WO2019225230A1

WO2019225230A1 - Swallowing function evaluation method, program, swallowing function evaluation device, and swallowing function evaluation system

Info

Publication number: WO2019225230A1
Application number: PCT/JP2019/016396
Authority: WO
Inventors: 絢子中嶋; 健一入江
Original assignee: パナソニックＩｐマネジメント株式会社
Priority date: 2018-05-23
Filing date: 2019-04-17
Publication date: 2019-11-28
Also published as: JP7165900B2; JPWO2019225230A1

Abstract

A swallowing function evaluation method that includes: an acquisition step (step (S101)) for acquiring an image that is contactlessly captured of the inside of the oral cavity of an evaluee; a calculation step (step (S102)) for calculating a feature value from the acquired image; and an evaluation step (step (S103)) for evaluating the swallowing function of the evaluee from the calculated feature value.

Description

Swallowing function evaluation method, program, swallowing function evaluation device, and swallowing function evaluation system

The present invention relates to a swallowing function evaluation method, a program, a swallowing function evaluation device, and a swallowing function evaluation system, which can evaluate a subject's swallowing function.

Eating dysphagia has risks such as aspiration, malnutrition, loss of eating pleasure, dehydration, weakness in physical strength and immunity, oral contamination and aspiration pneumonia, and prevent dysphagia Is required. Conventionally, by evaluating the swallowing function, for example, eating a meal with an appropriate dietary form, rehabilitation to recovering an appropriate function, etc. has been handled, There are various evaluation methods. For example, a device for evaluating the swallowing function is attached to the neck of the person to be evaluated, the pharyngeal movement feature quantity is acquired as a swallowing function evaluation index (marker), and the person's swallowing function is evaluated. A method for evaluation is disclosed (for example, see Patent Document 1).

JP 2017-23676

However, in the method disclosed in Patent Document 1, it is necessary to attach an instrument to the person to be evaluated, which may give the person to be evaluated uncomfortable. In addition, the swallowing function can be evaluated by visual inspection, interview, or palpation by a specialist such as a dentist, dental hygienist, speech auditor, or internal medicine doctor. Diagnosis by experts after dysphagia becomes serious, such as when paralysis occurs or when a dysphagia is caused by surgery on an organ related to dysphagia (eg, tongue, soft palate or pharynx) There are many cases to do. However, due to the effects of aging, elderly people may be overlooked or spilled, but they may overlook a decline in swallowing function as a natural symptom because they are old. . By overlooking the lowering of swallowing, for example, undernutrition resulting from a decrease in the amount of meal is caused, and undernutrition causes a decrease in immunity. In addition, aspiration is easy, and aspiration and reduced immunity result in a vicious circle that can lead to aspiration pneumonia.

Therefore, an object of the present invention is to provide a method for evaluating a swallowing function that can easily evaluate the swallowing function of a person to be evaluated.

The method for evaluating a swallowing function according to one aspect of the present invention includes an acquisition step of acquiring an image obtained by non-contacting imaging of the evaluation subject's oral cavity, and a calculation for calculating a feature amount from the acquired image And an evaluation step for evaluating the swallowing function of the person to be evaluated from the calculated feature amount.

Also, a program according to an aspect of the present invention is a program for causing a computer to execute the above-described swallowing function evaluation method.

Moreover, the eating and swallowing function evaluation device according to one aspect of the present invention includes an acquisition unit that acquires an image obtained by non-contact imaging of the evaluation subject's oral cavity, and the image acquired by the acquisition unit. A calculation unit that calculates a feature amount; an evaluation unit that evaluates the swallowing function of the person to be evaluated based on the feature amount calculated by the calculation unit; and an output unit that outputs an evaluation result evaluated by the evaluation unit; .

In addition, the eating and swallowing function evaluation system according to one aspect of the present invention includes the eating and swallowing function evaluation device and an imaging device that images the intra-evaluator's oral cavity in a non-contact manner, and the eating The acquisition unit of the swallowing function evaluation device acquires an image obtained by imaging the inside of the oral cavity of the person to be evaluated without contact with the imaging device.

According to the method for evaluating the swallowing function of the present invention, it is possible to easily evaluate the swallowing function of the person to be evaluated.

FIG. 1 is a diagram illustrating a configuration of a swallowing function evaluation system according to an embodiment. FIG. 2 is a block diagram illustrating a characteristic functional configuration of the swallowing function evaluation system according to the embodiment. FIG. 3 is a flowchart illustrating a processing procedure for evaluating a person to be swallowed by the swallowing function evaluation method according to the embodiment. FIG. 4 is a diagram illustrating an outline of an acquisition method of an image obtained by imaging an intra-oral cavity of a person to be evaluated according to the swallowing function evaluation method according to the embodiment. FIG. 5 is a diagram for explaining a method of calculating the tongue color as a feature amount. FIG. 6 is a diagram showing a specific example of the swallowing function in the preparation period and symptoms when each function is lowered. FIG. 7 is a diagram illustrating an example of the evaluation result. FIG. 8 is a diagram illustrating an example of the evaluation result. FIG. 9 is a diagram illustrating an example of the evaluation result.

Hereinafter, embodiments will be described with reference to the drawings. It should be noted that each of the embodiments described below shows a comprehensive or specific example. Numerical values, shapes, materials, constituent elements, arrangement positions and connection forms of constituent elements, steps, order of steps, and the like shown in the following embodiments are merely examples, and are not intended to limit the present invention. In addition, among the constituent elements in the following embodiments, constituent elements that are not described in the independent claims indicating the highest concept are described as optional constituent elements.

Each figure is a schematic diagram and is not necessarily shown strictly. Moreover, in each figure, the same code | symbol is attached | subjected to the substantially same structure, and the overlapping description may be abbreviate | omitted or simplified.

(Embodiment)
[Swallowing function]
The present invention relates to a method for evaluating a swallowing function and the like. First, the swallowing function will be described.

The swallowing function is a function of the human body that is necessary for recognizing food, taking it into the mouth, and achieving a series of processes from the stomach to the stomach. The swallowing function consists of five stages: the early phase, the preparation phase, the oral phase, the pharyngeal phase, and the esophageal phase.

In the preceding period (also called the cognitive period) of swallowing, the shape, hardness, temperature, etc. of food are determined. The swallowing function in the preceding period is, for example, an eye viewing function. In the preceding period, the nature and condition of the food are recognized and the necessary preparations for eating such as how to eat, salivation and posture are made.

During the preparatory period for swallowing (also called chewing), food taken into the oral cavity is chewed with teeth, crushed (ie chewed), and the chewed food is mixed with saliva by the tongue And put together into a bolus. The swallowing function during the preparation period, for example, recognizes the motor function of facial muscles (such as lip muscles and cheek muscles) that take food into the oral cavity without spilling it, recognizes the taste of food, and recognizes hardness. Tongue recognition function, or tongue movement function to push food to teeth or mix finely mixed food with saliva, occlusal state of teeth to chew and crush food, tooth and The cheek movement function that prevents food from entering between the cheeks, the movement function of the masticatory muscles (such as the masseter and temporal muscles), which is the generic name of the muscles used for mastication, and the fine food For example, the saliva secretion function. The masticatory function is affected by the occlusal state of the teeth, the function of the masticatory muscles, the function of the tongue, and the like. Due to these swallowing functions during the preparation period, the bolus has physical properties that make it easy to swallow (size, lump, viscosity), and the bolus easily moves from the oral cavity through the pharynx to the stomach.

During the oral phase of swallowing, the tongue (tip of the tongue) is lifted and the bolus is moved from the oral cavity to the pharynx. The swallowing function in the oral phase includes, for example, a tongue movement function for moving the bolus to the pharynx, a soft palate raising function for closing the space between the pharynx and the nasal cavity, and the like.

In the pharyngeal phase during swallowing, when the bolus reaches the pharynx, a swallowing reflex occurs and the bolus is sent to the esophagus within a short time (about 1 second). Specifically, the soft palate is raised and the space between the nasal cavity and the pharynx is closed, the base of the tongue (specifically the hyoid bone that supports the base of the tongue) and the larynx are raised, and the bolus becomes the pharynx In that case, the epiglottis is inverted downward, the trachea entrance is blocked, and the bolus is sent to the esophagus so that aspiration does not occur. The swallowing function in the pharyngeal phase includes, for example, a pharyngeal motor function (specifically, a motor function that raises the soft palate) to close the space between the nasal cavity and the pharynx, and a tongue ( Specifically, when the bolus moves from the pharynx to the esophagus, or when the bolus flows into the pharynx, the glottis closes and closes the trachea, and the epiglottis from above reaches the entrance to the trachea It is a motor function of the larynx that is covered by hanging down.

In the esophageal phase of swallowing, peristaltic movement of the esophageal wall is induced, and the bolus is sent from the esophagus to the stomach. The swallowing function in the esophageal stage is, for example, a peristaltic function of the esophagus for moving the bolus to the stomach.

For example, as a person ages, he goes from a healthy state to a state requiring care through a pre-frail period and a flail period. Decreased swallowing function (also called oral flail) is said to begin to appear during the prefrail period. Decreased swallowing function can be a factor that accelerates the progression from the flail phase to the state of need for care. For this reason, we notice how the swallowing function has declined at the pre-frail stage, and by performing prevention and improvement in advance, it becomes difficult to fall into the nursing care state that continues from the flail stage, and a healthy and independent life You can keep it long.

According to the present invention, the eating and swallowing function of the evaluated person can be evaluated from an image (still image or moving image) obtained by imaging the intraoral area of the evaluated person. Evaluate the subject's swallowing function by calculating specific features in the teeth or tongue of the subject's oral cavity that have a reduced ability to swallow. It is because it can do. Below, the evaluation of the swallowing function in the preparation period will be described. The present invention relates to a method for evaluating a swallowing function, a program for causing a computer to execute the method, a swallowing function evaluating device that is an example of the computer, and a swallowing function evaluating system including the swallowing function evaluating device. Realized. Below, the swallowing function evaluation method etc. are demonstrated, showing the swallowing function evaluation system.

[Configuration of the swallowing function evaluation system]
The configuration of the swallowing function evaluation system according to the embodiment will be described.

FIG. 1 is a diagram illustrating a configuration of a swallowing function evaluation system 200 according to an embodiment.

The swallowing function evaluation system 200 is a system for evaluating the swallowing function of the person to be evaluated U by analyzing an image obtained by imaging the inside of the oral cavity of the person to be evaluated U. FIG. As shown, the device includes a swallowing function evaluation device 100 and a portable terminal 300. In addition, the swallowing function evaluation system 200 may evaluate the eating / swallowing function of the person to be evaluated U by analyzing not only a still image but also a moving image.

The swallowing function evaluation apparatus 100 acquires an image obtained by imaging the oral cavity of the person to be evaluated U using the mobile terminal 300, and evaluates the swallowing function of the person to be evaluated U from the acquired image. It is.

The portable terminal 300 is an imaging device that images the inside of the oral cavity of the person to be evaluated U in a non-contact manner, and outputs an image obtained by the imaging to the swallowing function evaluation device 100. For example, the mobile terminal 300 is a smartphone or a tablet having an imaging function (camera). Since it is necessary to perform flash photography when imaging the oral cavity of the person to be evaluated U, the mobile terminal 300 also has a flash function (light source). The mobile terminal 300 is not limited to a smartphone or a tablet as long as it has an imaging function and a flash function, and may be a notebook PC or a camera (for example, an RGB-D camera). The swallowing function evaluation system 200 may include an imaging device (camera) and a light source instead of the mobile terminal 300. Moreover, although the swallowing function evaluation system 200 is mentioned later, you may be provided with the input interface for acquiring the to-be-evaluated person's U personal information. The input interface is not particularly limited as long as it has an input function such as a keyboard and a touch panel.

Further, the mobile terminal 300 may be a display device that has a display and displays an image or the like based on image data output from the swallowing function evaluation device 100. The display device may not be the portable terminal 300 but may be a monitor device configured by a liquid crystal panel or an organic EL panel. That is, in this embodiment, the mobile terminal 300 is both an imaging device and a display device, but the imaging device (camera), the light source, the input interface, and the display device may be provided separately.

The swallowing function evaluation apparatus 100 and the portable terminal 300 may be capable of transmitting and receiving an image obtained by imaging or image data for displaying an image indicating an evaluation result to be described later, and may be connected by wire. They may be connected wirelessly.

The eating and swallowing function evaluation device 100 analyzes the state of the teeth or tongue in the oral cavity of the person to be evaluated U based on an image obtained by imaging by the mobile terminal 300, and from the result of the analysis, the person to eat and swallow the evaluation person Evaluate functions and output evaluation results. For example, the swallowing function evaluation apparatus 100 uses image data for displaying an image indicating the evaluation result, or data for making a proposal regarding swallowing for the person to be evaluated U generated based on the evaluation result. Output to the mobile terminal 300. In this way, the swallowing function evaluation device 100 can notify the person to be evaluated U of the degree of the swallowing function and the proposal for preventing the deterioration of the swallowing function. Can prevent or improve the deterioration of swallowing function.

Note that the swallowing function evaluation apparatus 100 is, for example, a personal computer, but may be a server apparatus. In addition, the swallowing function evaluation device 100 may be a portable terminal 300. That is, the portable terminal 300 may have the function of the swallowing function evaluation device 100 described below.

FIG. 2 is a block diagram showing a characteristic functional configuration of the swallowing function evaluation system 200 according to the embodiment. The swallowing function evaluation apparatus 100 includes an acquisition unit 110, a calculation unit 120, an evaluation unit 130, an output unit 140, a suggestion unit 150, and a storage unit 160.

The acquisition unit 110 acquires an image obtained by imaging the oral cavity of the person to be evaluated U in a non-contact manner. Further, the acquisition unit 110 may further acquire personal information of the person to be evaluated U. For example, personal information is information input to the mobile terminal 300, such as age, weight, height, sex, BMI (Body Mass Index), dental information (for example, number of teeth, presence of dentures, location of occlusal support, etc.) Serum albumin level or eating rate. The personal information may be acquired by a swallowing screening tool called EAT-10 (Eat Ten), a sacramental swallowing questionnaire or an interview. The acquisition unit 110 is, for example, a communication interface that performs wired communication or wireless communication.

The calculation unit 120 is a processing unit that analyzes the image acquired by the acquisition unit 110. Specifically, the calculating unit 120 is realized by a processor, a microcomputer, or a dedicated circuit.

The calculation unit 120 calculates a feature amount from the image acquired by the acquisition unit 110. The feature amount is a numerical value indicating a feature such as a state of a tooth or a tongue in the oral cavity of the evaluated person U calculated from an image used by the evaluating unit 130 to evaluate the eating and swallowing function of the evaluated person U. . Details of the calculation unit 120 will be described later.

The evaluation unit 130 compares the feature amount calculated by the calculation unit 120 with the reference data 161 stored in the storage unit 160, and evaluates the eating / swallowing function of the person to be evaluated U. For example, the evaluation unit 130 may evaluate the subject U's swallowing function after distinguishing whether it is a swallowing function in the preparation period, the oral period, or the pharyngeal stage. Specifically, the evaluation unit 130 is realized by a processor, a microcomputer, or a dedicated circuit. Details of the evaluation unit 130 will be described later.

The output unit 140 outputs the evaluation result of the swallowing function of the person to be evaluated U evaluated by the evaluation unit 130 to the suggestion unit 150. Further, the output unit 140 outputs the evaluation result to the storage unit 160, and the evaluation result is stored in the storage unit 160. Specifically, the output unit 140 is realized by a processor, a microcomputer, or a dedicated circuit.

The proposing unit 150 makes a proposal regarding swallowing to the person to be evaluated U by collating the evaluation result output by the output unit 140 with predetermined proposal data 162. In addition, the suggestion unit 150 may collate the personal information acquired by the acquisition unit 110 with the proposal data 162 and make a proposal regarding swallowing to the evaluated person U. Proposal unit 150 outputs the proposal to portable terminal 300. The proposing unit 150 is realized by, for example, a processor, a microcomputer or a dedicated circuit, and a communication interface that performs wired communication or wireless communication. Details of the proposal unit 150 will be described later.

The storage unit 160 includes reference data 161 that indicates the relationship between the feature amount and the person's swallowing function, proposal data 162 that indicates the relationship between the evaluation result of the swallowing function and the proposed content, The storage device stores personal information data 163 indicating personal information. The reference data 161 is referred to by the evaluation unit 130 when the degree of the swallowing function of the evaluation subject U is evaluated. The proposal data 162 is referred to by the suggestion unit 150 when a proposal related to swallowing for the person to be evaluated U is made. The personal information data 163 is data acquired via the acquisition unit 110, for example. The personal information data 163 may be stored in the storage unit 160 in advance. The storage unit 160 is realized by, for example, a ROM (Read Only Memory), a RAM (Random Access Memory), a semiconductor memory, an HDD (Hard Disk Drive), or the like.

In addition, the storage unit 160 stores the program executed by the calculation unit 120, the evaluation unit 130, the output unit 140, and the suggestion unit 150, and the evaluation result used when the evaluation result of the swallowing function of the person to be evaluated U is output. And data such as an image, a moving image, a voice or a text indicating the proposal content are also stored. The storage unit 160 may also store voice data for instructions that will be described later.

Although not illustrated, the swallowing function evaluation apparatus 100 may include an instruction unit for instructing the person to be evaluated U to image the mouth of the person to be evaluated U. Specifically, the instruction unit acquires voice data for instruction and image data for instructing to image the oral cavity of the person to be evaluated U stored in the storage unit 160, and the voice data The image data is output to the portable terminal 300.

[Processing procedure for evaluating swallowing function]
Then, the specific process sequence in the swallowing function evaluation method which the swallowing function evaluation apparatus 100 performs is demonstrated.

FIG. 3 is a flowchart showing a processing procedure for evaluating the swallowing function of the person to be evaluated U by the swallowing function evaluation method according to the embodiment. Drawing 4 is a figure showing an outline of an acquisition method of an image obtained by imaging in a mouth of a person to be evaluated U by a swallowing function evaluation method according to an embodiment.

First, the instruction unit instructs to image the intra-oral cavity of the person to be evaluated U (step S100). For example, in step S <b> 100, the instruction unit acquires audio data for an instruction for instructing the user U, stored in the storage unit 160, and outputs the audio data to the mobile terminal 300. Then, as shown in (a) of FIG. 4, a voice for instructing the person to be evaluated U is output to the mobile terminal 300. Imaging may be performed by the evaluator U himself or an evaluator (family, doctor, etc.) who wants to evaluate the evaluator's U swallowing function. Further, the instruction unit obtains image data of an image for instructing the person to be evaluated U stored in the storage unit 160 and outputs the image data to the portable terminal 300 to instruct imaging. The instruction may be given using an instruction image for instructing imaging without using the instruction voice. Furthermore, the evaluator (family, doctor, etc.) may give an instruction to the person to be evaluated U with his / her own voice, without using an instruction image and sound for instructing to take an image.

Next, as illustrated in FIG. 3, the acquisition unit 110 acquires the intra-oral image of the person to be evaluated U who received the instruction in step S <b> 100 via the portable terminal 300 (step S <b> 101). As shown in FIG. 4B, in step S <b> 101, for example, the person to be evaluated U photographs the inside of his / her mouth using the mobile terminal 300. Thereby, the acquisition part 110 acquires the image obtained by imaging the intraoral area of the to-be-evaluated person U.

Next, the calculation unit 120 calculates a feature amount from the image acquired by the acquisition unit 110 (step S102), and the evaluation unit 130 calculates the eating and swallowing function of the evaluated person U from the feature amount calculated by the calculation unit 120. Is evaluated (step S103).

For example, when the image acquired by the acquisition unit 110 is an image obtained by imaging the teeth of the person to be evaluated U, the calculation unit 120 calculates the number of teeth in the image as a feature amount.

The reference data 161 includes a threshold corresponding to the number of teeth, and the evaluation unit 130, for example, eats depending on whether the number of teeth is equal to or greater than the threshold (for example, 20). Evaluate swallowing function.

A small number of teeth (below the threshold value) indicates, for example, that the occlusal state of the teeth for chewing and crushing food in the preparation period is deteriorated. That is, by evaluating the number of teeth of the person to be evaluated U, the occlusal state of the teeth in the preparation period can be evaluated.

For example, when the image acquired by the acquisition unit 110 is an image obtained by imaging the teeth of the person to be evaluated U, the calculation unit 120 calculates the position of the remaining tooth (residual tooth) in the image as a feature amount. To do.

The reference data 161 includes a threshold value corresponding to the position of the remaining tooth, and the evaluation unit 130 performs, for example, a swallowing function depending on whether or not the position of the remaining tooth is equal to or greater than the threshold value. evaluate.

If the remaining teeth are below the threshold, that is, the front teeth remain and the molars do not remain, it indicates that it is difficult to crush food, for example, the teeth for chewing and crushing food during preparation Indicates that the occlusal state has deteriorated. That is, by evaluating the position of the remaining teeth of the person to be evaluated U, the occlusal state of the teeth in the preparation period can be evaluated.

For example, when the image acquired by the acquisition unit 110 is an image obtained by imaging the tongue of the person to be evaluated U, the calculation unit 120 calculates the color of the tongue in the image as a feature amount.

The reference data 161 includes a threshold value corresponding to the color of the tongue (for example, whiteness of the tongue), and the evaluation unit 130 determines whether the whiteness of the tongue is equal to or greater than the threshold value, for example. To evaluate the swallowing function. This will be described with reference to FIG.

FIG. 5 is a diagram for explaining a method of calculating the tongue color as a feature amount.

For example, TCI (Tongue Coating Index) is used as a method of calculating the color of the tongue as a feature amount. As shown in FIG. 5, scores are recorded for nine portions from the A portion to the I portion of the tongue according to the adhesion state of tongue coating. For example, if tongue coating is not recognized for each part, the score is 0. If tongue coating is thin enough to recognize the tongue papillae, the score is 1. If the tongue papillae are not recognized, thick tongue coating is attached. If so, score 2 is recorded. The evaluation unit 130 evaluates the swallowing function according to whether or not the total score (for example, 0 to 18).

A white tongue (beyond the threshold), that is, thick tongue coating on the tongue, indicates that the oral cavity is unclean, for example, recognizing the taste of food during the preparation period or recognizing hardness It shows that the recognition function of the tongue for doing so has declined. That is, by evaluating the color of the tongue of the person to be evaluated U, the recognition function of the tongue in the preparation period can be evaluated.

For example, when the image acquired by the acquisition unit 110 is an image obtained by imaging the tongue of the person to be evaluated U, the calculation unit 120 calculates the degree of reflection of the light of the tongue in the image as a feature amount.

The reference data 161 includes a threshold value corresponding to the degree of light reflection of the tongue, and the evaluation unit 130, for example, takes a value according to whether or not the degree of light reflection of the tongue is equal to or greater than the threshold value. Evaluate swallowing function.

When the light is applied to the tongue, the light does not reflect and does not shine (below the threshold value), indicating that the tongue is dry, for example, saliva secretion to gather fine food during preparation Indicates that the function is degraded. That is, the saliva secretion function in the preparation period can be evaluated by evaluating the degree of reflection of light on the tongue of the person to be evaluated U.

In this way, the evaluation unit 130 provides the eating / swallowing function of the person to be evaluated U in any stage of the preparation period, the oral period and the pharyngeal period, such as the tongue recognition function “in the preparation period”. We evaluate after distinguishing whether it is swallowing function. For example, the reference data 161 includes a correspondence relationship between the type of feature quantity and the swallowing function in at least one stage of the preparation period, the oral period, and the pharyngeal period. For example, when attention is paid to the number of teeth as a feature quantity, the number of teeth and the occlusal state of the teeth in the preparation period are associated with each other. For this reason, the evaluation part 130 can evaluate the to-be-evaluated person's U swallowing function, after distinguishing whether it is a swallowing function in a preparation period, an oral cavity period, and a pharyngeal period. What kind of symptom is given to the subject U by evaluating the subject's U swallowing function after distinguishing whether it is a swallowing function in the preparation phase, oral phase or pharyngeal phase You can see if there is a risk of occurrence. This will be described with reference to FIG.

FIG. 6 is a diagram showing a specific example of the swallowing function in the preparation period and symptoms when each function is lowered.

Decreased ability to recognize the tongue during the preparation period may lead to a loss of appetite in swallowing and symptoms of anorexia. Or cannot be crushed). Moreover, the symptom that it cannot chew correctly comes to be seen because the occlusal state of the tooth in a preparation period deteriorates. When the secretory function of saliva is reduced in the preparation period, there is a symptom that the food remains scattered during swallowing and cannot form a bolus.

Since it is known that such a symptom is observed when the swallowing function in each stage is lowered, the swallowing function of the subject U can be set in any stage of the preparation stage, the oral stage and the pharyngeal stage. It is possible to make detailed countermeasures for each corresponding symptom by evaluating after distinguishing whether or not it is a swallowing function. Moreover, although mentioned later for details, the proposal part 150 can propose the countermeasure according to evaluation result to the to-be-evaluated person U. FIG.

Next, as shown in FIG. 3, the output unit 140 outputs the evaluation result of the swallowing function of the person to be evaluated U evaluated by the evaluation unit 130 (step S104). The output unit 140 outputs the evaluation result of the swallowing function of the evaluated person U evaluated by the evaluation unit 130 to the suggestion unit 150. Note that the output unit 140 may output the evaluation result to the mobile terminal 300. In this case, the output unit 140 may include a communication interface that performs wired communication or wireless communication, for example. In this case, for example, the output unit 140 acquires image data of an image corresponding to the evaluation result from the storage unit 160 and transmits the acquired image data to the mobile terminal 300. An example of the image data (evaluation result) is shown in FIGS.

7 to 9 are diagrams illustrating an example of the evaluation result. For example, the evaluation result is a two-stage evaluation result of OK or NG. OK means normal and NG means abnormal. The evaluation result is not limited to a two-stage evaluation result, and may be a fine evaluation result in which the degree of evaluation is divided into three or more stages. That is, the threshold value corresponding to each feature amount included in the reference data 161 stored in the storage unit 160 is not limited to one threshold value, and may be a plurality of threshold values. Specifically, for a certain feature amount, the evaluation result is normal when it is equal to or greater than the first threshold, and the evaluation result is slightly abnormal when it is smaller than the first threshold and greater than the second threshold, and is equal to or less than the second threshold. In this case, the evaluation result may be abnormal. Further, a circle mark or the like may be shown instead of OK (normal), a triangle mark or the like may be shown instead of slightly abnormal, and a cross mark or the like may be shown instead of NG (abnormal). Also, as shown in FIGS. 12 to 16, normality and abnormality may not be shown for each swallowing function, and for example, only items that are suspected of lowering the swallowing function may be shown.

The image data of the image corresponding to the evaluation result is, for example, a table as shown in FIGS. Such a table showing the evaluation results after distinguishing whether it is a swallowing function in the preparation phase, oral phase or pharyngeal phase (in this embodiment, the evaluation results in the preparation phase are shown) Table) can be confirmed by the evaluated person U. For example, if the person to be evaluated U knows in advance what measures should be taken when the function decreases for each of the swallowing functions in the preparation period, oral period and pharyngeal period, U can make detailed countermeasures by confirming such a table.

However, the to-be-evaluated U may not know in advance what countermeasures should be taken regarding swallowing when the swallowing function in each stage is reduced. Therefore, as shown in FIG. 3, the proposing unit 150 makes a proposal regarding swallowing to the person to be evaluated U by collating the evaluation result output by the output unit 140 with predetermined proposal data 162. . (Step S105). For example, the proposal data 162 includes proposal contents regarding swallowing for the person to be evaluated U corresponding to each combination of evaluation results for the swallowing function in the preparation period, the oral period, and the pharyngeal period. In addition, the storage unit 160 includes data (for example, an image, a moving image, sound, text, etc.) indicating the proposal content. The suggestion unit 150 makes a proposal regarding swallowing to the person to be evaluated U using such data.

In the following, the evaluation results evaluated after distinguishing whether the swallowing function of the subject U is the swallowing function in the preparation stage, the oral stage or the pharyngeal stage are shown in FIGS. The contents of the proposal in the case where the result is shown in FIG.

In the evaluation results shown in FIG. 7, the saliva secretion function in the preparation period is NG, and the other swallowing functions are OK. In this case, there is a possibility that there is a problem of dry mouth in the preparation period because the saliva secretion function is NG. As a result, the bolus cannot be formed correctly, and it becomes difficult to swallow the dried food. By avoiding the dried food, the nutrition is biased or it takes time to eat.

In contrast, the proposal unit 150 collates the combination of the evaluation results with the proposal data 162 to make a proposal corresponding to the combination. Specifically, when eating food (bread, cake, grilled fish, rice cracker, etc.) that absorbs moisture in the oral cavity, it is proposed to eat while taking moisture. This is because it becomes easy to form a bolus with water taken instead of saliva, and the difficulty of swallowing can be eliminated. For example, the suggestion unit 150 uses the mobile terminal 300 to display content such as “Let's take water together when eating bread” or “Yaki fish etc. It may be a good idea to make a trick. ”

In the evaluation results shown in FIG. 8, the occlusal state of the teeth in the preparation period is NG, and the other swallowing functions are OK. In this case, there is a possibility that there is a problem in the chewing ability and the occlusal ability because the occlusal state of the teeth in the preparation period is NG. As a result, avoiding hard food can result in unbalanced nutrition and take time to eat.

In contrast, the proposal unit 150 collates the combination of the evaluation results with the proposal data 162 to make a proposal corresponding to the combination. Specifically, when eating hard food (vegetables, meat, etc.), it is proposed to make it fine or soft before eating. This is because even if there is a problem with the chewing ability and the occlusal ability, it becomes possible to eat hard food. For example, the suggestion unit 150 uses the mobile terminal 300 to display a content such as “let's chop it small if it is hard and difficult to eat”, or “because it is difficult to eat leafy vegetables. We recommend that you take it aggressively by softening, chopping, etc. so that you do n’t avoid eating, but rather nutrition.

In the evaluation results shown in FIG. 9, the tongue recognition function and saliva secretion function in the preparation period are NG, and the other swallowing functions are OK. In this case, there is a possibility that the oral cavity is in an unclean state because the tongue recognition function and saliva secretion function in the preparation period are NG. As a result, the appetite is lost due to a decrease in taste, which may lead to aspiration pneumonia due to a malnutrition state.

In contrast, the proposal unit 150 collates the combination of the evaluation results with the proposal data 162 to make a proposal corresponding to the combination. Specifically, oral care is proposed. This is because oral hygiene can eliminate oral hygiene and restore the recognition function of the tongue. At this time, the suggestion unit 150 may use personal information (for example, an address) of the evaluated person U acquired by the acquisition unit 110. For example, the suggestion unit 150 can visit a medical institution through an image, text, voice, or the like via the mobile terminal 300, and can check the dentist or the swallowing function in the vicinity of the person U to be evaluated. Present a map showing the institution.

Note that the evaluation unit 130 does not need to evaluate the swallowing function of the person to be evaluated U after distinguishing whether the swallowing function is in the preparation period, the oral cavity period, or the pharyngeal period. That is, the evaluation unit 130 may evaluate what kind of swallowing function of the person to be evaluated U is deteriorated.

Other than that, although not shown, the suggestion unit 150 may make a proposal described below according to a combination of evaluation results for each swallowing function.

For example, the proposal unit 150 collates the combination of the evaluation results with the proposal data 162 to make a proposal corresponding to the combination. Specifically, the suggestion unit 150 proposes to reduce the amount of food that is put into the mouth at a time, such as softening a hard object. This is because by reducing the amount of food put into the mouth at a time, it becomes possible to chew without difficulty, and the bolus becomes smaller and it becomes easier to swallow the bolus. For example, the suggestion unit 150 may use the mobile terminal 300 by an image, text or voice, etc. “Reducing the amount to put into the mouth and eat slowly. Propose a content such as In addition, the suggestion unit 150 proposes to thicken the liquid contained in the food. By thickening the liquid, it becomes easy to chew food, and it is possible to prevent the liquid from flowing slowly in the pharynx. For example, the suggestion unit 150 proposes a content such as “Let's eat a soup or a liquid such as a soup” via an image, text, or voice via the mobile terminal 300.

Also, for example, the suggestion unit 150 may propose to take a protein or rehabilitate. This is because the decrease in muscle strength can be eliminated. At this time, the suggestion unit 150 may use personal information (for example, age, weight) of the evaluated person U acquired by the acquisition unit 110. For example, the suggestion unit 150 uses an image, text or voice via the mobile terminal 300, “Let's take protein. Since the current weight is 60 kg, the protein is 20 g to 24 g per serving, 3 meals total. “Let ’s take 60g to 72g.” In order to avoid losing it when eating, let ’s eat with a thick liquid soup and soup. In addition, the proposal unit 150 proposes specific training content related to rehabilitation. For example, the suggestion unit 150 uses the mobile terminal 300 to perform muscle strength training for the whole body according to the age of the person to be evaluated U (such as training that repeats standing and sitting) and lip muscle strength recovery training (such as training that repeats standing and sitting). Examples such as training that repeats breath blowing and inhalation), recovery training of tongue muscle strength (training that moves the tongue in and out, movement up and down, left and right, etc.) are shown. For example, installation of an application for such rehabilitation may be proposed. In addition, details of training actually performed during rehabilitation may be recorded. Thereby, it is possible to reflect the recorded contents in rehabilitation by the specialists by confirming the recorded contents by a specialist (such as a doctor, a dentist, a speech therapist, or a nurse).

Further, for example, the suggesting unit 150 may present a code indicating a food form such as a code of “swallowing adjusted meal classification 2013” of the Japanese Society for Swallowing Rehabilitation, when proposing meal contents. For example, when the person to be evaluated U purchases a product corresponding to a dysphagia, it is difficult to describe the “meal form” in words, but the code is used in a one-to-one correspondence with the code. Meals can be easily purchased. Moreover, the proposal part 150 may present the site for purchasing such goods, and may enable it to purchase using the internet. For example, after evaluating the swallowing function via the mobile terminal 300, the mobile terminal 300 may be used for purchase. Further, the suggestion unit 150 may present other products that supplement the nutrition so that the nutrition of the evaluated person U is not biased. At that time, the proposing unit 150 uses the personal information (for example, body weight, BMI (Body Mass Index), serum albumin value, eating rate, etc.) of the evaluated person U acquired by the acquiring unit 110, so that the evaluated person U After determining the nutritional status of the product, a product supplementing nutrition may be presented.

Further, for example, the suggestion unit 150 may propose a posture at the time of eating. This is because the ease of swallowing food varies depending on the posture. For example, the proposing unit 150 proposes to eat with a leaning posture in which the angle from the pharynx to the trachea is not likely to be a straight line.

Also, for example, the suggestion unit 150 may present a menu in consideration of nutritional bias due to a decrease in the swallowing function (present a menu site describing such a menu). A menu site is a site where ingredients and cooking procedures necessary for completing a menu are described. In that case, the proposal part 150 may present the menu which considered the bias | inclination of nutrition, considering the menu which the to-be-evaluated person U input by the to-be-evaluated person U and which the acquisition part 110 acquired. Further, the suggestion unit 150 may present a menu that is nutritionally balanced in a specific period over a specific period such as one week.

Also, for example, the suggestion unit 150 may transmit information indicating the degree to which food is fined or softened to a cooker that has been converted to IoT (Internet of Things). Thereby, food can be finely and softened correctly. In addition, it is possible to save time and effort for the person to be evaluated U to make food fine or soft.

[Effects]
As described above, the swallowing function evaluation method according to the present embodiment obtains an image obtained by imaging the oral cavity of the person to be evaluated U in a non-contact manner as shown in FIG. A step (step S101), a calculation step (step S102) for calculating a feature amount from the acquired image, an evaluation step (step S103) for evaluating the eating swallowing function of the evaluated person U from the calculated feature amount, including.

According to this, by obtaining an intra-oral image of the person to be evaluated U that is suitable for evaluation of the swallowing function obtained by non-contact imaging, the user's U swallowing function can be easily performed. Can be evaluated. That is, it is possible to evaluate the eating and swallowing function of the person to be evaluated U only by imaging the oral cavity of the person to be evaluated U using an imaging device such as the portable terminal 300.

In the evaluation step, as a swallowing function, at least one of a tongue recognition function, a saliva secretion function, and a tooth occlusion state may be evaluated.

According to this, for example, the tongue recognition function in the preparation period, the saliva secretion function in the preparation period, or the occlusal state of the teeth in the preparation period can be evaluated.

In the obtaining step, an image obtained by imaging the teeth of the person to be evaluated U may be obtained, and in the calculating step, the number of teeth in the image may be calculated as a feature amount.

According to this, it is possible to easily evaluate the occlusal state of the evaluated person U during the preparation period simply by imaging the teeth of the evaluated person U using an imaging device such as the portable terminal 300.

In the acquisition step, an image obtained by imaging the teeth of the person to be evaluated U may be acquired, and in the calculation step, the position of the remaining teeth in the image may be calculated as a feature amount.

In the acquisition step, an image obtained by imaging the tongue of the person to be evaluated U may be acquired, and in the calculation step, the color of the tongue in the image may be calculated as a feature amount.

According to this, it is possible to simply evaluate the recognition function of the evaluated person U during the preparation period simply by imaging the tongue of the evaluated person U using an imaging device such as the portable terminal 300.

In the obtaining step, an image obtained by imaging the tongue of the person to be evaluated U may be obtained, and in the calculating step, the degree of reflection of the tongue light in the image may be calculated as a feature amount.

According to this, it is possible to simply evaluate the saliva secretion function of the evaluation subject U during the preparation period simply by imaging the tongue of the evaluation subject U using an imaging device such as the portable terminal 300.

Moreover, the swallowing function evaluation method may further include an output step (step S104) for outputting an evaluation result.

According to this, the evaluation result can be confirmed.

In addition, the swallowing function evaluation method further includes a proposing step (step S105) of making a proposal regarding swallowing to the evaluated person U by collating the output evaluation result with predetermined data. May be.

According to this, the to-be-evaluated person U can receive a proposal as to what countermeasures should be taken regarding swallowing when the swallowing function at each stage is lowered. For example, it is possible to prevent aspiration pneumonia by suppressing aspiration by allowing the evaluated person U to perform rehabilitation based on the proposal or to take a diet based on the proposal. Can reduce malnutrition due to decline.

Further, in the suggestion step, at least one of a proposal related to a meal corresponding to the evaluation result of the swallowing function and a proposal related to exercise corresponding to the evaluation result of the swallowing function may be performed.

According to this, the to-be-evaluated person U can receive a suggestion of what kind of meal should be performed or what kind of exercise should be performed when the swallowing function is lowered.

In the acquisition step, personal information of the person to be evaluated U may be acquired.

According to this, for example, in a proposal related to swallowing, a more effective proposal can be made to the evaluated person U by combining the evaluation result of the swallowing function of the evaluated person U and personal information. Can do.

Moreover, the swallowing function evaluation apparatus 100 according to the present embodiment acquires an acquisition unit 110 that acquires an image obtained by non-contact imaging of the evaluation subject U in the oral cavity, and an image acquired by the acquisition unit 110. The calculation unit 120 that calculates the feature amount from the calculation unit 120, the evaluation unit 130 that evaluates the swallowing function of the person to be evaluated U from the feature amount calculated by the calculation unit 120, and the output that outputs the evaluation result evaluated by the evaluation unit 130 Unit 140.

According to this, it is possible to provide the swallowing function evaluation device 100 that can easily evaluate the swallowing function of the person U to be evaluated.

In addition, the swallowing function evaluation system 200 according to the present embodiment includes a swallowing function evaluation device 100 and an imaging device (in this embodiment, a mobile terminal 300) that images the intra-estimate U's mouth without contact. And). The acquisition unit 110 of the swallowing function evaluation apparatus 100 acquires an image obtained by imaging the inside of the oral cavity of the person to be evaluated U in a non-contact manner.

According to this, it is possible to provide the swallowing function evaluation system 200 that enables the evaluation of the swallowing function of the person to be evaluated U easily.

(Other embodiments)
As mentioned above, although the swallowing function evaluation method etc. which concern on embodiment were demonstrated, this invention is not limited to the said embodiment.

For example, the reference data 161 is predetermined data, but may be updated based on an evaluation result obtained when an expert actually diagnoses the swallowing function of the person to be evaluated U. Thereby, the evaluation precision of a swallowing function can be improved. Note that machine learning may be used to improve the evaluation accuracy of the swallowing function.

Further, for example, the proposal data 162 is predetermined data, but the evaluated person U may evaluate the proposal content and may be updated based on the evaluation result. That is, for example, when a proposal corresponding to the fact that the person to be evaluated U cannot chew based on a certain feature amount even though the person to be evaluated U can chew without problems, It is evaluated that it is wrong. Then, by updating the proposal data 162 based on the evaluation result, the erroneous proposal as described above is not made based on the same feature amount. Thus, the proposal content regarding swallowing for the person to be evaluated U can be made more effective. Note that machine learning may be used to make proposals related to swallowing more effective.

Also, for example, the evaluation result of the swallowing function may be stored as big data together with personal information and used for machine learning. Moreover, the proposal content regarding swallowing may be accumulated as big data together with personal information and used for machine learning.

Also, for example, in the above embodiment, the eating and swallowing function evaluation method includes the suggestion step (step S105) for making a suggestion regarding swallowing, but it may not be included. In other words, the swallowing function evaluation device 100 may not include the suggestion unit 150.

Also, for example, in the above embodiment, in the acquisition step (step S101), the personal information of the person to be evaluated U is acquired, but it is not necessary to acquire it. In other words, the acquisition unit 110 may not acquire the personal information of the evaluated person U.

Also, for example, the steps in the swallowing function evaluation method may be executed by a computer (computer system). The present invention can be realized as a program for causing a computer to execute the steps included in these methods. Furthermore, the present invention can be realized as a non-transitory computer-readable recording medium such as a CD-ROM on which the program is recorded.

For example, when the present invention is realized by a program (software), each step is executed by executing the program using hardware resources such as a CPU, a memory, and an input / output circuit of a computer. . That is, each step is executed by the CPU obtaining data from a memory or an input / output circuit or the like, and outputting the calculation result to the memory or the input / output circuit or the like.

In addition, each component included in the swallowing function evaluation device 100 and the swallowing function evaluation system 200 of the above embodiment may be realized as a dedicated or general-purpose circuit.

In addition, each component included in the swallowing function evaluation apparatus 100 and the swallowing function evaluation system 200 of the above embodiment is realized as an LSI (Large Scale Integration) that is an integrated circuit (IC). Also good.

Further, the integrated circuit is not limited to an LSI, and may be realized by a dedicated circuit or a general-purpose processor. A programmable FPGA (Field Programmable Gate Array) or a reconfigurable processor in which connection and setting of circuit cells inside the LSI can be reconfigured may be used.

Furthermore, if integrated circuit technology that replaces LSI emerges as a result of advances in semiconductor technology or other derived technology, it is naturally included in the swallowing function evaluation device 100 and the swallowing function evaluation system 200 using that technology. Each component may be integrated into an integrated circuit.

Other forms obtained by subjecting the embodiments to various modifications conceived by those skilled in the art, and forms realized by arbitrarily combining the components and functions in the embodiments without departing from the spirit of the present invention. Are also included in the present invention.

DESCRIPTION OF SYMBOLS 100 Swallowing function evaluation apparatus 110 Acquisition part 120 Calculation part 130 Evaluation part 140 Output part 150 Proposal part 161 Reference data 162 Proposal data (data)
200 Eating and swallowing function evaluation system 300 Mobile terminal (imaging device)
U Evaluated person

Claims

An acquisition step of acquiring an image obtained by imaging the oral cavity of the evaluator in a non-contact manner;
A calculation step of calculating a feature amount from the acquired image;
An evaluation step for evaluating the swallowing function of the person to be evaluated from the calculated feature amount,
Method for evaluating swallowing function.
In the evaluation step, as the swallowing function, at least one of a tongue recognition function, a saliva secretion function, and a tooth occlusion state is evaluated.
The method for evaluating a swallowing function according to claim 1.
In the acquisition step, an image obtained by imaging the subject's teeth is acquired;
In the calculation step, the number of teeth in the image is calculated as the feature amount.
The method for evaluating a swallowing function according to claim 1 or 2.
In the acquisition step, an image obtained by imaging the subject's teeth is acquired;
In the calculation step, the position of the remaining tooth in the image is calculated as the feature amount.
The method for evaluating a swallowing function according to any one of claims 1 to 3.
In the acquisition step, an image obtained by imaging the tongue of the evaluated person is acquired,
In the calculating step, the color of the tongue in the image is calculated as the feature amount.
The method for evaluating a swallowing function according to any one of claims 1 to 4.
In the acquisition step, an image obtained by imaging the tongue of the evaluated person is acquired,
In the calculating step, the degree of reflection of light of the tongue in the image is calculated as the feature amount.
The method for evaluating a swallowing function according to any one of claims 1 to 5.
The swallowing function evaluation method further includes an output step of outputting an evaluation result,
The method for evaluating a swallowing function according to any one of claims 1 to 6.
The method for evaluating swallowing function further includes a proposing step for making a proposal regarding swallowing for the person to be evaluated by collating the output evaluation result with predetermined data.
The method for evaluating a swallowing function according to claim 7.
In the acquisition step, the personal information of the evaluated person is further acquired.
The method for evaluating a swallowing function according to any one of claims 1 to 8.
A program for causing a computer to execute the swallowing function evaluation method according to any one of claims 1 to 9.
An acquisition unit for acquiring an image obtained by imaging the oral cavity of the evaluator in a non-contact manner;
A calculation unit that calculates a feature amount from the image acquired by the acquisition unit;
From the feature amount calculated by the calculation unit, an evaluation unit that evaluates the swallowing function of the evaluated person,
An output unit that outputs an evaluation result evaluated by the evaluation unit,
Ingestion swallowing function evaluation device.
The device for evaluating swallowing function according to claim 11,
An imaging device that images the subject's oral cavity in a non-contact manner,
The acquisition unit of the swallowing function evaluation apparatus acquires an image obtained by imaging the intra-evaluator's oral cavity without contact with the imaging apparatus,
A swallowing function evaluation system.