Elucidation of the optimal period of PAP therapy aiming at oral ingestion by ALS patients.

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K20753
• Project/Area Number (Other): 16H07002 (2016-2018)
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund (2019); Single-year Grants (2016-2018)
• Research Field: Prosthodontics/ Dental materials science and
• Research Institution: Hiroshima University
• Principal Investigator: Hiraoka Aya 広島大学, 病院(歯), 歯科診療医 (60781812)
• Project Period (FY): 2016-08-26 – 2021-03-31
• Keywords: 歯学 / 舌圧 / ALS / 舌接触補助床

Outline of Final Research Achievements

The purpose of this study was to clarify the optimal start time and end criteria for palatal augmentation prosthesis (PAP) therapy in patients with amyotrophic lateral sclerosis (ALS). We followed the time course of maximal tongue pressure and oral intake and swallowing kinetics in 35 patients. PAP was prepared in 8 patients. As a result, the relationship between the maximum tongue pressure and the residue of epiglottis valley was found. Furthermore, with PAP attached, the approach to the oral phase was successful. From this, it was considered that muscle weakness in the oral phase was the main cause in the early stage of ALS progression. It may be possible to extend the period of oral intake by controlling the body weight from an early stage using the maximum tongue pressure. The time when muscle weakness and delayed swallowing reflex were observed during the pharyngeal phase was considered to be end criteria of PAP.

Free Research Field

歯学

Academic Significance and Societal Importance of the Research Achievements

ALS患者の嚥下障害は急速に進行するため，早期からの対応が必要であるが，モニタリングのため頻回に行うことのできる確立された定量的検査はほとんどない．舌圧検査は舌機能を定量評価でき，侵襲の少ない検査法だが，ALS患者の嚥下機能との関連の報告は少ない．近年ALS患者の嚥下および構音障害に対して舌接触補助床（PAP）を用いた治療が行われているが，ALS患者に対するPAP適用の報告は少なく，PAP装着と経口摂取期間の関連や，その終了基準は明らかになっていない．
本研究では，ALS患者を長期に追跡し，最大舌圧と経口摂取状況の変化の関連を調べ，さらにPAPの有効性とその終了基準について考察した．