| Project/Area Number |
21500500
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Rehabilitation science/Welfare engineering
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| Research Institution | Fujita Health University (2011)
Kawasaki Medical School (2009-2010) |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
YAMAMOTO Toshiyasu 岡山理科大学, 工学部, 教授 (20412158)
METANI Hiromichi 川崎医科大学, 医学部, 講師 (30330583)
椿原 彰夫 川崎医科大学, 医学部, 教授 (10138117)
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| Co-Investigator(Renkei-kenkyūsha) |
TSUBAHARA Akio 川崎医科大学, 医学部, 教授 (10138117)
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| Project Period (FY) |
2009 – 2011
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| Project Status |
Completed (Fiscal Year 2011)
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| Budget Amount *help |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2011: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2010: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2009: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 嚥下障害 / 電気刺激 / リハビリテーション医学 / 摂食・嚥下障害 / A型ボツリヌス毒素 / 治療的電気刺激 / 輪状咽頭筋 |
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| Research Abstract |
We evaluated the effectiveness of a cricopharyngeal block using a local anesthetic agent in advance and administered BTX-A injections in various patients with dysphagia. The criteria for this study were : (1) patients with a history of dysphagia who did not improve with conventional swallowing therapy after more than 3 months, (2) oropharyngeal dysphagia in which UES dysfunction appeared to be the primary cause based on videofluorography. A percutaneous lidocaine injection into the cricopharyngeal muscle was first administered in patients who met the above criteria in order to determine the application of BTX-A injections. In cases where the lidocaine injection was judged to improve the passage of bolus in the area of UES using videofluorography, the patients then received a BTX-A injection. Thirty-nine patients met the criteria for the lidocaine injection. The BTX-A injection was done for 28 patients(72%). In 26 patients out of this group(93%), the passage of bolus improved in the area of UES at 1 month after the BTX-A injection. BTX-A is a very effective treatment in selected patients. A local anesthetic agent trial may predict the effectiveness of BTX-A injection.
From the viewpoint of functional electric stimulation(FES), we investigated a surface electrode stimulation method to support laryngeal elevation in helthy subjects and patients with pharyngeal dysphagia. Informed consent was obtained from 15 healthy men and 4 patients with pharyngeal dysphagia. Digastric and stylohyoid muscles were stimulated by silver-textile surface electrodes covering the muscle belly. Laryngeal elevation by the electrical stimulation(ES) during liquid(water, 3ml) swallowing movement was measured by digital video camera. Laryngeal elevation by ES was 76% in the healthy subjects and 87% in patients when measured during liquid swallowing. Applying FES for laryngeal elevation may assist in improving the swallowing reflex.
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