Development of a program to maintain swallowing function in person with severe physical and intellectual disabilities

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K12007
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Social dentistry
• Research Institution: Osaka University
• Principal Investigator: Tanaka Nobukazu 大阪大学, 歯学部附属病院, 助教 (20570295)
• Co-Investigator(Kenkyū-buntansha): 野原 幹司 大阪大学, 歯学研究科, 准教授 (20346167)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 摂食嚥下障害 / 重症心身障害児者 / 嚥下頻度 / 嚥下機能 / 廃用

Outline of Final Research Achievements

In this study, we examined whether swallowing frequency in daily life is an index of swallowing function in patints with severe motor and intellectual disabilities (SMID). Fifty patients with SMID were included in this study. The swallowing frequency was measured three times for each case, and the reproducibility was examined. Further, we compared the swallowing frequencies of 30 patients who ingested food orally (group O) and 20 patients who were fed via tube feeding (group T).
The intraclass correlation coefficient in all the cases was almost perfect , indicating that the swallowing frequency in each subject was highly reproducible. Further, the mean swallowing frequency in group T was significantly lower than that in group O. These results suggest that in patients with SMID, the swallowing frequency in daily life was maintained within a certain range in each case; additionally, reduced swallowing frequency is associated with a decreased swallowing function.

Free Research Field

摂食嚥下障害

Academic Significance and Societal Importance of the Research Achievements

嚥下リハの適応が困難な重症児者にとって，廃用の予防は重要である．嚥下機能の廃用は，嚥下運動の減少による助長されると考えられているが，重症児者の日常の嚥下頻度については明らかではなかった．本研究では，重症児者の日常の嚥下頻度を測定し，被験者内では変動が少ないことを明らかにした．さらに，経口摂取をしていない被験者で嚥下頻度が有意に減少していること明らかにし，嚥下機能と嚥下頻度の多寡に関連があることを示した．
これらの結果は，日常の生理的な現象である嚥下の頻度が嚥下機能の指標として有用であること，「食べる」ことが自体が嚥下頻度を維持し，廃用を予防するための訓練となる可能性があることを示している．