Changes in hyo-laryngeal elevation post-pharyngeal electrical stimulation

Basson, Tobias Johannes (2015-04)

Thesis (MScMedSc)--Stellenbosch University, 2015.

Thesis

ENGLISH ABSTRACT: Swallowing disorders are prevalent in many elderly individuals and are common amongst individuals suffering from neurological diseases. These individuals are affected from slight swallowing difficulty to total swallowing inability. In severe cases this may cause aspiration pneumonia, dehydration, malnutrition and ultimately death. Swallowing disorders can be diagnosed and treated to increase quality of life. New treatment strategies to understand the pathophysiology and impaired swallowing response are needed. Neuromuscular electrical stimulation is used as rehabilitation method in various disciplines. This method of rehabilitation of physiological dysfunction is used in treating swallowing disorders and has become a focus for current research. To understand the effect of electrical stimulation to the swallowing centre it is proposed to study its mechanism on normal swallowing musculature. The outcome of the effect that electrical stimulation has on healthy individuals may possibly be used to extrapolate to clinical settings and its benefit for modern dysphagia rehabilitation. The purpose of this study was to report on the hyo-laryngeal movement pattern of young healthy, male and female, individuals and to measure the effect of a single neuromuscular electrical stimulation session on the hyo-laryngeal complex of 22 young healthy individuals. Lastly, the aim was to determine the detraining or lasting effect on the hyo-laryngeal swallowing complex of a single neuromuscular electrical stimulation session. The study reported on baseline hyo-laryngeal complex movement patterns by measuring the anterior movement and elevation of the hyo-laryngeal complex through the use of videofluoroscopy swallow study. Analysis of these measurements where done to report on the effect of electrical stimulation on the hyo-laryngeal complex movement pattern pre- and post- electrical stimulation. Significant changes were revealed with elevation of the hyo-laryngeal complex, however no significant effects could be found with anterior movement of the hyo-laryngeal complex pre- and post- electrical stimulation. It was found that elevation of the hyo-laryngeal complex lowered after a single electrical stimulation session. The hyo-laryngeal complex movement pattern remained similar between genders. Lastly it was found that a single electrical stimulation session showed significant reversibility towards baseline levels. This might be related to muscle fatigue and one would need to take into account muscle recovery for future research.

AFRIKAANSE OPSOMMING: Sluk versteurings is algemeen onder bejaardes asook individue wat ly aan neurologiese siektes. Hierdie individue word geaffekteer deur matige sluk probleme tot totale sluk onvermoë. In ernstige gevalle kan dit aanleiding gee tot aspirasie longontsteking, dehidrasie, wanvoeding en selfs dood. Sluk versteurings kan gediagnoseer en behandel word om die kwaliteit van lewe te verbeter. Dit is daarom noodsaaklik om die patofisiologiese en verswakte sluk reaksie te verstaan om sodoende nuwe behandeling strategieë te ontwikkel. Neuromuskulêre elektriese stimulasie word gebruik as rehabilitasie tegniek in verskeie dissiplines. Hierdie metode van behandeling van fisiologiese disfunksie word ook gebruik in die behandeling van sluk afwykings en geniet tans baie navorsings aandag. Om die effek van elektriese stimulasie op die sluk sentrum te verstaan word dit dus voorgestel dat die meganisme op die normale sluk spierstelsel bestudeer word. Hierdie bevindinge kan dus moontlik toegepas word op persone met sluk afwykings en sodoende meer effektiewe rehabilitasie tegnieke bevorder. Die doel van hierdie studie was om die effek op die hyo-laringeale bewegings patroon van jong, gesonde, manlike en vroulike individue te bestudeer, asook om verslag te doen oor die uitwerking van 'n enkele neuromuskulêre elektriese stimulasie sessie op die hyo-laringeale kompleks van 22 jong, gesonde individue. Laastens was die doel van hierdie studie ook om die blywende effek van 'n enkele sessie neuromuskulêre elektriese stimulasie op die sluk sentrum te bepaal. Die studie het basislyn hyo-laringeale kompleks bewegings patrone gerapporteer deur die voorwaartse asook opwaartse beweging van die hyo-laringeale kompleks te meet deur gebruik te maak van videofluoroskopie sluk studies. Ontleding van hierdie metings is gedoen om die uitwerking van elektriese stimulasie op die hyo-laringeale kompleks bewegings patroon voor en na elektriese stimulasie te bepaal. Beduidende veranderinge is in die opwaartse beweging van die hyo-laringeale kompleks gevind, alhoewel geen veranderinge gevind is in die voorwaartse beweging van die hyo-laringeale kompleks voor en na elektriese stimulasie nie. Daar is vasgestel dat die opwaartse beweging van die hyo-laringeale kompleks verlaag het na 'n enkele elektriese stimulasie sessie. Verder het die hyo-laringeale kompleks bewegings patroon geen beduidende verskille tussen geslagte getoon nie. Laastens is bevind dat 'n enkele elektriese stimulasie sessie beduidende omkeerbaarheid terug na basislyn vlakke van beweging toon. Dit kan verband hou met die uitputting van die hyo-laringeale spiere as gevolg van die elektriese stimulasie en toekomstige navorsing sal dus uitputting, asook die tempo van herstel in ag moet neem.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/96764
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