帕金森病患者的呼吸-吞咽测量及食团保持的影响
Respiratory-swallowing Measures and the Impact of Bolus Hold in Individuals with Parkinson's Disease.
文献信息
| PMID | 42848084 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Rabab Rangwala |
| 作者单位 | Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, School of Communication, Northwestern University, 2240 Campus Drive, Evanston, IL, 60208, USA. rababrangwala2024@u.northwestern.edu. |
| 期刊 | Dysphagia |
| SCI 分区 | Q1 |
| IF | 3.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 呼吸和吞咽障碍在帕金森病（PD）中很常见，可能破坏呼吸-吞咽协调。本研究旨在1）检查PD患者在不同食团稠度和吞咽任务下的呼吸-吞咽相位模式及呼吸停止持续时间，以及2）探讨“食团保持”言语提示对这些指标的影响。方法：20名PD患者（平均年龄=71.7岁，6名女性）完成了14次吞咽试验，食团稠度不同（稀薄、花蜜、蜂蜜、布丁、固体），任务不同（5mL、20mL），每个试验呈现两次。使用呼吸感应体积描记法和鼻导管记录呼吸运动学和气流测量。使用描述性统计、估计方程和线性模型分析食团稠度、吞咽任务和食团保持对相位模式和停止持续时间的影响。结果：与健康成人相比，参与者表现出次优的呼吸-吞咽相位模式，但停止持续时间最佳。趋势表明，较稠和较小的食团与EX-EX模式增加相关，较稠的稠度，花蜜（p=0.049）、蜂蜜（p=0.002）、布丁（p=0.002），与稀薄液体相比显著缩短了停止持续时间。食团保持条件倾向于最佳模式和更短的停止持续时间，在稀薄5mL（p=0.035）、稀薄杯啜20mL（p=0.020）和布丁（p=0.025）稠度中模式有显著变化，在稀薄杯啜20mL吞咽中停止持续时间有显著变化（p=0.014）。结论：了解这些因素如何影响呼吸相位模式和停止持续时间——气道保护和食团清除的关键要素——对PD患者吞咽康复中使用的临床指导和策略具有重要意义。
英文摘要
Respiratory and swallowing impairments are common in Parkinson's disease (PD), potentially disrupting respiratory-swallow coordination. This study aimed 1) to examine respiratory-swallowing phase patterns and respiratory cessation duration in individuals with PD across varying bolus consistencies and swallow tasks, and 2) to investigate the influence of the 'bolus hold' verbal cue on these measures. Twenty individuals with PD (mean age = 71.7 years, 6 female) completed 14 swallow trials with varying bolus consistencies (thin, nectar, honey, pudding, solid) and tasks (5mL, 20mL) with each trial presented twice. Respiratory kinematic and airflow measures were recorded using respiratory inductance plethysmography and nasal cannula. Descriptive statistics, estimating equations, and linear models were used to analyze the effects of bolus consistency, swallow task, and bolus hold on phase patterns and cessation duration. Participants exhibited sub-optimal respiratory-swallowing phase patterns but optimal cessation durations, compared to healthy adults. Trends indicated that thicker and smaller boluses were associated with increased EX-EX patterns, and thicker consistencies, nectar (p = 0.049), honey (p = 0.002), pudding (p = 0.002), significantly shortened cessation durations compared to thin liquids. The bolus hold condition trended towards optimal patterns and shorter cessation durations, with significant changes in pattern for thin 5mL (p = 0.035), thin cup sip 20mL (p = 0.020), and pudding (p = 0.025) consistencies, and in cessation duration for thin cup sip 20 mL swallows (p = 0.014). Understanding how these factors contribute to respiratory phase patterns and cessation durations, critical elements for airway protection and bolus clearance, has significant implications for clinical instructions and strategies used with individuals with PD during swallowing rehabilitation.