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Trunk Inclination on Respiratory-swallowing Coordination

Not Applicable
Completed
Conditions
Disabling Disease
Interventions
Behavioral: angle of inclination
Other: food type
Registration Number
NCT05221801
Lead Sponsor
Chang Gung Memorial Hospital
Brief Summary

Most caregivers do not know the influence of improper positioning therefore subjects suffer from possible choking risks. The aims of this study were to investigate the timing and coordination of swallowing and respiration in 4 different seat inclination angles, with liquid and bolus. A self-developed wearable device to measure the submandibular muscle surface EMG, the movement of thyroid cartilage and respiratory status of nasal cavity. This program could auto-analysis the onset and offset of duration, and the excursion and strength of thyroid cartilage will be calculated when it was moving, coordination between breathing and swallowing was also included. The results of this study would serve as the clinical guidelines for proper feeding positions for different populations and for different food contents.

Detailed Description

Swallowing is not only an important function for life maintenance, but also for quality of life improvement. Statistics revealed that subjects with intellectual disability or multiple disabilities have problems in controlling muscle tone and maintaining posture. In such circumstances, these subjects experience problems during feeding or eating. The adjustment of seat inclination would help in feeding/eating process. However, the proper inclination angle should be evaluated by medical professionals, however, most caregivers do not know the influence of improper positioning therefore subjects suffer from possible choking risks. The aims of this study were to investigate the timing and coordination of swallowing and respiration in 4 different seat inclination angles, with liquid and bolus. In the first stage, the investigators intend to use a self-developed wearable device to measure the submandibular muscle surface EMG, the movement of thyroid cartilage and respiratory status of nasal cavity. This particular program could auto-analysis the onset and offset of duration, and the excursion and strength of thyroid cartilage will be calculated when it was moving, coordination between breathing and swallowing was also included. The measurement would be done in four seat inclination angles (5, 15, 30, 45) for each subject. The data collected between different conditions would be compared, and suggestions of ideal angles during swallowing would be made. The second stage is the design and development of a feedback-controlled seat angle adjustment device, based on the data collected. The results of this study would serve as the clinical guidelines for proper feeding positions for different populations and for different food contents. The ergonomic data would also provide references for assistive technology professionals and practitioners in device design and development.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria

Typical-developed:

  1. ages ranged from 20 to 60 years old,

People with disabilities:

  1. ages ranged from 20 to 60 years old,
  2. usually a need for supplementary feeding.

Exclusion criteria:

  • Excluded conditions are cases of intubation and feeding, severely mentally retarded or autistic cases that cannot express comfort, cases of frequent choking, and those who have been treated with a throat tube and have a narrow throat.
  • Exclude subjects who have undergone throat or nasal cavity surgery or have abnormalities in these two parts
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
angle 5 + 5 ml puddingfood typeThe measurement would be done in seat inclination angles of 5 degrees with 5 ml pudding intake.
angle 45 + 1ml waterangle of inclinationThe measurement would be done in seat inclination angles of 45 degrees with 1 ml water intake.
angle 45 + 1ml waterfood typeThe measurement would be done in seat inclination angles of 45 degrees with 1 ml water intake.
angle 45 + 5 ml waterangle of inclinationThe measurement would be done in seat inclination angles of 45 degrees with 5 ml water intake.
angle 15 + 1ml waterangle of inclinationThe measurement would be done in seat inclination angles of 15 degrees with 1 ml water intake.
angle 15 + 5 ml puddingangle of inclinationThe measurement would be done in seat inclination angles of 15 degrees with 5 ml pudding intake.
angle 5 + 5 ml waterfood typeThe measurement would be done in seat inclination angles of 5 degrees with 5 ml water intake.
angle 5 + 5 ml puddingangle of inclinationThe measurement would be done in seat inclination angles of 5 degrees with 5 ml pudding intake.
angle 30 + 5 ml waterfood typeThe measurement would be done in seat inclination angles of 30 degrees with 5 ml water intake.
angle 30 + 5 ml puddingangle of inclinationThe measurement would be done in seat inclination angles of 30 degrees with 5 ml pudding intake.
angle 15 + 1ml waterfood typeThe measurement would be done in seat inclination angles of 15 degrees with 1 ml water intake.
angle 30 + 5 ml waterangle of inclinationThe measurement would be done in seat inclination angles of 30 degrees with 5 ml water intake.
angle 5 + 1ml waterangle of inclinationThe measurement would be done in seat inclination angles of 5 degrees with 1 ml water intake.
angle 5 + 5 ml waterangle of inclinationThe measurement would be done in seat inclination angles of 5 degrees with 5 ml water intake.
angle 15 + 5 ml waterangle of inclinationThe measurement would be done in seat inclination angles of 15 degrees with 5 ml water intake.
angle 15 + 5 ml waterfood typeThe measurement would be done in seat inclination angles of 15 degrees with 5 ml water intake.
angle 15 + 5 ml puddingfood typeThe measurement would be done in seat inclination angles of 15 degrees with 5 ml pudding intake.
angle 30 + 1ml waterfood typeThe measurement would be done in seat inclination angles of 30 degrees with 1 ml water intake.
angle 5 + 1ml waterfood typeThe measurement would be done in seat inclination angles of 5 degrees with 1 ml water intake.
angle 30 + 1ml waterangle of inclinationThe measurement would be done in seat inclination angles of 30 degrees with 1 ml water intake.
angle 30 + 5 ml puddingfood typeThe measurement would be done in seat inclination angles of 30 degrees with 5 ml pudding intake.
angle 45 + 5 ml waterfood typeThe measurement would be done in seat inclination angles of 45 degrees with 5 ml water intake.
angle 45 + 5 ml puddingangle of inclinationThe measurement would be done in seat inclination angles of 45 degrees with 5 ml pudding intake.
angle 45 + 5 ml puddingfood typeThe measurement would be done in seat inclination angles of 45 degrees with 5 ml pudding intake.
Primary Outcome Measures
NameTimeMethod
thyroid cartilage excursion5 seconds before the beginning of the swallow to 5 seconds after the end of the swallow.

A force-sensing resistor (FSR) was fixed over the larynx at the thyroid cartilage position with an elastic belt to detect the cartilage excursion.

Electromyography5 seconds before the beginning of the swallow to 5 seconds after the end of the swallow.

Two electrodes were attached to the submandibular muscle to register the electric potential generated by the muscles.

nasal airflow5 seconds before the beginning of the swallow to 5 seconds after the end of the swallow.

A nasal airflow cannula was placed in front of the nasal cavity and was connected to a pressure transducer (Pro-Tech Services, Murrysville, PA, USA) to detect exhalation and inhalation.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Chang Gung University

🇨🇳

Taoyuan, Taiwan

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