Objective To investigate the correlation between ultrasonic measurements of swallowing movement parameters and aggravation of swallowing dysfunction in patients with chronic obstructive pulmonary disease (COPD). Methods COPD patients with swallowing dysfunction (n = 120) and COPD patients with normal swallowing function (n = 100) treated in our hospital between January 2020 and January 2023 were included in observation and control groups, respectively. The correlation between ultrasonic measurements of swallowing movement parameters and COPD with swallowing dysfunction was analyzed. The observation group was divided into mild and severe groups according to their Gugging Swallowing Screen (GUSS) scores. The correlation between ultrasonic measurements of swallowing movement parameters and COPD exacerbation combined with swallowing dysfunction was analyzed. Results In the observation group, Hyoid muscle thickness, hyoid bone displacement, geniohyoid muscle movement distance, HLAS, and CSR were lower compared to the control group, negatively associated with COPD‐related swallowing issues. Conversely, geniohyoid muscle movement time and minimum hyohyoid distance (NHLA) were higher in the observation group, positively correlated with COPD‐related swallowing dysfunction. In COPD patients with swallowing problems, the severe group exhibited lower values for lingual muscle thickness, hyoid bone displacement, geniohyoid muscle movement distance, HLAS, and CSR compared to the mild group, while geniohyoid muscle movement time and NHLA were higher in the severe group. Receiver operating characteristic (ROC) curves were created, indicating the promising diagnostic utility of these parameters for assessing the presence and severity of swallowing dysfunction in COPD patients. Conclusion The ultrasonic measurement of swallowing motion parameters can effectively assess swallowing dysfunction in COPD patients. 

Assessing Swallowing Dysfunction Aggravation in Chronic Obstructive Pulmonary Disease Patients Using Ultrasonic Measurements With Swallowing Movement Parameters

Ultrasound imaging may be useful for tracking oral-pharyngeal structures of the vocal tract critical for effective swallowing, but use of this technology has been hampered by a lack of validation against standard clinical measures derived from x-ray video fluoroscopy (Modified Barium Swallow Studies or MBSS). Here, we compare quantitative tracking of hyoid bone and tongue motion from ultrasound imaging and simultaneously measured MBSS from a range of participants with disordered and healthy swallowing behavior. The proximal edge of the hyoid bone in MBSS and ultrasound recordings is tracked using CASM (Computational Analysis of Swallowing Mechanics) software, while tongue motion is tracked using TonguePART software, originally developed for analysis of speech. Hyoid trajectories and velocities measured from synchronized ultrasound and MBSS recordings are compared and standard deviations of differences between the two measurements are evaluated. Tongue motion during swallowing is characterized by analysis of root, dorsum, and blade displacement, velocity, and timingas well as tongue base retraction in the pharynx. Preliminary findings show quantitatively similar patterns in ultrasound and MBSS, suggesting that ultrasound has potential utility as an accessible tool for bedside diagnosis and biofeedback. Characteristic patterns separating normal from healthy swallowing, as well as potential therapeutic targets for biofeedback treatment of dysphagia, will be discussed.

Quantification of swallowing movements by ultrasound imaging in normal and disordered subjects

Speech is one of the most complex motor tasks, due to its rapid timing and necessary precision. The difficulty of measuring articulatory movement in real time has made it difficult to investigate motion-based biofeedback for speech. Previously, we demonstrated the use of an automatic measure of tongue movement accuracy from ultrasound imaging. Using this measure for articulatory biofeedback in a simplified, game-like display may benefit the learning of speech movement patterns. To better understand real-time articulatory biofeedback and improve the design of this display, this study presented articulatory biofeedback for the target word /ɑr/ (“are”) in a game with two conditions for feedback timing (delayed and concurrent, indicating whether the game object started moving after or during speech production) and for difficulty level (easy and hard target width, indicating the articulatory precision necessary for achieving the target). For each participant, two blocks of biofeedback for 20–50 productions were presented (randomizing whether the delayed or concurrent block was presented first) in one collection session, with the difficulty level randomized for each production within each block. Data from nine children with typical speech or residual speech sound disorder were analyzed, showing that response and preference of feedback condition vary among individuals.

Articulatory response to delayed and real-time feedback based on regional tongue displacements

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Quantification of swallowing movements by ultrasound imaging in normal and disordered subjects

Articulatory response to delayed and real-time feedback based on regional tongue displacements