多模态咀嚼评估方案的开发

文献信息

中文摘要

目的： 在言语-语言病理学领域，唯一经过验证的非仪器化咀嚼评估是固体咀嚼与吞咽测试。该评估方案适用性和生态效度有限，因为它不能反映典型膳食，而典型膳食涉及更大的量和多样的质地。认识到需要对咀嚼进行更全面的评估，本研究旨在开发并评估一种针对口腔准备期的新型评估方案，研究对象为具有典型咀嚼/吞咽的健康参与者。该方案包括基于文献的咀嚼参数测量、变色口香糖和运动分析。
方法： 采用被试内设计，50名参与者咀嚼一块变色口香糖，并使用国际照明委员会L*a*b*（CIELAB）值进行分析。参与者咀嚼一根小胡萝卜、一块酥饼和一颗Hi-Chew糖果。咀嚼次数通过人工计数，并进一步使用二维运动分析进行测量。参与者完成了一份评估该评估方案的社会效度问卷。CIELAB值与咀嚼参数使用Pearson r进行相关性分析。人工计数与运动分析数据之间的一致性使用组内相关系数进行检验。社会效度问卷的Likert量表回答进行描述性统计分析。
结果： 平均CIELAB值反映了现有的常模数据；然而，未观察到比色数据与咀嚼参数之间存在显著相关性。二维运动分析的准确性因质地而异。胡萝卜的咀嚼次数表现出最高的信度，Hi-Chew糖果的咀嚼次数具有中等信度，而酥饼的咀嚼次数信度最低。参与者对该方案评价良好，强调其价值在于评估组合而非单个组成部分。
结论： 研究结果为支持咀嚼的多维评估提供了初步证据。咀嚼参数与口香糖结果之间的非显著相关性表明，二者各自捕捉了咀嚼的不同方面。二维运动分析在半自动咀嚼计数方面显示出前景，但需要进一步改进以适用于更广泛的质地。总体而言，参与者积极的感知支持在临床人群中继续探索该评估方案。
补充材料： https://doi.org/10.23641/asha.34033494。

英文摘要

PURPOSE: Within the field of speech-language pathology, the only validated noninstrumental assessment of mastication is the Test of Mastication and Swallowing Solids. This assessment protocol offers limited applicability and ecological validity, as it does not reflect typical meals, which involve greater volume and varied textures. Recognizing the need for a more comprehensive evaluation of mastication, this study aims to develop and evaluate a novel assessment protocol of the oral preparatory phase in healthy participants with typical chewing/swallowing. This protocol includes literature-based measures of masticatory parameters, a color-changing gum, and motion analysis.
METHOD: Using a within-subject design, 50 participants chewed a color-changing gum that was analyzed using Commission Internationale de l'Eclairage L*a*b* (CIELAB) values. Participants chewed a baby carrot, a shortbread cookie, and a Hi-Chew candy. The number of chews was manually counted and further measured using two-dimensional motion analysis. Participants completed a social validity questionnaire evaluating the assessment protocol. CIELAB values were correlated with masticatory parameters using Pearson's r. Agreement between manually counted and motion analysis data was examined using intraclass correlation coefficients. Descriptive statistics were analyzed from Likert scale responses on the social validity questionnaire.
RESULTS: Mean CIELAB values reflected existing normative data; however, no significant correlation was observed between colorimetric data and masticatory parameters. The accuracy of two-dimensional motion analysis varied by texture. Chews for the carrot demonstrated the highest reliability, chews for the Hi-Chew candy had moderate reliability, and chews for the shortbread cookie had the lowest reliability. Participants rated the protocol favorably, emphasizing value in the assessment battery rather than individual components.
CONCLUSIONS: Findings provide preliminary evidence in support of a multidimensional evaluation of mastication. Nonsignificant correlations between masticatory parameters and gum outcomes suggest that each captures distinct aspects of mastication. Two-dimensional motion analysis shows promise for semi-automated chew counting, though further refinement is needed for broader texture applications. Overall, positive participant perceptions support continued exploration of the assessment protocol in clinical populations.
SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.34033494.