JP6980245B2 - How to operate the swallowing ability measuring device and the swallowing ability measuring device - Google Patents

Description

The present invention relates to a swallowing ability measuring device and a swallowing ability determination method, and more specifically, the subject-specific swallowing without depending on a determination standard or a statistical index set uniformly or uniformly. It relates to a swallowing ability measuring device and a swallowing ability determining method capable of objectively determining a function or a swallowing ability.

Many developed countries, including Japan, are facing an aging society, and as a result of the development of swallowing rehabilitation, food with appropriate physical properties is provided to people with swallowing disorders, and the elderly and people with illnesses have suffered. Improvements in QOL (quality of life), such as patients feeling the joy of eating again, have come to be emphasized. In addition, in an aging society, safe oral intake is important for overcoming malnutrition such as sarcopenia and frail, but in general, this type of oral intake is manual in terms of long-term care, etc. It is also known that it takes. Furthermore, suffocation accidents such as elderly people caused by aspiration and dysphagia, aspiration pneumonia, etc. have been regarded as a particular problem in recent years as major causes of death. In order to overcome such poor oral intake, prevent aspiration or suffocation, or overcome dysphagia, patients should be aware of or correctly understand their swallowing ability, and should be properly trained. Measures such as providing an environment or equipment for recovering or maintaining the ability to swallow are desired.

Swallowing is established in a physiological process in which voluntary movements and reflex activities coexist, while complex swallowing movements are carried out by both neural control and reflex activity by the cerebrum. It is believed that swallowing movement can be arbitrarily controlled to some extent by the control mechanism of the cerebrum. The present inventor reports in Non-Patent Document 1 that the site of increased blood flow in the brain differs depending on the food (Non-Patent Document 1: "Cortical activation during solid bolus swallowing" (J Med Dent Sci 2007; 54). )). Further, in Non-Patent Document 2, in the temporal relationship between the activity of the organ at the time of swallowing and the amount of liquid to be swallowed, the start time of the organ activity is earlier and the duration thereof is slightly extended as the amount of liquid increases. (Non-Patent Document 2: "Timing of Videofluoroscopic, Manometric Events, and Bolus Transit During the Oral and Pharyngeal Phases of Swallowing" (Dysphagia 4: 8-15 (1989)).

The present inventor studies to examine the voluntary variability of swallowing, which is considered to represent the control of the brain, by acoustic analysis of swallowing sound, and the tongue associated with the voluntary variability of the subject (or subject). I am researching a technique to measure the amount of muscle activity of the suprahyoid muscle group with a surface electromyogram. As a technique for measuring swallowing function using a surface EMG, for example, in Patent Document 1 (Japanese Unexamined Patent Publication No. 2005-304890), detection of dysphagia in which a subject's swallowing ability is measured using a surface EMG is described. The method is described. In this detection method, electrodes are placed on the muscle surface of the hyoid muscle group of the subject to acquire a surface EMG during swallowing, and the parameters visualized by the surface EMG are used as data for healthy and disabled people. This is a swallowing function evaluation method for evaluating the swallowing function of a subject.

Further, in Patent Document 2 (Japanese Unexamined Patent Publication No. 2009-39516), in order to objectively evaluate the swallowing sensation (so-called “soothing sensation”) obtained when swallowing food and drink, the hyoid muscle group of the subject. Described is a technique for evaluating the swallowing sensation of food and drink by arranging electrodes on the surface of the muscle of the body, acquiring a surface electromyogram at the time of swallowing, and using the surface myoelectric potential of a specific frequency band as an index. However, this technique is an evaluation method for foods and drinks that attempts to numerically clarify the characteristics peculiar to foods and drinks related to "feeling of throat" from the surface myoelectric potential of the subject, and evaluates the swallowing function of the subject. Not a technology.

Japanese Unexamined Patent Publication No. 2005-304890 Japanese Unexamined Patent Publication No. 2009-39516

"Cortical activation during solid bolus swallowing" (J Med Dent Sci 2007; 54) "Timing of Videofluoroscopic, Manometric Events, and Bolus Transit During the Oral and Pharyngeal Phases of Swallowing" (Dysphagia 4: 8-15 (1989)

According to the conventional swallowing function evaluation method using a surface electromyogram (Patent Document 1), the swallowing ability of the subject may be visualized, and the subject may be aware of and respond to his / her own swallowing ability. However, in the conventional swallowing function evaluation method, the swallowing function of the subject must be evaluated by comparing the swallowing function of the subject with the data of the healthy person and the handicapped person. , It is necessary to preset or prepare evaluation criteria, judgment criteria or statistical indicators that can be uniformly or uniformly applicable to many subjects. On the other hand, the required swallowing function or swallowing ability is relatively large for each subject or test depending on age, gender, physical ability, lifestyle, test conditions, test environment, etc., so that the swallowing function or swallowing ability is normal. In order to determine whether or not the disease is present, a large amount of objective data or statistical data is accumulated and analyzed, and the normal value or normal range such as myoelectric potential is objectively and numerically uniformly or uniformly. It will need to be set, but this is extremely difficult. That is, there is no objective numerical standard such as myoelectric potential for determining the swallowing function or the swallowing ability. Therefore, at present, it is difficult to objectively determine the swallowing function or the swallowing ability peculiar to the subject. ..

The present invention has been made in view of such circumstances, and an object thereof is peculiar to a subject without depending on a judgment standard or a statistical index set uniformly or uniformly. It is an object of the present invention to provide a swallowing ability measuring device and a swallowing ability determining method capable of objectively determining a swallowing function or a swallowing ability.

In order to achieve the above object, the present invention has a detection electrode portion arranged on the muscle surface of the hyoid muscle group of the subject and a myoelectric potential measurement for quantifying the surface myoelectric potential detected by the detection electrode portion. In a swallowing ability measuring device having a device and a display device for displaying the measurement result of the myoelectric potential measuring device,
When the subject swallows a liquid, liquid fluid, or semi-solid food or drink with the consciousness of "drinking normally", the first muscle activity measured by the myoelectric potential measuring device is the "muscle activity level during normal swallowing". When the subject swallows a liquid, liquid fluid, or semi-solid food or drink with the consciousness of "drinking strongly", the second muscle activity measured by the myoelectric potential measuring device is set as "maximum effort swallowing". It has a swallowing ability determination means that sets it as "muscle activity level" and obtains the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" as the swallowing ability of the subject.
The display device provides a swallowing ability measuring device characterized by having a display means for displaying a determination result of the swallowing ability determining means.

The present invention also arranges a detection electrode portion on the muscle surface of the hyoid muscle group of the subject, quantifies the surface myoelectric potential detected by the detection electrode portion, and obtains the quantified surface myoelectric potential measurement result. In the swallowing ability determination method for determining the swallowing ability of the subject based on
The amount of first muscle activity obtained by quantifying the surface myoelectric potential detected when the subject swallows a liquid, liquid fluid, or semi-solid food or drink with the consciousness of "drinking normally" is the "muscle during normal swallowing". Set as "activity level" and
The second muscle activity obtained by quantifying the surface myoelectric potential detected when the subject swallows liquid, liquid fluid, or semi-solid food and drink with the consciousness of "drinking strongly" is the "muscle during maximum effort swallowing". Set as "activity level" and
Provided is a method for determining swallowing ability, which comprises setting the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" as the swallowing ability of a subject.

According to the above configuration of the present invention, the subject swallows a liquid or the like in two swallowing modes, "drink normally" and "drink strongly", and each swallowing mode reflects the swallowing ability peculiar to the subject. It was done. The present invention is to detect a relative difference in muscle activity level of each swallowing mode and determine the swallowing ability of a subject based on the difference between both muscle activity levels. Therefore, according to the present invention, it is not necessary to compare the swallowing function of a subject with the swallowing function of another subject, and a large amount of objective data or statistical data is accumulated and analyzed uniformly or uniformly. If the swallowing function of the subject is judged using the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" as a parameter without the need to set a specific criterion or statistical index. good.

In addition, the determination of this parameter can be made from the viewpoint of whether or not the subject has a swallowing function that clearly changes the "drinking strongly" swallowing movement and the "normally drinking" swallowing movement. In order to determine whether or not the 1st muscle activity amount and the 2nd activity amount are clearly different, the value of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" is, for example, 1. A simple comparison may be made as to whether or not it is 5.5 or more, or whether it is 2.0 or more.

In the present specification, the "drinking normally" swallowing exercise is a swallowing exercise in which the subject is instructed by the examiner to "drink normally" immediately before and consciously drinks saliva, water, etc. .. This can be grasped as a "normal swallowing" swallowing movement that is performed unconsciously on a daily basis. On the other hand, the "drinking strongly" swallowing exercise is a swallowing exercise in which the subject is instructed by the examiner to "drink strongly" immediately before and consciously drinks saliva, water, or the like. This can be grasped as the "maximum effort swallowing" peculiar to the subject, consciously conscious of the effort of the subject to swallow.

According to a preferred embodiment of the present invention, the muscle activity amount is the value of the surface myoelectric potential at the maximum amplitude, the liquid or the liquid fluid is the saliva of the subject himself, and the muscle activity amount is the subject's own saliva. , Measured during swallowing of the subject.

Preferably, the swallowing ability determining means sets the average value of the values of a plurality of muscle activities measured when swallowing multiple times with the consciousness of "drinking normally" as the "muscle activity level during normal swallowing". Set. If desired, it is also possible to set the average value of the values of multiple muscle activities measured when swallowing multiple times with the consciousness of "drinking strongly" as the "muscle activity level during maximum effort swallowing". be.

Preferably, the swallowing ability determining means stores a determination threshold value for determining the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing". The threshold value for determining the swallowing ability of a healthy person is a value in the range of 1.5 to 2.5, preferably a value in the range of 1.8 to 2.2 (for example, 2.0). ) Is set. The threshold value for determining dysphagia requiring treatment is set to a value in the range of 1.0 to 2.0, preferably a value in the range of 1.3 to 1.7 (for example, 1.5). Will be done.

According to the swallowing ability measuring device and the swallowing ability determining method according to the present invention, the swallowing function or the swallowing ability peculiar to the subject is objectively obtained without depending on the determination criteria or statistical indexes set uniformly or uniformly. Can be determined.

FIG. 1 is a system configuration diagram showing the configuration of a swallowing ability measuring device according to a preferred embodiment of the present invention as a whole. FIG. 2 is a block diagram schematically showing the configuration and function of the myoelectric potential measuring unit. FIG. 3 is a front view showing each image of the three types of determination results displayed on the screen of the display device shown in FIG. FIG. 4 is a diagram showing the original waveform of the surface myoelectric potential detected in the detection electrode portion in the myoelectric potential measurement test. FIG. 5 is a diagram showing the values (muscle activity amount) of the average amplitude and the maximum amplitude of the surface myoelectric potential obtained by the myoelectric potential measuring unit based on the original waveform shown in FIG. FIG. 6 is a flow chart showing a swallowing ability evaluation / determination method according to a preferred embodiment of the present invention. FIG. 7 is a front view and a side view showing another embodiment of the swallowing ability measuring device.

FIG. 1 is a system configuration diagram showing the configuration of a swallowing ability measuring device according to a preferred embodiment of the present invention as a whole.

The swallowing ability measuring device 1 shown in FIG. 1 includes a myoelectric potential measuring unit 2, a detection electrode unit 3, an unrelated electrode unit 4, and a desktop PC (personal computer) 5. The detection electrode unit 3 and the unrelated electrode unit 4 are connected to the input / output unit of the myoelectric potential measurement unit 2 by the control signal line 6. As shown in FIG. 1, a pair of detection electrode portions 3 are arranged in the left hyoid muscle group involved in swallowing movement (for example, a site of the anterior 1/3 of the left-right chin-mandibular angular distance). The hyoid muscle group involved in the swallowing movement includes the geniohyoid muscle, the thyrohyoid muscle, the sternohyoid muscle, and the sternothyroid muscle. Further, the unrelated electrode portion 4 is arranged in the earlobe (earlobe). The unrelated electrode portion 4 is for setting a reference electrode, and may be arranged at an arbitrary portion of the body away from the detection electrode portion 3.

The detection electrode portion 3 has a disk-shaped or dish-shaped silver / silver chloride surface electrode for deriving the action potential of the muscle from above the skin, and the surface of the detection electrode portion 3 in contact with the skin of the subject is , At least partially covered with a cloth coated with an adhesive, and the surface electrodes are in close contact with the skin surface. The myoelectric potential measuring unit 2 has a control unit that analyzes waveform data (original waveform) of the surface myoelectric potential detected by the detection electrode unit 3. The control unit of the myoelectric potential measuring unit 2 has a function of a general electromyogram that analyzes and records the detected value of the surface myoelectric potential input from the detection electrode unit 3 as the waveform of the surface electromyogram. The surface electromyogram is a recorded waveform in which the vertical axis represents the amplitude of the action potential and the horizontal axis represents the temporal transition.

The PC 5 has a CPU (central processing unit) that executes arithmetic processing and the like, and a PC main body 5a that incorporates a storage device such as a memory and a hard disk. The swallowing ability evaluation software developed and created by the present inventor for evaluating or determining the swallowing ability of the subject is installed in the PC main body 5a. The PC main body 5a is connected to the input / output unit of the myoelectric potential measurement unit 2 by the control signal line 7, and the display device 5d, the keyboard 5e, the mouse (not shown), etc. are connected via the control signal lines 5b, 5c, and the like. Connected to a human interface device. The output of the myoelectric potential measuring unit 2 (electromyographic waveform data or the like) is input to the storage unit of the PC main body 5a via the input / output interface of the PC main body 5a. On the screen of the display device 5d, a determination diagram 5f is displayed as an image as an index showing the swallowing ability of the subject, and a determination result display 5g for displaying the determination result in three stages is displayed as an image. The determination diagram 5f shows a myoelectric potential waveform and a determination threshold value as will be described later. In the judgment result display 5g, the characters "safety", "caution required" and "danger" are selectively displayed, and the display of the traffic light form indicating these states by green light, yellow light and red light is displayed. do. The index of swallowing ability, the display of the determination result, etc. will be described later.

FIG. 2 is a block diagram schematically showing the configuration and function of the myoelectric potential measuring unit 2.

The myoelectric potential measurement unit 2 has an input / output unit (I / O), an amplification unit, a control unit, and an A / D conversion unit, and the control unit includes a filter processing unit, a rectification processing unit, an RMS processing unit, and a quantification unit. Has. The myoelectric potential detection value of the original waveform input from the detection electrode unit 3 to the input / output unit is amplified in the amplification unit and filtered based on the low frequency 20 Hz and the high frequency 500 Hz. Since the myocardial waveform is composed of a positive waveform (+) and a negative waveform (-), after undergoing rectification processing to invert the negative waveform to a positive waveform, the root mean square (Root Mean) is based on a time constant of 100 ms. After undergoing Square, RMS) processing, and then quantification processing, the value of muscle activity (quantified) quantified (quantified) by mean amplitude, maximum amplitude, and integrated myoelectric potential as an analysis result (quantified result) (quantified) Unit: μV) is obtained. These analysis results are A / D converted together with the waveform data of the EMG waveform that has undergone rectification processing and RMS processing, and are output to the PC main body 5a via the input / output unit.

The PC main body 5a evaluates and determines the swallowing ability of the subject based on the analysis result of the myoelectric potential measurement unit 2 and the EMG waveform by the above-mentioned software for evaluating the swallowing ability, and the determination diagram 5f and the determination result. The display 5g (FIG. 1) is displayed on the screen of the display device 5d.

FIG. 3 is a front view showing each image of the three types of determination results displayed on the screen of the display device 5d. As described above, the determination diagram 5f and the determination result display 5g are displayed on the screen of the display device 5d. As shown in FIG. 3, the determination diagram 5f is a diagram showing the myoelectric potential waveform 5h and the determination thresholds 5i and 5j, and the value on the vertical axis is an index or indicated value of swallowing ability displayed in%. , The horizontal axis is the time axis. In the present embodiment, as shown by the broken line in FIG. 3, a reference level (100%) for determining swallowing ability is set, and 1.5 times (150%) and 2.0 times (150%) of this reference level ( The value of 200%) is set to the determination threshold value 5i and 5j. In addition, the character display of "safety", "caution required", and "danger" is selectively displayed on the determination result display 5g, and the green signal B, the yellow signal Y, and the red signal R are selectively displayed in the figure in the form of a traffic light. Is visually displayed (lit). In the figure of the present application, the lighting state of each signal lamp (signals B, Y, R) is shown in black.

Hereinafter, the evaluation / determination method according to the present invention will be described, and the significance of the three types of determination results will be described in relation to the evaluation / determination method.

As a demonstration experiment of the present invention, the present inventor conducted a myoelectric potential measurement test for 10 healthy young subjects (average age 20.9 years, female) who had no history of dysphagia. Was carried out. In this myoelectric potential measurement test, water was used as food, the single intake was set to 5 ml, and the myoelectric potential during the sitting posture and swallowing was measured by the myoelectric potential measurement unit 2. The attachment site of the detection electrode portion 3 was set to the left suprahyoid muscle group, and the distance between the electrodes of the two detection electrode portions 3 was set to 2 cm. Each subject swallows water after putting water in the oral cavity at the time of each myoelectric potential measurement, and consciously "drink strongly" or "drink normally" at each swallow. Each subject randomly performed the "drinking strongly" form or the "drinking normally" form 5 times each for a total of 10 times. The subject is aware of either "drinking strongly" or "drinking normally" according to the instructions of the examiner immediately before swallowing, and swallows water under such consciousness.

FIG. 4 is a diagram showing the original waveform of the surface myoelectric potential detected by the detection electrode unit 3 in this myoelectric potential measurement test, and FIG. 5 is a diagram obtained by the myoelectric potential measurement unit 2 based on this original waveform. It is a diagram which shows the value (muscle activity amount) of the average amplitude and the maximum amplitude of the surface myoelectric potential.

As shown in FIGS. 4 and 5, in the case of healthy young people, the amount of muscle activity obtained by "drinking strongly" is significantly higher than the amount of muscle activity obtained by "drinking normally". This is thought to be a phenomenon associated with an increase in the force with which the tongue is pressed against the palate when "drinking hard". According to the findings of the present inventor, when a healthy young person (subject) is aware of the form of "drinking strongly" or "drinking normally" according to the instructions of the examiner, as shown in FIGS. 4 and 5, "strongly drink". When instructed to "drink", the amount of muscle activity (mean amplitude, maximum amplitude) of the suprahyoid muscle group increases relatively significantly as compared with the case where "drink normally" is instructed. This phenomenon is common to almost all healthy young people. On the other hand, this phenomenon is not generally seen in subjects with reduced swallowing ability, even if they are instructed to "drink strongly" in the case of subjects with reduced swallowing ability. , The amount of muscle activity (mean amplitude, maximum amplitude) of the suprahyoid muscle group is equal to or only slightly increased when instructed to "drink normally".

In addition, such a phenomenon is not only observed when swallowing a small amount of liquid such as water, but also when swallowing only saliva, other liquids or liquid liquids, or semi-solid foods. It is a phenomenon that can be seen when swallowing.

The present inventor pays attention to such a phenomenon, and calculates the muscle activity amount (maximum amplitude) η of the subject obtained when the examiner instructs the subject to "drink strongly" at the time of "maximum effort swallowing". The muscle activity level (maximum amplitude) α of the subject obtained when the examiner instructed the subject to "drink normally" is defined as "muscle activity level of normal swallowing". It is defined as "level", and swallowing ability is defined as "swallowing ability" = "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" (η / α).

The present inventor sets the judgment criteria of swallowing ability in the evaluation / judgment method of the present invention as follows, and associates the character display and the traffic light display of the judgment result display 5g shown in FIG. 3 with the judgment criteria as follows. suggest.
(1) Swallowing ability (= η / α) ≧ 2.0 (200%):
A state where you can continue your eating habits ⇒ "Safety", green light B
(2) 2.0 (200%)> Swallowing ability (= η / α) ≧ 1.5 (150%):
State to be re-evaluated after conducting swallowing ability improvement training ⇒ "Caution required", yellow light Y
(3) 1.5 (150%)> Swallowing ability (= η / α):
A condition where you should consult a medical institution and perform swallowing rehabilitation, etc. ⇒ "Danger", red light R

FIG. 6 is a flow chart showing a swallowing ability evaluation / determination method using this determination criterion. Hereinafter, the swallowing ability evaluation / determination method according to the present invention will be described with reference to FIG.

As described above, in the case of measuring the myoelectric potential of a healthy person, the amount of muscle activity obtained when "drinking strongly" is significantly higher than the amount of muscle activity obtained when "drinking normally". On the other hand, in the case of myoelectric potential measurement of an unhealthy person, this phenomenon is hardly observed. This is a phenomenon that can be seen not only when swallowing a small amount of liquid such as water, but also when swallowing only saliva. Therefore, the swallowing ability evaluation / determination method shown in FIG. 6 is configured to evaluate / determine the swallowing ability by empty swallowing of the subject.

As a preparation before evaluating / determining the swallowing ability, the detection electrode portion 3 is attached to the left hyoid muscle group of the subject as shown in FIG. The Seki electrode portion 4 is attached, and the myoelectric potential measuring unit 2 and the PC 5 are activated. After that, the examiner instructs the subject to "drink normally" saliva, and the subject swallows saliva in the form of "drinking normally". The examiner and the subject repeat this three times at predetermined time intervals (for example, 30 second intervals). It is known that it is difficult for a subject to repeatedly perform three swallows in a relatively short time when the subject has significant dysphagia, and it is difficult for the subject to swallow three times. In this case, it is considered necessary to complete the examination before evaluating / determining the swallowing ability in accordance with the present invention, and to urge the subject to perform a detailed examination and treatment. Regarding the validity of three times of swallowing, for example, "Examination of the Repetitive Saliva Swallowing Test (RSST) (2) Examination of validity" ("Rehabilitation") Since it is described in "Medicine" VOL.37 NO.6 (383-388) June 2000), further detailed explanation is omitted by quoting this paper.

As shown in FIG. 6, the myoelectric potential measuring unit 2 acquires the myoelectric potential detection value (original waveform) at the time of three swallows (S1, S2). The control unit of the myoelectric potential measurement unit 2 amplifies the myoelectric potential detection value, executes each processing such as filter processing, rectification processing, RMS processing and quantification, and the maximum obtained during "normal drinking" swallowing. The amplitude muscle activity amount α is obtained for each swallowing, and the myoelectric potential measuring unit 2 A / D-converts the data of each time muscle activity amount (maximum amplitude) α and outputs it to the PC main body 5a (S3). The myoelectric potential measuring unit 2 also performs A / D conversion of data on the amount of muscle activity of the average amplitude and integrated myoelectric potential, waveform data of the EMG waveform, and the like, and outputs the data to the PC main body 5a.

The PC 5 displays the waveform data of the myoelectric potential subjected to the rectification processing and the RMS processing on the screen of the display device 5d, and obtains the average value of the muscle activity amount (maximum amplitude) α three times, which is referred to as “normal swallowing”. Muscle activity level of "α" (S4).

As a next step, the examiner instructs the subject to "drink strongly" saliva, and the subject swallows saliva in the form of "drinking strongly". This dry swallowing may be done once. The myoelectric potential measurement unit 2 acquires the myoelectric potential detection value (original waveform) during "drinking strongly" swallowing (S5), and the control unit of the myoelectric potential measurement unit 2 amplifies the myoelectric potential detection value and filters it. Each process such as processing, rectification processing, RMS processing and quantification is executed, the muscle activity amount η of the maximum amplitude obtained at the time of "drinking strongly" swallowing is obtained, and the muscle activity amount data is A / D converted. Output to the PC main body 5a (S6). The myoelectric potential measuring unit 2 also performs A / D conversion of data on the amount of muscle activity of the average amplitude and integrated myoelectric potential, waveform data of the EMG waveform, and the like, and outputs the data to the PC main body 5a. The PC 5 displays the waveform of the myoelectric potential subjected to the rectification processing and the RMS processing on the screen of the display device 5d as shown in FIG. 3, and sets this muscle activity amount η as the “muscle activity level during maximum effort swallowing” η. do.

Next, the PC 5 calculates the value of "swallowing ability" = "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" (η / α), and the ratio η / α ≧ 2.0 ( It is determined whether or not it is (200%) (S7). When the ratio η / α ≧ 2.0, the PC5 determines that the subject has a healthy swallowing ability and is in a state where he / she can continue his / her eating habits, and is shown in FIG. 3 (A). As described above, the characters "safety" and the lighting of the green light B are displayed on the screen of the display device 5d (S8). When the ratio η / α ≧ 2.0, as shown in FIG. 3A, the peak portion ρ of the waveform exceeds the determination threshold value 5j.

On the other hand, when the ratio η / α <2.0 (200%), the PC5 further determines whether or not the ratio η / α ≧ 1.5 (150%) (S9). When the ratio η / α ≧ 1.5, PC5 determined that the swallowing ability of the subject was not always healthy and was in a state to be re-evaluated by conducting swallowing ability improvement training, and FIG. 3 (B). ), The characters "Caution required" and the lighting of the yellow signal Y are displayed on the screen of the display device 5d (S10). When 1.5 ≦ ratio η / α <2.0, the peak portion ρ of the waveform is located between the determination threshold values 5i and 5j as shown in FIG. 3 (B).

On the other hand, when the ratio η / α <1.5 (150%), the swallowing ability of the subject is not healthy, and the PC5 is in a state where it should consult a medical institution and perform swallowing rehabilitation or the like. As shown in FIG. 3C, the character "danger" and the lighting of the red light R are displayed on the screen of the display device 5d (S11). When the ratio η / α <1.5, the peak portion ρ of the waveform is located below the determination threshold value 5i as shown in FIG. 3C.

Therefore, according to the swallowing ability evaluation / determination method according to the present invention, the subject swallows a liquid or the like in two swallowing modes of "normal drinking" and "strong drinking", but each swallowing mode is a test. It reflects a person's unique swallowing ability. The present invention is to detect a relative difference in muscle activity level of each swallowing mode and determine the swallowing ability of a subject based on the difference between both muscle activity levels. Therefore, according to the present invention, it is not necessary to compare the swallowing function of a subject with the swallowing function of another subject, and a large amount of objective data or statistical data is accumulated and analyzed uniformly or uniformly. Criteria set to determine the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" without the need to set a specific criterion or statistical index (for example, The swallowing function of the subject may be determined by 2.0 or 1.5).

FIG. 7 is a front view and a side view showing another embodiment of the swallowing ability measuring device. In FIG. 7, the same reference numerals are given to the components or components substantially the same as those of the above-described embodiments.

The swallowing ability measuring device 1 shown in FIG. 1 is configured as a complex system including the myoelectric potential measuring unit 2 and the PC 5, but the swallowing ability measuring device 10 according to the present embodiment is each of the myoelectric potential measuring unit and the PC. It is configured as an integrated device or device with functions. Since such a swallowing ability measuring device 10 is a portable device such as a portable automatic blood pressure monitor, it is extremely advantageous in terms of convenience.

The swallowing ability measuring device 10 has a structure in which the main body 12 and the display unit 15 are connected by the pivot unit 11, and the display unit 15 rotates around the central axis of the pivot portion as shown by an arrow in FIG. 7 (B). It can be moved and stored or carried in a relatively compact form. A start switch 12a, a key input unit 12b, and an operation switch group 12c are arranged on the upper surface of the main body 12. Similar to the display device 5d (FIG. 1) described above, the display unit 15 displays images of the determination diagram 5f and the determination result display 5g. The detection electrode portion 3 and the unrelated electrode portion 4 are connected to the side surface of the main body 12 by the control signal line 6.

Since the other configurations and functions of the swallowing ability measuring device 10 are substantially the same as the configurations and functions of the swallowing ability measuring device 1 described above, further detailed description will be omitted.

Although the preferred embodiments of the present invention have been described in detail above, the present invention is not limited to the above embodiments, and various modifications or changes can be made within the scope of the present invention described in the claims. It goes without saying that it is possible.

For example, in the above embodiment, the present invention has been described for swallowing swallowing only saliva or swallowing a small amount of water, but the present invention uses other liquids or liquid liquids or semi-solid foods and drinks. The invention may be carried out.

Further, in the above embodiment, the values of 2.0 (200%) and 1.5 (150%) are adopted as the determination threshold values for determining the swallowing ability (η / α), but the present invention has the present invention. , Not necessarily limited to this, but other values can be used, for example, 1.8 (180%) and 1.3 (130%).

Further, in the above embodiment, a desktop PC is adopted as a component of the swallowing ability measuring device, but instead of this type of PC, a notebook PC, a tablet PC, a mobile terminal device, or the like is adopted. Is also good.

Further, in the above embodiment, the swallowing ability measuring device is a wired device in which the detection electrode portion is connected to the myoelectric potential measuring unit or the like by a control signal line, but the detection electrode portion is connected to the myoelectric potential measuring unit or the like by wireless communication. A swallowing ability measuring device may be configured as a wireless device to be connected.

Furthermore, a swallowing sound measuring device such as a pharyngeal microphone is further connected to the myoelectric potential measuring unit, a recording means is further provided in the myoelectric potential measuring unit, the myoelectric potential measuring unit is used as the swallowing sound measuring unit, and software for swallowing sound analysis is used. You may install it on your PC. In addition, by such a swallowing sound measurement system, data such as swallowing sound duration and frequency distribution are also acquired, and these are used as auxiliary factors for swallowing ability evaluation (for example, "drink normally" and "drink strongly". It can also be used as a factor to clarify the difference, or a factor related to the difference in the amount, viscosity or type of liquid).

INDUSTRIAL APPLICABILITY The present invention can be preferably applied to a swallowing ability measuring device and a swallowing ability determining method for objectively determining a swallowing function or a swallowing ability peculiar to a subject. According to the present invention, the swallowing function or swallowing ability peculiar to a subject can be objectively determined without depending on a criterion or a statistical index set uniformly or uniformly, and thus its practical use. The effect is remarkable.

Further, according to the swallowing ability measuring device and the swallowing ability determining method according to the present invention, the subject can be aware of his / her own swallowing ability by visualizing the swallowing ability. By arranging the swallowing ability measuring device, the general public and the like can be aware of their swallowing ability by visual display and can rationally select food suitable for their swallowing ability.

Further, according to the swallowing ability measuring device and the swallowing ability determining method according to the present invention, the subject can self-identify the change in his / her swallowing ability by visualizing the swallowing ability. The swallowing ability can be trained while confirming the change in the swallowing ability by using the created and installed PC and the swallowing ability measuring device of the present invention. This is considered to be an effective and useful measure for preventing suffocation accidents, aspiration pneumonia, etc. in the elderly.

1, 10 Swallowing ability measuring device 2 Myoelectric potential measuring unit 3 Detection electrode part 4 Unrelated electrode part 5 PC (personal computer)
5a PC main body 5d Display device 5f Judgment diagram 5g Judgment result display 5h Myoelectric potential waveform 5i, 5j Judgment threshold 6, 7 Control signal line 11 Axis 12 Main body 15 Display α Muscle activity (maximum amplitude), "Normal Muscle activity level during swallowing "
η Muscle activity (maximum amplitude), “Muscle activity level during maximum effort swallowing”
η / α "Swallowing ability"("Muscle activity level during maximum effort swallowing" / "Muscle activity level during normal swallowing")
ρ Waveform peak

Claims (14)

The detection electrode part arranged on the muscle surface of the hyoid muscle group of the subject, the myoelectric potential measuring device for quantifying the surface myoelectric potential detected by the detection electrode part, and the measurement result of the myoelectric potential measuring device. In a swallowing ability measuring device having a display device for displaying,
The first muscle activity of the hyoid muscle group measured by the myoelectric potential measuring device when the subject performs a swallowing exercise with the consciousness of "drinking normally" liquid, liquid fluid or semi-solid food and drink. The hyoid bone measured by the myoelectric potential measuring device when the subject performs a swallowing exercise with the consciousness of "drinking strongly" liquid, liquid fluid or semi-solid food and drink, which is set as "normal muscle activity level during swallowing". The second muscle activity of the hyoid muscle group is set as the "muscle activity level during maximum effort swallowing", and the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" is set as the subject. Has a swallowing ability determination means required as the swallowing ability of
The display device is a swallowing ability measuring device comprising a display means for displaying a determination result of the swallowing ability determining means. The swallowing ability measuring device according to claim 1, wherein the muscle activity amount is a value of the surface myoelectric potential at the maximum amplitude. The swallowing ability measuring device according to claim 1 or 2, wherein the liquid or the liquid fluid is the saliva of the subject himself / herself, and the muscle activity amount is measured at the time of swallowing of the subject. .. The swallowing ability determining means recognizes a value obtained by averaging the values of a plurality of muscle activities measured when swallowing multiple times with the consciousness of "drinking normally" as "muscle activity level during normal swallowing". The swallowing ability measuring device according to any one of claims 1 to 3, wherein the swallowing ability measuring device is characterized. The swallowing ability determination means stores a determination threshold value for determining the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing", and indicates that it is the swallowing ability of a healthy person. The swallowing ability measuring device according to any one of claims 1 to 4, wherein the threshold value for determination is set to a value in the range of 1.5 to 2.5. The swallowing ability determining means stores a determination threshold value for determining the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing", and the threshold value for determining dysphagia. The swallowing ability measuring device according to any one of claims 1 to 4, wherein the device is set to a value in the range of 1.0 to 2.0. The surface myoelectric potential is detected by the detection electrode portion arranged on the muscle surface of the hyoid muscle group of the subject, the surface myoelectric potential is quantified, and the subject is based on the quantified measurement result of the surface myoelectric potential. It is a method of operating a swallowing ability measuring device for measuring the swallowing ability of
The swallowing ability determining means of the swallowing ability measuring device is
The first muscle activity of the hyoid muscle group obtained by quantifying the surface myoelectric potential detected when the subject drinks liquid, liquid fluid or semi-solid food and drink with the consciousness of "drinking normally". Set the amount as "normal swallowing muscle activity level"
The second muscle activity of the hyoid muscle group obtained by quantifying the surface myoelectric potential detected when the subject drinks liquid, liquid fluid or semi-solid food and drink with the consciousness of "drinking strongly". Is set as the "muscle activity level during maximum effort swallowing",
A method of operating a swallowing ability measuring device, which comprises setting the ratio of "muscle activity level during maximum effort swallowing" / "muscle activity level during normal swallowing" as the swallowing ability of a subject. The operating method according to claim 7, wherein the muscle activity amount is a value of the surface myoelectric potential at the maximum amplitude. 7. How to operate. The swallowing ability determining means sets a value obtained by averaging the values of a plurality of muscle activities measured when swallowing a plurality of times with the consciousness of "drinking normally" as a "muscle activity level during normal swallowing". The operation method according to any one of claims 7 to 9, wherein the operation method is characterized by that. The swallowing ability determining means sets a determination threshold value for determining the swallowing ability of a healthy person to a value within the range of 1.5 to 2.5, and based on this threshold value, "maximum effort swallowing". The operation method according to any one of claims 7 to 10, wherein the ratio of "muscle activity level at the time" / "muscle activity level at the time of normal swallowing" is determined. The swallowing ability determination means sets a determination threshold value for determining dysphagia to a value in the range of 1.0 to 2.0, and based on this threshold value, "muscle activity level during maximum effort swallowing". / The operation method according to any one of claims 7 to 10, wherein the ratio of "muscle activity level during normal swallowing" is determined. The swallowing ability measuring device according to any one of claims 1 to 6, wherein the hyoid muscle group is a suprahyoid muscle group. The operation method according to any one of claims 7 to 12, wherein the hyoid muscle group is the suprahyoid muscle group.

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