JP2019050967A - Swallowing ability examination device - Google Patents

Abstract

To provide a swallowing ability examination device that adopts simplified examination means and is capable of quantitatively measuring swallowing ability on saliva of a person to be examined, water, and bolus, objectively performing examination and determination by a waveform, and managing records of measurement results continuously.SOLUTION: A swallowing ability examination device 1 includes: detection means having a middle air pad sensor 11, etc. arranged in the peripheral area of the larynx of a person to be examined, for detecting a temporal change in the movement of the peripheral area of the larynx of the person to be examined; smoothing processing means 55 for extracting an extremely low frequency signal by executing data processing by smoothing processing for a state of change in detection signals successive in a time-series manner; swallowing movement measurement processing means 57 for measuring the movement of the peripheral area of the larynx involved in swallowing based on the extremely low frequency signal; data storage means 58 for storing a result of the processing by the swallowing movement measurement processing means 57; and display means 47 for outputting a result of the processing by the swallowing movement measurement processing means 57 as waveform data that can be visually recognized.SELECTED DRAWING: Figure 8

Description

  The present invention relates to a swallowing ability inspection device, and more specifically, quantitatively measures the swallowing ability of a subject's saliva, water, and bolus and objectively inspects the waveform, and continues to record the measurement results. The present invention relates to a swallowing ability testing device that can be managed by a user.

  Usually, elderly people experience hypoperception of the oral and throat mucosa. There is also general weakness of the muscle groups surrounding the pharynx and larynx.

  In addition, patients with physical disabilities (for example, Parkinson's disease, sequelae due to cerebral infarction, etc.) also develop sensory impairment and muscle paralysis. In such a case, the laryngeal fist is delayed with respect to the inflow of saliva, water or bolus into the pharynx, and aspiration is likely to occur.

  When aspiration occurs, saliva containing bacteria in the oral cavity enters the lungs, causing aspiration pneumonia.

  Conventionally, a repeated saliva swallowing test exists as a means for diagnosing a symptom of swallowing disease. This mainly consists of examinations by palpation on the larynx fist by a doctor.

  However, in the case of examination of swallowing ability by palpation, it has been difficult to measure the degree quantitatively or to keep track of the progress and to manage the progress.

   Patent Document 1 discloses a laryngeal displacement comprising a combination of a transmitting coil and a receiving coil which are arranged on both sides of a subject's thyroid cartilage (throat bud) and detect two lateral displacements in the larynx. Detection means, swallowing sound detection means for detecting swallowing sound when the subject's subject swallows, display means, and two portions of the larynx generated based on information obtained from the laryngeal displacement detection means There has been proposed a biopsy apparatus including a processing unit that instructs a display unit to display a waveform related to displacement and a waveform related to swallowing sound generated based on information obtained from the swallowing sound detection unit. Further, there is described a biopsy device characterized in that in the biopsy device, a feature amount related to swallowing operation is calculated and the display means is instructed to display the calculated feature amount.

  However, in the case of the biopsy device of Patent Document 1, the swallowing ability is inspected by using the waveform relating to the displacement of the larynx at two locations and the swallowing sound by the swallowing sound detecting means. It is presumed that extremely specialized knowledge and technology are required for the judgment.

  In Patent Document 2, at least one air bag is arranged in a region around the larynx of a living body, the air pressure in the air bag is transmitted by an air tube, and one corresponding to the temporal change of the movement in the region around the larynx. Detection means for outputting the above detection signal, conversion means for converting a change state of the detection signal into an electric signal using a piezoelectric element, and display means for outputting the electric signal so as to be visible for a swallowing ability test There is described a swallowing ability test apparatus characterized by comprising:

  However, the display means obtained from the swallowing ability test apparatus of Patent Document 2 does not extract and display a very low frequency signal peculiar to swallowing movement, and does not accurately capture the movement of the larynx peripheral region.

  Moreover, since the laryngeal region is covered with the swallowing ability inspection device when the air bag is placed on the subject, it is difficult to accurately place the air bag as a detector in the laryngeal movement region.

  Furthermore, since the laryngeal protuberance places a film material with an air bag in close contact with or attached to the subject's neck, it restricts the natural movement of the laryngeal protuberance, and thus accurate swallowing ability could not be examined.

JP 2008-301895 A Japanese Patent Laid-Open No. 2015-100382

  The problem to be solved by the present invention is that a simplified detection means is employed, and the swallowing ability of the subject's saliva, water and bolus is measured quantitatively without requiring skill, and is objectively determined by the waveform. In addition, there is no swallowing ability testing device that can perform inspection, determination, and management of recording of measurement results.

  The swallowing ability test apparatus according to the present invention has at least one detector arranged in a region around the larynx of a subject, and one corresponding to a temporal change in movement of the region around the larynx by the detector. A detection means for outputting the above detection signal, a data smoothing processing means for extracting a very low frequency signal by performing data processing by smoothing the change state of the detection signal connected in time series, and the extremely low frequency The swallowing movement measurement processing means for measuring the movement around the larynx for swallowing based on the signal, the storage means for storing the processing result of the swallowing movement measurement processing means, and the processing result of the swallowing movement measurement processing means are visible And a display means for outputting as waveform data.

  According to the first aspect of the present invention, the detector is configured to output one or more detection signals corresponding to the temporal change in the movement of the laryngeal region by the detector, and the change state of the detection signals is smoothed. Performs data processing, extracts a very low frequency signal, measures the movement around the larynx for swallowing based on the very low frequency signal by the swallowing movement measurement processing means, and displays the processing result of the swallowing movement measurement processing means on the display means Is output as waveform data that can be visually recognized, and the swallowing ability of the subject's saliva, water, and bolus is measured quantitatively and objectively without requiring skill in swallowing the subject. It is possible to provide a swallowing ability testing device that can test and determine the above.

  In addition, it is possible to provide a swallowing ability test apparatus capable of continuously managing recording of measurement results by a storage unit that stores waveform data.

  In particular, when measuring the swallowing motion of a subject, it is desirable to eliminate vibrations that cause noise as much as possible. However, since swallowing motion is an extremely low frequency signal, the frequency of swallowing motion can be obtained only by processing a low-pass filter. Is difficult to capture.

  However, the frequency of swallowing movement can be accurately captured by performing digital data processing by smoothing processing.

  For example, even if the swallowing exercise is performed as soon as possible, it is about once every 2 seconds. In other words, the vibration frequency is 0.5 Hz or less, but a general low-pass filter has a pass frequency band of about 10 Hz to 100 Hz. Have difficulty.

  According to the first aspect of the present invention, the change in data with time in the laryngeal region by the detector is calculated by using an average of several previous and subsequent data, and the waveform data is smoothed. The movement around the larynx can be accurately output and displayed as visible waveform data.

  According to the invention described in claim 2, in the invention described in claim 1, since the detector is a detector that uses an air bag to detect a change in air pressure or air vibration of the air bag, the detector The detection signal can be detected without any burden on the subject, and the change state of the detection signal is stored in the storage means for the swallowing ability test and displayed by the display means, so that the subject can be detected without requiring skill. Quantitative measurement of the examiner's ability to swallow about saliva, water and bolus, which can be visually inspected and judged, and can also continue to manage measurement results An apparatus can be provided.

  According to a third aspect of the present invention, in the invention according to any one of the first to second aspects, the apparatus further comprises a detector mounting device that arranges one or more detectors on the front neck of the subject, The detector mounting device is equipped with a laryngeal protuberance position confirmation hole in the portion corresponding to the laryngeal protuberance of the subject, so that the doctor can check the position of the laryngeal protuberance of the subject by finger or visual observation, measurement accuracy, reproduction It is possible to provide a swallowing ability test apparatus capable of improving accuracy.

  According to a fourth aspect of the present invention, in the third aspect of the present invention, the detector includes a detector mounting tool that arranges one or more detectors on the front neck of the subject. Is a notch in the length direction of the detector mounting tool, a front neck fixing part region for fixing the detector mounting tool to the front neck, and a laryngeal protuberance of the subject can contact the detector In the case of a configuration in which the laryngeal protuberance of the subject is fixed with the detector wearing tool, the movement of the laryngeal protuberance is obstructed. Although accurate movement of the oral protuberance cannot be detected, the detector mounting tool can be firmly secured by forming the front neck fixing portion region and the detector fixing portion region separately by the cut portions as in the invention of claim 4. Secure to the subject's neck and accurately detect laryngeal protuberance movement It is possible to provide a possible swallowing capability testing apparatus.

  According to inventions of claims 5 and 6, in the invention of any one of claims 1 to 4, one or more detectors arranged in the laryngeal peripheral region are arranged along the movement direction of the laryngeal protuberance. In addition, since one or more pairs are arranged in the left and right pairs with the moving direction of the laryngeal protuberance as the center, the time point when the detection signal exceeds a certain value is set as the inspection reference point, and the pair of left and right sides with respect to the inspection reference point By inspecting the delay state of the detection signal of the detection means, it is possible to provide a swallowing ability inspection device capable of determining the paralysis state of the left and right muscle functions of the laryngeal protuberance.

According to a seventh aspect of the invention, in the invention according to any one of the first to fourth or sixth aspects, the detector detects the laryngeal protuberance and the movement of the laryngeal peripheral region as a change in air pressure or a change in air vibration. A three-part air pad sensor with an air bag to be installed, a middle air pad sensor arranged along the laryngeal ridge, a right air pad sensor arranged on the right side of the laryngeal ridge, and a left side of the laryngeal ridge Therefore, it is possible to provide a swallowing ability test apparatus including a detector mounting tool that has a simple structure and is easy to handle.
According to an eighth aspect of the present invention, in the invention according to any one of the first to seventh aspects, the detector further includes a sound detection air sensor for detecting a swallowing-related sound of the subject on the side of the neck. It is said that it is possible to collect and record swallowing-related sounds in association with measurement of movement around the larynx of the subject, and it is said that voice etc. will become hoarse as aspiration pneumonia progresses Therefore, it is possible to record swallowing-related sounds in association with movements around the larynx, and it is possible to provide a swallowing ability test apparatus that can perform a swallowing ability test more effectively.

  According to a ninth aspect of the present invention, in the invention according to any one of the first to eighth aspects, the swallowing movement measurement processing means is a threshold based on an arbitrary threshold value for an extremely low frequency signal from the data smoothing processing means. Since the region exceeding the threshold is extracted as a feature point, it is possible to extract the movement of the larynx around the larynx, and the larynx where swallowing is performed and the larynx where swallowing is not performed It is possible to set a threshold value for clearly determining the movement of the camera.

  This makes it possible to quantitatively measure the subject's ability to swallow about saliva, water and bolus without requiring skill, and to visually inspect and determine the object, and continue to record measurement results. It is possible to provide a swallowing ability testing device that can also be managed.

  According to a tenth aspect of the present invention, the swallowing movement measurement processing means in the invention according to any one of the first to ninth aspects, wherein the swallowing measures the feature points extracted in a preset time as the number of swallowing times. Since it is configured to include a frequency measurement unit, the swallowing ability of the subject's saliva, water, and bolus can be quantified without requiring skill because it can automatically measure the number of times the subject swallows without counting each time. Thus, it is possible to provide a swallowing ability test apparatus that can measure and measure and visually check and determine objectively, and that can continuously manage recording of measurement results.

  According to the invention described in claim 11, in the invention described in claim 9, the swallowing movement measurement processing means is configured such that the detection signal detected by the detector arranged along the movement direction of the laryngeal ridge has the threshold value. Since the time point that exceeded the test reference point, and the test reference point as a reference, it is configured to be able to inspect the paralysis status of the left and right muscle functions of the laryngeal protuberance from the delay status of the detection signals of the pair of left and right detection means, It is possible to provide a swallowing ability test apparatus that can determine the state of paralysis of the left and right muscle functions of a person's laryngeal protuberance.

  According to the invention of claim 12, in the invention of claim 9, the swallowing movement measurement processing means compares the detection signals of the pair of left and right detectors to determine the left and right of the laryngeal protuberance of the subject. Therefore, it is possible to provide a swallowing ability test apparatus that can determine the ability of each of the left and right muscle functions of the laryngeal protuberance of the subject.

FIG. 1 illustrates a middle air pad sensor, a left air pad sensor, a right air pad sensor, a sound detection air pad sensor, and a larynx, which are detectors provided on a detector mounting device in a swallowing ability test apparatus according to an embodiment of the present invention. It is a schematic explanatory drawing which shows the arrangement | positioning state with respect to the subject's neck circumference of a protruding position confirmation hole. FIG. 2 shows the detection of the middle 1 air pad sensor, the middle 2 air pad sensor, and the laryngeal protuberance position confirmation hole, which are detectors provided on the detector mounting device according to the modification of the swallowing ability test apparatus according to the present embodiment. It is a schematic explanatory drawing which shows the arrangement | positioning state with respect to a person's neck circumference. FIG. 3 shows a middle air pad sensor, a left air pad sensor, a right air pad sensor, and a neck of a laryngeal protuberance position confirmation hole when the detector wearing tool shown in FIG. 1 is used in the swallowing ability test apparatus according to the present embodiment. It is explanatory drawing which shows the arrangement | positioning relationship with respect to each internal muscle. FIG. 4 is a swallowing ability test apparatus according to the present embodiment, using the detector mounting tool shown in FIG. 1, and a middle air pad sensor in the case where the oral cavity and neck of the subject are in a longitudinal sectional state, and It is explanatory drawing which shows the arrangement | positioning relationship with respect to each muscle in a neck of a laryngeal protruding position confirmation hole. FIG. 5 is an explanatory view showing a specific configuration example of the detector mounting device in the swallowing ability test apparatus according to the present embodiment. FIG. 5 (a) shows a middle air pad sensor and a left air pad each provided with a cushioning material for the sensor. External view showing a configuration including a sensor, a right air pad sensor, a sound detection air pad sensor, and a laryngeal protuberance position confirmation hole, FIG. 5 (b) shows a lower cushion material on the detector mounting tool shown in FIG. (C) is a partially enlarged explanatory view of a configuration in which a lower cushion material and an upper cushion material are added to the detector mounting tool shown in FIG. ) Is an external view showing a configuration including one medium air pad sensor provided with a sensor cushion material as a detector mounting tool and a laryngeal protuberance position confirmation hole, and FIG. 8E is a detector shown in FIG. Dress FIG. 4F is a partially enlarged explanatory view of a configuration in which a lower cushion material and an upper cushion material are added to the detector mounting tool shown in FIG. It is. FIG. 6 is an explanatory diagram showing a wearing state of the detector wearing tool on the neck in the swallowing ability test apparatus according to the present embodiment, and FIG. 6 (a) uses the detector wearing tool to which the lower cushion material is added. Explanatory drawing which shows the laryngeal protuberance detection state from the laryngeal protuberance position confirmation hole by a doctor etc. in the case, The figure (b) is detection of the laryngeal protuberance of the middle air pad sensor in the case of using the detector mounting device which added the lower cushion material. An explanatory view showing a state, the same figure (c) is an explanatory view showing a laryngeal protuberance detection state from a laryngeal protuberance position confirmation hole by a doctor or the like in the case of using a detector wearing tool to which a lower cushion material and an upper cushion material are added, FIG. 4D shows the laryngeal protuberance detection state of the middle air pad sensor in the case of using the detector mounting device to which the lower cushion material and the upper cushion material are added. It is. FIG. 7 is a schematic block diagram showing the overall configuration of the swallowing ability test apparatus according to the present embodiment. FIG. 8 is a schematic block diagram showing details of data processing means of the swallowing ability test apparatus according to the present embodiment. FIG. 9 is a schematic block diagram illustrating the configuration of the swallowing movement measurement processing unit in the swallowing ability test apparatus according to the present embodiment. FIG. 10 is an explanatory view showing the oral period, the larynx period, and food synchronization when the subject's bolus is swallowed. FIG. 11 is an explanatory view showing the test data waveform of the subject in the swallowing ability test apparatus according to the present embodiment. FIG. 11 (a) is a data waveform diagram showing the change state of the detection signal of the detector. b) is a data waveform diagram after data processing by smoothing processing is performed. FIG. 11 is an explanatory diagram of the smoothing process of a plurality of data in the present embodiment, the upper column shows a plurality of data before the smoothing process in a line graph form, and the lower column shows the plurality of data after the smoothing process. It is shown in the form of a dotted line graph.

  The present invention adopts a simplified detection means, without requiring skill, quantitatively measuring the swallowing ability of the subject's saliva, water and bolus, and objectively examining and determining the waveform, For the purpose of providing a swallowing ability testing device that can continuously manage the recording of the measurement results, it has a detector comprising at least one air pad sensor arranged in the region around the larynx of the subject. And detecting means for outputting one or more detection signals corresponding to the temporal change in the movement of the laryngeal region by the detector, and data processing by smoothing the change status of the detection signals in time series. Data smoothing processing means for extracting a very low frequency signal, swallowing movement measurement processing means for measuring movement around the larynx for swallowing based on the extremely low frequency signal, and processing of the swallowing movement measurement processing means result Storage means for storing for a display unit for outputting the processing result of the swallowing movement measurement processing means as a visible waveform data, it was realized by the configuration with.

  Hereinafter, a swallowing ability test apparatus according to an embodiment of the present invention will be described in detail with reference to FIGS.

  As shown in FIG. 1, the swallowing ability test apparatus 1 according to the present embodiment is disposed in close contact with the region of the laryngeal protuberance 3 around the neck (neck portion) 2 of the subject M, and the movement of the region around the larynx over time. Details of outputting a detection signal corresponding to the change include a detector described later, and a detection means 4 that holds the detector and includes a detector attachment 5 that can be wound around the neck 2 of the subject M. doing.

  Here, the detection means 4 will be described in detail with reference to FIG. 1 and FIG.

The detection means 4 attaches the middle air pad sensor 11, the left air pad sensor 12, and the right air pad sensor 13, which are detectors, in a horizontal arrangement while interposing a sensor cushion material 10 to the detector mounting device 5. In addition, a laryngeal protuberance position confirmation hole 5a for confirming the laryngeal protuberance of the subject M visually or with a finger is provided at a lower position of the middle air pad sensor 11, and a swallowing sound in the laryngeal region of the subject M is further provided. The sound detection air pad sensor 16 for detecting the sound is provided.
The sound detection air pad sensor 16 collects swallowing-related sounds in association with the measurement of the movement around the larynx, and therefore may not be provided if collection of swallowing-related sounds is unnecessary.

  The middle air pad sensor 11 captures the displacement of the laryngeal protuberance of the subject M as a change in air pressure or vibration of the air bag using an air bag as a detection signal from the air tube 11b to the data processing means 46 described later. It is configured to send.

  Similarly, the left air pad sensor 12 and the right air pad sensor 13 are configured to send detection signals from the air tubes 12b and 13b to the data processing means 46 described later. The sound detection air pad sensor 16 is also configured to send a detection signal from the air tube 16b to the data processing means 46 described later.

  The middle air pad sensor 11, the left air pad sensor 12, the right air pad sensor 13, and the sound detection air pad sensor 16 include a displacement sensor, a vibration sensor, an acceleration sensor, a sound sensor, in addition to the case described above. It is also possible to use displacement, movement, sound, current, etc. of laryngeal protuberances such as sensors, light sensors, myoelectric sensors, capacitance sensors, ultrasonic sensors, etc. In this case, data processing described later according to the type of sensor The piezoelectric element 51 of the means 46 can be omitted.

  Further, the detection means 4 shown in FIG. 1 will be described in detail. The detection means 4 includes a middle air pad sensor 11 disposed in close contact with the laryngeal ridge 3 along the direction of movement of the laryngeal ridge 3, and the middle air pad. A left air pad sensor 12 disposed on the left side of the sensor 11, a right air pad sensor 13 disposed on the right side of the middle air pad sensor 11, and the sound detection air pad sensor disposed in the vicinity of the right air pad sensor 13. 16.

The middle air pad sensor 11 constitutes detection means 4 for detecting movement of the muscle, bone, etc. of the subject M in a flexible material made of flexible rubber, resin, cloth, etc. having airtightness. It is a sealed air type equipped with an air bag and is equipped with an air bag for detecting the movement of muscles, bones, etc. The left air pad sensor 12, the right air pad sensor 13, and the sound detecting air pad sensor 16 are also included. These are configured in the same manner, and these are arranged in a horizontal arrangement, and only the sound detection air pad sensor 16 is arranged on the side of the neck of the subject. The configuration is such that 12b, 13b, and 16b are derived to the outside.
Note that the sound detection air pad sensor 16 can be accurately detected without being affected by noise caused by the fist of the laryngeal protuberance when it is arranged on the side of the neck rather than the front of the neck.

  FIG. 2 shows a modified example of the detection means 4A. The detection means 4A has the same basic configuration as that of the detection means 4, but the detector M is attached to the subject M. Arranged so that the middle 1 air pad sensor 14 and the middle 2 air pad sensor 15 having the same structure as described above are in close contact with the laryngeal bump along the movement direction (vertical direction) of the laryngeal bump. It is what. In FIG. 2, the sound detection air pad sensor 16 is not shown.

  An air tube 14 b and an air tube 15 b are led out from the middle 1 air pad sensor 14 and the middle 2 air pad sensor 15.

  Further, the detector mounting tool 5 is provided with a laryngeal protuberance position confirmation hole 5 a in an arrangement located below the middle 1 air pad sensor 14.

  FIG. 3 schematically shows muscles in the neck of the subject M corresponding to the arrangement of the middle air pad sensor 11, the left air pad sensor 12, the right air pad sensor 13, and the laryngeal protuberance position confirmation hole 5a. It is shown.

  The middle air pad sensor 11 is located at a position corresponding to the upper part of the laryngeal protuberance in order to detect the movement of the laryngeal protuberance of the subject M, and the left air pad sensor 12 and the right air pad sensor 13 are arranged to the left and right. Further, the laryngeal protuberance position confirmation hole 5a is arranged for confirming the movement of the laryngeal protuberance of the subject M.

  FIG. 4 shows the arrangement of the middle air pad sensor 11 (shown by the round numeral 1) and the laryngeal protuberance position confirmation hole 5a (shown by the round numeral 2) when the oral cavity and neck of the subject M are in the longitudinal cross-sectional state. (Laryngeal protuberance (region of throat)).

  FIGS. 5A to 5C show the detailed structure of the detection means 4 in the swallowing ability test apparatus 1 according to this embodiment.

  FIGS. 6A to 6D show the wearing state of the detection means 4 on the neck 2 in the swallowing ability test apparatus 1 according to this embodiment.

  The detector mounting tool 5 in the detection means 4 is formed in a belt shape, and the detector is disposed while interposing a cushion material 10 for the sensor, as shown in FIG. The middle air pad sensor 11, the left air pad sensor 12, and the right air pad sensor 13 are attached in a horizontal array, and the laryngeal protuberance of the subject M is visually or visually confirmed at a lower position of the middle air pad sensor 11. For this purpose, a laryngeal raised position confirmation hole 5a is provided.

  Further, in the detector mounting tool 5, a notch 6 is provided in the length direction of the detector mounting tool 5 in a region between the sensors and the laryngeal protuberance position confirmation hole 5a.

The lower side of the cut portion 6 is a front neck fixing part region for closely attaching the detector mounting device 5 to the front neck of the subject M, and the upper side is the laryngeal protuberance of the subject M. It is configured to function as a detector fixing portion region arranged so as to be able to come into contact with the detector. Further, the sound detection air pad sensor 16 is disposed below the right corner position of the cut portion 6 in FIG.
The sound detection air pad sensor 16 may be disposed below the left corner position.

  FIG. 5B shows a configuration in which one notch portion 6 is provided in the detector mounting tool 5 and the lower cushion material 7 is fixed to the lower front side neck fixing portion region by bonding or the like.

  Further, FIG. 5 (c) shows that two cut portions 6, 6 are provided in a vertical arrangement with respect to the detector mounting tool 5, and a lower cushion material is provided in the front neck fixing portion region on the lower side of the lower cut portion 6. 7 shows an example in which the upper cushion material 8 is fixed by bonding or the like to the detector fixing portion region that occupies the upper portion of the upper cut portion 6.

  With such a configuration, when the laryngeal protuberance of the subject M is conventionally fixed with the detector mounting device as a whole, the movement of the laryngeal protuberance is obstructed and the accurate movement of the oral protuberance cannot be detected. However, in the present embodiment, the front neck fixing portion region and the detector fixing portion region are configured separately, so that the detector mounting tool 5 is firmly fixed to the neck 2 in the front neck fixing portion region. It becomes possible to accurately detect the movement of the natural laryngeal bulge of the subject M in the fixing part region (the detector fixing part region is easy to move in the radial direction of the neck using the upper sides of both ends of the cut portion 6 as fixed ends) ).

  Further, a pair of hook-and-loop fasteners 9 are provided in opposite positions at both ends of the detector mounting tool 5 so that a required portion of the detector mounting tool 5 is in close contact with the neck of the subject M. .

  Further, a middle air pad sensor 11, a left air pad sensor 12 and a right air pad sensor 13 placed on the sensor cushion material 10 are disposed in the detector fixing portion region. The height of the upper surfaces of the left air pad sensor 12 and the right air pad sensor 13 and the height of the upper surface of the lower cushion material 7 are set to substantially the same height.

  Each of the air tubes 11b, 12b, 13b, 16b is configured to be connected to the data processing means 46 along the inner side or the outer side of the detector mounting tool 5.

  In addition, the said notch | incision part 6 is not limited to one, Two or more may be sufficient. As shown in FIG. 5C, whether or not the two cut portions 6 are required can be selected depending on the difference in the physique of the subject M.

  For example, when the laryngeal protuberance is raised like the subject M such as a child or a woman, if a space between the laryngeal protuberance and the hyoid bone cannot be secured, a single cut portion as shown in FIG. 6 is suitable.

  On the other hand, in the case of the subject M such as an adult male, since a space between the laryngeal protuberance and the hyoid bone is relatively secured, two incisions 6 as shown in FIG. 5C are provided. The configuration is suitable.

  Further, as in the detector mounting device 5 shown in FIGS. 5 (a) to 5 (c), the middle air pad sensor 11, the left air pad sensor 12, and the right air pad sensor 13 are arranged in a horizontal row so that the larynx is arranged. In addition to the momentum of fist movement, there is an advantage that the ability of the muscles on the left and right of the laryngeal protuberance can be measured.

  Further, as in the detection means 4A of the modified example shown in FIG. 2 described above, the middle 1 air pad sensor 14 and the middle 2 air pad sensor 15 are arranged along the laryngeal ridge movement direction, so that The displacement can be measured in more detail.

  Furthermore, if two or more pairs of the middle 1 air pad sensor 14 and the middle 2 air pad sensor 15 are arranged in left and right pairs, the momentum of the larynx behavior, the displacement of the laryngeal behavior, the ability of the left and right muscles of the larynx, the opening and closing of the epiglottis, etc. Measure various swallowing abilities.

  In addition, as shown in FIGS. 5 (d) to 5 (f), another modified detection means provided with one medium air pad sensor 11, a cut portion 6, and a laryngeal protuberance position confirmation hole 5a is configured. Even if only one middle air pad sensor 11 is provided as in the detector mounting tool 5A, the behavior of the laryngeal bulge can be confirmed by one middle air pad sensor 11 and the laryngeal bulge position confirmation hole 5a. By extracting the time from the uplift behavior peak to the next behavior peak, it is possible to detect the food swallowing speed (momentum).

  The remaining configuration of the detector mounting tool 5A is the same as that of the detector mounting tool 5. In FIG. 5D, the sound detection air pad sensor 16 is not shown.

  6 (a) to 6 (d) show a state in which the detector mounting tool 5 is mounted on the neck 2 of the subject M in the swallowing ability test apparatus 1 according to the present embodiment. 6 (a) and 6 (b) show an example in which the detector mounting tool 5 shown in FIG. 5 (a) is used with the lower cushion material 7 added as shown in FIG. 5 (b).

  6 (c) and 6 (d) show the detector mounting tool 5 shown in FIG. 5 (a), to which a lower cushion material 7 and an upper cushion material 8 are added as shown in FIG. 5 (c). The example used is shown.

  Since the finger portion of the doctor or the like shown in FIG. 6 (a) can contact the position of the laryngeal protuberance 3 of the subject through the laryngeal protuberance confirmation hole 5a, the doctor or the like can detect the position of the laryngeal protuberance 3 by touching the finger. Or can be confirmed by visual observation by looking into the inner side of the laryngeal protuberance position confirmation hole 5a from the outside, thereby improving the measurement accuracy and the reproduction accuracy.

  That is, as shown in FIG. 6 (a), the position of the laryngeal protuberance in a normal state is confirmed visually or with a finger using the laryngeal protuberance position confirmation hole 5a, and the detector attachment 5 is wrapped around the neck and the hook-and-loop fastener 9 Secure with. At the same time, the front neck is closely fixed by the lower cushion material 7, and the middle air pad sensor 11 placed on the sensor cushion material 10 can detect the behavior of the laryngeal protuberance 3.

  If there is a behavior of the laryngeal protuberance 3 of the subject M, the middle air pad sensor 11 and the laryngeal protuberance 3 come into contact with each other as shown in FIG. It can be measured by the sensor 11. It is also possible to capture the behavior peak at that time.

  At this time, the notch portion 6 frees the detector fixing portion region without hindering the movement of the laryngeal protuberance, so that the natural movement of the laryngeal protuberance of the subject M can be accurately detected.

  FIGS. 6C and 6D show a case where the detector mounting tool 5 including the upper cushion material 8 in addition to the lower cushion material 7 is used, and such a detector mounting tool 5 is used. Even in the case, the same operation and effect as the above-described case can be exhibited by the use manner similar to the case shown in FIGS. 6 (a) and 6 (b).

FIG. 7 shows the overall configuration of the swallowing ability test apparatus 1 according to the present embodiment, and FIG. 8 shows the detailed structure of the data processing means 46 in the swallowing ability test apparatus 1.
The swallowing ability test apparatus 1 is for inspecting the swallowing ability of the subject M based on the detection means 4 worn around the neck 2 of the subject M and a detection signal from the detection means 4. Computer apparatus 41.

  As shown in FIG. 7, the computer device 41 controls a program memory 42 that stores a program for performing operation control, data processing, and image processing of the swallowing ability test apparatus 1, and controls the entire swallowing ability test apparatus 1. A control unit 43 to perform, a main storage unit 44 for storing various data, a keyboard 45 for inputting characters, numbers, etc. for threshold voltage setting, measurement time setting, etc., the middle air pad sensor 11, left air Data processing means 46 for processing the detection signals from the detection means 4 including the pad sensor 12, the right air pad sensor 13, and the sound detection air pad sensor 16, and outputting waveform data corresponding to the detection signals; and the waveform data Display means 47 such as a liquid crystal display for outputting the waveform information corresponding to the above in a visible manner.

Next, the data processing means 46 will be described in detail with reference to FIG.
In this embodiment, the detection means 4 has a four-system configuration for processing each detection signal from the middle air pad sensor 11, the left air pad sensor 12, the right air pad sensor 13, and the sound detection air pad sensor 16. The following will be described.

As shown in FIG. 8, the data processing unit 46 includes the air tubes 11 b, 12 b, 13 b, 16 b from the middle air pad sensor 11, the left air pad sensor 12, the right air pad sensor 13, and the sound detection air pad sensor 16. The three piezoelectric elements 51 that convert the detection signals (air fluctuation signals) transmitted through the above to piezoelectric signals into electrical signals, the three amplifiers 52 that amplify the electrical signals from the piezoelectric elements 51, and the amplifiers 52 Filtering is performed on the electrical signal corresponding to each of the detection signals amplified by the above, and for example, a signal of 4.4 kHz or higher is cut to show the movement of the muscle, hyoid bone, and laryngeal protuberance 3 corresponding to the detection signal Three low-pass filters 53 as waveform data, and three low-pass filters 53 that take the waveform data and convert it into digital waveform data / D converter 54 and three smoothing means for performing smoothing processing to be described later in detail on each digital waveform data converted by the three A / D converters 54 and outputting extremely low frequency signal data 55, swallowing movement measurement processing means 57 comprising three swallowing movement measurement processing sections 56, data storage means 58 for storing the processing results of the swallowing movement measurement processing means 57, and various kinds of data stored by the data storage means 58 And an output processing unit 59 that processes the data and sends it to the display means 47.
Further, the data processing means 46 has one piezoelectric element 51 that converts the detection signal from the sound detection air pad sensor 16 into an electric signal by piezoelectric conversion, and one element that amplifies the electric signal from the piezoelectric element 51. Amplifier 52, an audible sound pass filter 63 that passes an output signal in the audible sound frequency region among the output signals of the amplifier 52, and an A / D that converts the output signal from the audible sound pass filter 63 into a digital signal. And the output signal of the A / D converter 54 is stored in the data storage means 58 as swallowing sound information of the subject M.
With such a configuration from the sound detection air pad sensor 16 to the display means 47, swallowing-related sounds can be collected and recorded in association with the measurement of the movement of the subject M around the larynx, and aspiration pneumonia can be recorded. Since it is said that voices become hoarse as it progresses, swallowing-related sounds can be recorded in association with movements around the larynx and displayed as waveform data, making it possible to perform swallowing ability tests more effectively It is possible to provide a swallowing ability test apparatus that can be used.
For the middle air pad sensor 11, the left air pad sensor 12, the right air pad sensor 13, and the sound detection air pad sensor 16, when the vibration of the air bag is detected, the piezoelectric element 51 is used instead of the piezoelectric element 51. A vibration / electric conversion element such as a condenser microphone may be used.
Further, the swallowing related sound recorded in association with the measurement of the movement around the larynx may be a means for generating sound from a speaker or the like instead of the display means for displaying as waveform data.

  As shown in FIG. 9, the swallowing movement measurement processing unit 56 of the swallowing movement measurement processing means 57 is based on the threshold signal and the measurement time signal, and based on the waveform data after the smoothing process, A swallowing frequency measuring unit 61 that measures and outputs the swallowing frequency within a predetermined measurement time, and a waveform data transmission unit 62 that outputs waveform data after smoothing processing are provided.

  FIG. 10 is an explanatory diagram of the oral phase, laryngeal phase, and esophageal phase at the time of swallowing saliva, water and bolus (hereinafter referred to as “meat S”) in the subject M, and the oral phase shown in the left column of FIG. , Food is chewed and mixed with saliva to form a bolus S (easy to swallow) and fed from the mouth to the throat (pharynx).

  Next, in the laryngeal stage shown in the middle column of FIG. 10, when the tongue tip is raised and the bolus S reaches the pharynx, the hyoid bone is lifted and the larynx is also lifted upwards and the epiglottis is lowered to close the entrance of the trachea.

  Furthermore, in the esophageal phase shown in the right column of FIG. 10, when the bolus S is sent from the pharynx, the esophagus entrance portion is temporarily expanded to induce peristaltic movement, and the bolus S is sent down the esophagus. The laryngeal protuberance 3 is displaced with the above-described series of swallowing operations of the subject M.

  Next, with reference to FIGS. 11 and 12, the detection signal smoothing processing by the smoothing processing means 55 and the measurement processing of the swallowing movement measurement processing unit 56 in the swallowing ability test apparatus 1 according to the present embodiment. explain.

  The smoothing processing means 55 converts, for example, a detection signal from the middle air pad sensor 11 shown in FIG. 11 (a change in air pressure of the air bag of the middle air pad sensor 11 is converted into an electric signal using the piezoelectric element 51. The output voltage waveform data) is smoothed as will be described later in detail, and converted to low frequency waveform data shown in FIG.

  In FIG. 11, the horizontal axis represents the measurement time, and the vertical axis represents the voltage of the waveform data.

  In addition, the swallowing frequency measurement unit 61 of the swallowing movement measurement processing unit 57 measures the swallowing frequency within the measurement time of the subject M according to the threshold voltage and the measurement time set by the operation of the keyboard 45.

  The threshold voltage can be arbitrarily set to a level where the measurer confirms the behavior of the laryngeal protuberance 3 of the subject M and confirms the fact that it is regarded as swallowing. It is also possible to fix the setting at the time of shipment from the factory based on data obtained from examinations of a large number of subjects M in advance.

  The waveform data before the smoothing process shown in FIG. 11 shows, for example, the change state of the detection signal of the middle air pad sensor 11. More specifically, the output data of the piezoelectric element 51 is output by the amplifier 52. This is waveform data generated based on digital data that has been amplified and passed through a low-pass filter (filter that passes 20 Hz or more) 53 and converted by an A / D converter 54.

  The waveform data after smoothing processing shown in FIG. 11 shows that the waveform data before processing is subjected to data processing by smoothing processing to extract a very low frequency signal, and the laryngeal protuberance applied to swallowing the subject M 3 (or its surroundings) is generated as visually recognizable waveform data.

  In the waveform data shown in FIG. 11, when a threshold voltage for threshold setting is provided, four feature points (black circles in the figure) are extracted, but the first and second feature points from the beginning are extracted. Although there is a behavior of the laryngeal protuberance 3, swallowing is not actually performed, and accurate swallowing ability cannot be detected.

On the other hand, the waveform data shown in FIG. 11 is waveform data obtained by extracting an extremely low frequency signal by smoothing processing, and the last and last swallowing actually performed by setting a threshold voltage for threshold setting. The feature points can be extracted only from the second two locations.
That is, the actual swallowing frequency of the subject M is automatically and accurately measured by the waveform data obtained by extracting the extremely low frequency signal and the threshold voltage, and displayed by the display means. Thus, accurate swallowing ability measurement of the subject M can be realized.

  Furthermore, by setting the measurement time in advance, the number of feature points within the set time can be automatically measured by the data processing means 58, and the swallowing frequency can be automatically measured.

  Note that FIG. 11 shows waveform data from 6 seconds to 26 seconds after the meal start of the subject M.

  Next, the smoothing process will be outlined with reference to FIG.

  In the upper column of FIG. 12, the horizontal axis indicates time, and the vertical axis indicates a numerical value corresponding to the output value of the piezoelectric element 51 as a solid line as f (x). In the lower column of FIG. 12, the horizontal axis indicates time, and the vertical axis indicates the numerical value of the waveform data after the smoothing process as g (x) by a dotted line.

  The smoothing process is a five-point smoothing process in which five output values for each elapsed time are replaced with average values.

  For example, the third numerical value 19 from the beginning in the lower column of FIG. 12 is obtained by calculating the sum (12 + 15 + 38 + 14 + 17) by focusing on the first to fifth numerical values in the upper column of FIG. Is adopted.

  The first and second numerical values 12 and 15 in the lower column of FIG. 12 are the same as the first and second numerical values 12 and 15 in the upper column of FIG.

  Waveform data indicated by a dotted line in the lower column of FIG. 12 is obtained by repeating such arithmetic processing one after another for numerical values that are consecutively shifted while being shifted by 5 points.

  The general formula of the five-point smoothing process described above can be expressed by the following formula 1.

  The swallowing ability test device of the present invention has a repeated saliva swallowing ability test (how many swallows were made in 30 seconds: the normal lower limit of the elderly is 3 times), a revised drinking test (3 ml of cold water is poured into the oral cavity, and swallowing is performed. Order test), food test (a test where a teaspoon of pudding is placed on the back of the tongue and eaten), hyoid movement, laryngeal movement (pharyngeal Buddha movement), epiglottis closure and open sound, neck muscles Widely used as a testing device to detect movements of food, changes in chewing movement of food, determination of bite (single bite), change of generated sound, determination of rehabilitation effect of swallowing improvement, determination of various diseases such as Parkinson's disease it can.

DESCRIPTION OF SYMBOLS 1 Swallowing ability test apparatus 2 Neck 3 Laryngeal protuberance 4 Detection means 4A Detection means 5 Detector mounting tool 5A Detector mounting tool 5a Laryngeal protuberance position confirmation hole 6 Cut part 7 Lower cushion material 8 Upper cushion material 9 Surface fastener 10 Sensor cushion Material 11 Middle air pad sensor 11b Air tube 12 Left air pad sensor 12b Air tube 13 Right air pad sensor 13b Air tube 14 Middle 1 air pad sensor 14b Air tube 15 Middle 2 air pad sensor 15b Air tube 16 Sound detection air pad sensor 16b Air tube 41 Computer device 42 Program memory 43 Control unit 44 Main storage unit 45 Keyboard 46 Data processing means 47 Display means 51 Piezoelectric element 52 Amplifier 53 Low-pass filter Luther 54 A / D converter 55 Smoothing processing means 56 Swallowing movement measurement processing section 57 Swallowing movement measurement processing means 58 Data storage means 59 Output processing section 61 Swallowing frequency measurement section 62 Waveform data transmission section 63 Audible sound passing filter M Test Party S bolus

Claims (12)

Detection means for providing at least one or more detectors arranged in a region around the larynx of the subject, and outputting one or more detection signals according to a change with time of movement of the region around the larynx by the detector; ,
Data smoothing processing means for performing a data process by a smoothing process on a change state of the detection signal connected in time series and extracting an extremely low frequency signal;
Swallowing movement measurement processing means for measuring movement around the larynx for swallowing based on the extremely low frequency signal;
Storage means for storing the processing result of the swallowing movement measurement processing means;
Display means for outputting the processing result of the swallowing movement measurement processing means as visible waveform data;
A swallowing ability test apparatus characterized by comprising:   2. The swallowing device according to claim 1, wherein the detector is a detector that uses an air bag and outputs the movement of the region around the larynx of the subject as a change in air pressure of the air bag or a change in air vibration. Capability inspection device.   One or more detectors are disposed on the front neck of the subject, and the detector is equipped with a laryngeal bulge position confirmation hole in a portion corresponding to the laryngeal bulge of the subject. The swallowing ability test device according to claim 1 or 2.   It comprises a detector mounting tool that arranges one or more detectors on the front neck of a subject, and the detector mounting tool includes a notch in the length direction of the detector mounting tool and the detector. It has a front neck fixing part region for fixing the wearing tool to the front neck part, and a detector fixing part region arranged so that the laryngeal protuberance of the subject can come into contact with the detector, The swallowing ability test device according to any one of claims 1 to 3.   The swallowing ability test apparatus according to any one of claims 1 to 4, wherein one or more detectors arranged in the laryngeal peripheral region are arranged along a movement direction of the laryngeal protuberance.   One or more detectors arranged in the laryngeal peripheral region are arranged along the direction of movement of the laryngeal ridge, and one or more pairs are arranged in a pair on the left and right with the movement direction of the laryngeal ridge as a center. Item 5. A swallowing ability test device according to any one of Items 1 to 4.   The detector is a three-piece air pad sensor equipped with an air bag for detecting movements of the laryngeal protuberance and the laryngeal peripheral region as a change in air pressure or a change in air vibration, and a medium air disposed along the laryngeal protuberance. The pad sensor unit, a right air pad sensor arranged on the right side of the laryngeal protuberance, and a left air pad sensor arranged on the left side of the laryngeal protuberance, respectively, characterized by comprising: Swallowing ability testing device.   The swallowing ability according to any one of claims 1 to 7, wherein the detector further includes a sound detection air pad sensor that detects a swallowing sound of the subject disposed on a side surface of the neck of the subject. Inspection device.   The swallowing movement measurement processing means performs threshold processing by an arbitrary threshold on the extremely low frequency signal from the data smoothing processing means, and enables extraction of a region exceeding the threshold as a feature point. Item 9. A swallowing ability test device according to any one of Items 1 to 8.   10. The swallowing ability according to claim 1, wherein the swallowing movement measurement processing means includes a swallowing frequency measuring unit that measures the feature points extracted in a preset time as the swallowing frequency. Inspection device.   The swallowing movement measurement processing means uses a time point when a detection signal detected by a detector arranged along the movement direction of the laryngeal bump exceeds the threshold as an inspection reference point, and the pair of left and right sides with the inspection reference point as a reference. 10. The swallowing ability test apparatus according to claim 9, wherein a paralysis situation of left and right muscle functions of the laryngeal protuberance can be inspected from a delay situation of a detection signal of the detection means.   10. The swallowing ability according to claim 9, wherein the swallowing movement measurement processing means can compare the detection signals of the pair of left and right detectors to test the ability of each of the left and right muscle functions of the laryngeal protuberance. Inspection device.

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