2021 Fiscal Year Final Research Report

Establishment of pharyngeal strengthening exercise using Swallowing CT and manometry

Research Project

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Project/Area Number	19K11310
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 59010:Rehabilitation science-related
Research Institution	Fujita Health University
Principal Investigator	Inamoto Yoko 藤田医科大学, 保健学研究科, 教授 (70612547)
Co-Investigator(Kenkyū-buntansha)	青柳陽一郎藤田医科大学, 医学部, 准教授 (30286661) 加賀谷斉藤田医科大学, 医学部, 教授 (40282181) 柴田斉子藤田医科大学, 医学部, 准教授 (40319265) 才藤栄一藤田医科大学, 医学部, 教授 (50162186)
Project Period (FY)	2019-04-01 – 2022-03-31
Keywords	摂食嚥下 / 咽頭収縮 / CT / マノメトリー / 嚥下手技
Outline of Final Research Achievements	This study focused on two main points: 1) to clarify the kinematic effect of the swallowing maneuvers by the Kinematic analysis using 320-ADCT and 2) to clarify the validity of visual feedback using manometry during pharyngeal contraction exercise, to establish the evidence for swallowing exercise for pharyngeal contraction during swallowing. Kinematic analysis showed that the Mendelsohn maneuver facilitated the onset of hypopharyngeal contraction, meanwhile, the Effortful swallow facilitated the contraction of upper part of pharyngeal contraction. Also, it is suggested that the instruction of Effortful swallow is critical for the efficient pharyngeal construction. Visual feedback using manometry was shown to be effective for the patients with pharyngeal residue in increasing the pressure of upper pharynx and the base of tongue during swallowing. It is suggested that visual feedback promotes the well-coordinated swallowing and the tips to strengthen the pharyngeal contraction.
Free Research Field	リハビリテーション
Academic Significance and Societal Importance of the Research Achievements	嚥下訓練法のなかで，咽頭収縮を強化する訓練法や手技はその運動学的効果についていまだエビデンスが不十分である．また嚥下リハビリテーションでは，最適な訓練法の選択とともに重要な要点の一つとして効率の良い運動学習をもたらすフィードバック方法が挙げられるが，咽頭収縮の練習法のフィードバックに対しては方法論が確立されていない．本研究にて，手技の運動学的効果を示すことができ，臨床で用いている嚥下手技の適応と効果を明らかにすることができた．また咽頭収縮強化においてマノメトリーにょる視覚的フィードバックの有効性を示すことができ，訓練方法の精緻化につなげることができた．