Research On The Swallowing Behavior For Oropharyngeal Dysphagia

With the age of aging of population,dysphagia has become a major health problem facing our country.According to the severity of patients with oropharyngeal dysphagia,it is an important means to modify the food texture to match relatively safe functional food,and improve the life quality of patients and reduce the risk of swallowing.Due to the complexity of human swallowing system and the difficulty of in vivo data measurement,the law of oropharyngeal movement is still unclear.And it is difficult to explore the interaction between oropharyngeal movement and food texture,which hindering the treatment of dysphagia and the development of functional food.Therefore,this article studied the swallowing motion characteristics of patients with oropharyngeal dysphagia,designed and built an in vitro bionic swallowing device,and carried out in vitro swallowing research on fluid food.This study will provide support for the treatment of oropharyngeal dysphagia and the development of functional foods.First,based on retrospective data of videofluoroscopic swallowing of ALS patients admitted to the First Affiliated Hospital of Fujian Medical University,parameters of videofluoroscopic swallowing and oropharyngeal movement were collected to analyze the difference of swallowing characteristics among different populations.A neural network model using VFSS parameters to predict oropharyngeal motion was established.The results showed that compared with the normal swallowing group,the oral transport time,pharyngeal transport time and pharyngeal response time increased significantly in the abnormal swallowing group,while the laryngeal closure duration decreased significantly.In the abnormal swallowing group,the time point of complete closure of anterior tongue and posterior pharyngeal segment was delayed,the duration of movement of anterior tongue and posterior pharyngeal segment was prolonged,and the interval time of movement between oral and pharyngeal segment was increased.The R value between the output value of the neural network model and the target value reached 0.929,and the parameters of swallowing contrast could be used to predict the oropharyngeal movement of patients with dysphagia.Second,based on the motion law of oropharynx,the swallowing bionic device was designed.The Particleworks software was used to perform fluid simulation on the device model.The device was driven by stepper motors and controlled by Arduino in a 1:1 ratio.In vitro swallowing simulation was carried out to verify the effectiveness of the physical device.The results showed that the simulation trajectory of bolus was consistent with the real trajectory of swallowed bolus.In the simulation,the flow of bolus in the epiglottis at each time showed a good correlation with the real swallowing,and the correlation coefficient reached 0.86.In vitro simulated swallowing test could realize the purpose of continuous transportation of liquid pellets,and the positions of pellets at all times were basically consistent.The simulated swallowing time was close to the real swallowing time,and the simulated swallowing pressure was within the range of the real swallowing pressure,which verifies the effectiveness of the physical device.And last,based on the evaluation methods of rheology and tribology,the rheological properties and lubrication properties of thickener solutions with different concentrations of soybean protein isolate and other three common thickeners were studied under soft friction conditions.At the same time,the swallowing simulation test was carried out on the bionic swallowing device in vitro in the oropharyngeal dysphagia conditions.The results showed that the shear viscosity of soybean protein isolate solution increased with the increase of concentration.The use of soy protein isolate can improve the viscosity of fluid food and increase the safety of swallowing.Soybean protein isolate solution showed good lubrication characteristics.Compared with starch and xanthan gum thickeners,soy protein isolate solution has lower friction coefficient,which can bring more comfortable taste for patients with dysphagia.In addition,the viscosity and volume of thickened fluid had significant effects on the swallowing time and swallowing pressure in vitro,that is,higher fluid viscosity and smaller fluid volume can produce longer swallowing time.And swallowing pressure was positively correlated with swallowing volume,which was close to the real swallowing rule of human body and will provide better guidance for the development of functional food for patients with swallowing disorders.