Trunk Inclination on Respiratory-swallowing Coordination
Condition: Disabling Disease
Study type: Interventional

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.
    

Intervention name(s): angle of inclination; food type
Intervention type(s): Behavioral; Other
Intervention description(s): The measurement would be done in seat inclination angles of 5,15,30,45 degrees.; the swallowing was tested with 3 food types
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: The measurement would be done in 4 seat inclination angles (5, 15, 30, 45) and for 3 different food types for each subject.
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: positioning; swallowing; respiration; sensors; disability; assistive device