses regarding pain-induced and rehabilitation-induced motor activity changes. Can J Physiol Pharmacol 2018; 96:1051-1059. [PMID: 30067068 DOI: 10.1139/cjpp-2018-0100] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
According to the "pain adaptation model", temporomandibular disorder (TMD)-related pain induces a paradoxical activity of masticatory muscles: an agonistic hypoactivity during jaw closing and an antagonistic activity during jaw opening (agonist/antagonist co-activation). However, this model suffers several weaknesses; notably, it does not explain all types of neck muscle activities in neck pain (NP), which is a very prevalent TMD comorbid condition. In NP, neck muscle antagonistic activity is increased, and agonistic activity is decreased as postulated by the pain adaptation model. However, synergistic and compensatory activity may occur and agonistic activity may be unchanged or even increased as postulated within the "vicious cycle theory". Thus, both theories would apply partly as outlined currently in musculoskeletal disorders (MSD). Besides pain, psychological stress may also induce motor dysfunction in TMD and NP. In NP, rehabilitation may increase agonistic activity and decrease compensatory activity and antagonistic activity, thus inducing a switch from agonist/antagonist co-activation towards reciprocal inhibition. Thus, rehabilitation-induced motor activity changes constitute a new research field that should improve MSD therapeutics. Additionally, immature tongue function (so-called infantile swallow) might be connected to TMD where low agonistic activity of masticatory muscles would be compensated by facial muscle hyperactivity during oropharyngeal phase of deglutition.
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Affiliation(s)
- Nicolas Fougeront
- a Consultation de troubles fonctionnels oro-faciaux, service de médecine bucco-dentaire/odontologie, groupe hospitalier Pitié-Salpétrière Charles-Foix, 94200 Ivry-sur-Seine, France
| | - Bernard Fleiter
- a Consultation de troubles fonctionnels oro-faciaux, service de médecine bucco-dentaire/odontologie, groupe hospitalier Pitié-Salpétrière Charles-Foix, 94200 Ivry-sur-Seine, France.,b Faculté de chirurgie dentaire, Université René Descartes, Paris, France
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Tăut D, Pintea S, Roovers JPWR, Mañanas MA, Băban A. Play seriously: Effectiveness of serious games and their features in motor rehabilitation. A meta-analysis. NeuroRehabilitation 2018; 41:105-118. [PMID: 28527226 DOI: 10.3233/nre-171462] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Evidence for the effectiveness of serious games (SGs) and their various features is inconsistent in the motor rehabilitation field, which makes evidence based development of SGs a rare practice. OBJECTIVE To investigate the effectiveness of SGs in motor rehabilitation for upper limb and movement/balance and to test the potential moderating role of SGs features like feedback, activities, characters and background. METHODS We ran a meta-analysis including 61 studies reporting randomized controlled trials (RCTs), controlled trials (CTs) or case series designs in which at least one intervention for motor rehabilitation included the use of SGs as standalone or in combination. RESULTS There was an overall moderate effect of SGs on motor indices, d = 0.59, [95% CI, 0.48, 0.71], p < 0.001. Regarding the game features, only two out of 17 moderators were statistically different in terms of effect sizes: type of activity (combination of group with individual activities had the highest effects), and realism of the scenario (fantasy scenarios had the highest effects). CONCLUSIONS While we showed that SGs are more effective in improving motor upper limb and movement/balance functions compared to conventional rehabilitation, there were no consistent differences between various game features in their contribution to effects. Further research should systematically investigate SGs features that might have added value in improving effectiveness.
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Affiliation(s)
- Diana Tăut
- Department of Psychology, Babeş-Bolyai University of Cluj-Napoca, Cluj-Napoca, Romania
| | - Sebastian Pintea
- Department of Psychology, Babeş-Bolyai University of Cluj-Napoca, Cluj-Napoca, Romania
| | - Jan-Paul W R Roovers
- Department of Gynaecology, Amsterdam Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Miguel-Angel Mañanas
- Biomedical Engineering Research Centre, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Adriana Băban
- Department of Psychology, Babeş-Bolyai University of Cluj-Napoca, Cluj-Napoca, Romania
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Kumar A, Kothari M, Grigoriadis A, Trulsson M, Svensson P. Bite or brain: Implication of sensorimotor regulation and neuroplasticity in oral rehabilitation procedures. J Oral Rehabil 2018; 45:323-333. [DOI: 10.1111/joor.12603] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2017] [Indexed: 02/04/2023]
Affiliation(s)
- A. Kumar
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - M. Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - A. Grigoriadis
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - M. Trulsson
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - P. Svensson
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
- Section of Orofacial Pain and Jaw Function; Institute for Odontology and Oral Health; Aarhus University; Aarhus Denmark
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Kothari M, Stubbs PW, Figlewski K, Pedersen AR, Jensen J, Baad-Hansen L, Svensson P, Nielsen JF. Effect of transcranial direct current stimulation on neuroplasticity in corticomotor pathways of the tongue muscles. J Oral Rehabil 2017; 44:691-701. [DOI: 10.1111/joor.12529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - P. W. Stubbs
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - K. Figlewski
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - A. R. Pedersen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - J. Jensen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - L. Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Department of Odontology and Oral Health; Aarhus University; Hammel
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
| | - P. Svensson
- Section of Orofacial Pain and Jaw Function, Department of Odontology and Oral Health; Aarhus University; Hammel
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
- Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - J. F. Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
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Hadley AJ, Krival KR, Ridgel AL, Hahn EC, Tyler DJ. Neural network pattern recognition of lingual-palatal pressure for automated detection of swallow. Dysphagia 2015; 30:176-87. [PMID: 25618539 DOI: 10.1007/s00455-014-9593-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 12/27/2014] [Indexed: 11/26/2022]
Abstract
We describe a novel device and method for real-time measurement of lingual-palatal pressure and automatic identification of the oral transfer phase of deglutition. Clinical measurement of the oral transport phase of swallowing is a complicated process requiring either placement of obstructive sensors or sitting within a fluoroscope or articulograph for recording. Existing detection algorithms distinguish oral events with EMG, sound, and pressure signals from the head and neck, but are imprecise and frequently result in false detection. We placed seven pressure sensors on a molded mouthpiece fitting over the upper teeth and hard palate and recorded pressure during a variety of swallow and non-swallow activities. Pressure measures and swallow times from 12 healthy and 7 Parkinson's subjects provided training data for a time-delay artificial neural network to categorize the recordings as swallow or non-swallow events. User-specific neural networks properly categorized 96 % of swallow and non-swallow events, while a generalized population-trained network was able to properly categorize 93 % of swallow and non-swallow events across all recordings. Lingual-palatal pressure signals are sufficient to selectively and specifically recognize the initiation of swallowing in healthy and dysphagic patients.
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Affiliation(s)
- Aaron J Hadley
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Room 309 Wickenden Building, Cleveland, OH, 44106, USA,
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