嚥下運動における運動学習の重要性
Dysphagiaに「Human Hyolaryngeal Movements Show Adaptive Motor Learning During Swallowing」（Humbert IA, Christopherson H, Lokhande A, German R, Gonzalez-Fernandez M, Celnik P. 2012）が掲載されている。
Abstruct
The hyoid bone and larynx elevate to protect the airway during swallowing. However, it is unknown whether hyolaryngeal movements during swallowing can adjust and adapt to predict the presence of a persistent perturbation in a feed-forward manner (adaptive motor learning). We investigated adaptive motor learning in nine healthy adults. Electrical stimulation was administered to the anterior neck to reduce hyolaryngeal elevation, requiring more strength to swallow during the perturbation period of this study. We assessed peak hyoid bone and laryngeal movements using videofluoroscopy across thirty-five 5-ml water swallows. Evidence of adaptive motor learning of hyolaryngeal movements was found when (1) participants showed systematic gradual increases in elevation against the force of electrical stimulation and (2) hyolaryngeal elevation overshot the baseline (preperturbation) range of motion, showing behavioral aftereffects, when the perturbation was unexpectedly removed. Hyolaryngeal kinematics demonstrates adaptive, error-reducing movements in the presence of changing and unexpected demands. This is significant because individuals with dysphagia often aspirate due to disordered hyolaryngeal movements. Thus, if rapid motor learning is accessible during swallowing in healthy adults, patients may be taught to predict the presence of perturbations and reduce errors in swallowing before they occur.
嚥下運動と運動学習について述べられている論文である。この論文でセラピストにとり重要なのは「As such, exploiting training protocols that follow motor learning principles may be useful for treating dysphagia.」と述べられていることである。誤嚥防止のために、運動学習に基づくトレーニングの重要性を示唆している。
喉頭挙上については、電気刺激による方法がよく知られているが、徒手でも、運動学習を考慮し実施するだけで効果に差が出る可能性が考えられた。
図 電極の位置、電極の流し方
Abstruct
The hyoid bone and larynx elevate to protect the airway during swallowing. However, it is unknown whether hyolaryngeal movements during swallowing can adjust and adapt to predict the presence of a persistent perturbation in a feed-forward manner (adaptive motor learning). We investigated adaptive motor learning in nine healthy adults. Electrical stimulation was administered to the anterior neck to reduce hyolaryngeal elevation, requiring more strength to swallow during the perturbation period of this study. We assessed peak hyoid bone and laryngeal movements using videofluoroscopy across thirty-five 5-ml water swallows. Evidence of adaptive motor learning of hyolaryngeal movements was found when (1) participants showed systematic gradual increases in elevation against the force of electrical stimulation and (2) hyolaryngeal elevation overshot the baseline (preperturbation) range of motion, showing behavioral aftereffects, when the perturbation was unexpectedly removed. Hyolaryngeal kinematics demonstrates adaptive, error-reducing movements in the presence of changing and unexpected demands. This is significant because individuals with dysphagia often aspirate due to disordered hyolaryngeal movements. Thus, if rapid motor learning is accessible during swallowing in healthy adults, patients may be taught to predict the presence of perturbations and reduce errors in swallowing before they occur.
嚥下運動と運動学習について述べられている論文である。この論文でセラピストにとり重要なのは「As such, exploiting training protocols that follow motor learning principles may be useful for treating dysphagia.」と述べられていることである。誤嚥防止のために、運動学習に基づくトレーニングの重要性を示唆している。
喉頭挙上については、電気刺激による方法がよく知られているが、徒手でも、運動学習を考慮し実施するだけで効果に差が出る可能性が考えられた。
図 電極の位置、電極の流し方
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