{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T21:23:58Z","timestamp":1772313838141,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T00:00:00Z","timestamp":1672704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81472153"],"award-info":[{"award-number":["81472153"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"Natural Science Foundation of China","doi-asserted-by":"publisher","award":["201604020153"],"award-info":[{"award-number":["201604020153"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Science and Technology Program of Guangzhou","award":["81472153"],"award-info":[{"award-number":["81472153"]}]},{"name":"Science and Technology Program of Guangzhou","award":["201604020153"],"award-info":[{"award-number":["201604020153"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Objectives: Investigate the biomechanical characteristics in tracheostomized patients with aspiration following acquired brain injury (ABI) and further explore the relationship between the biomechanical characteristics and aspiration. Methods: This is a single-center cross-sectional study. The tracheostomized patients with aspiration following ABI and age-matched healthy controls were recruited. The biomechanical characteristics, including velopharynx (VP) maximal pressure, tongue base (TB) maximal pressure, upper esophageal sphincter (UES) residual pressure, UES relaxation duration, and subglottic pressure, were examined by high-resolution manometry and computational fluid dynamics simulation analysis. The penetration\u2013aspiration scale (PAS) score was evaluated by a videofluoroscopic swallowing study. Results: Fifteen healthy subjects and fifteen tracheostomized patients with aspiration following ABI were included. The decreased VP maximal pressure, increased UES residual pressure, and shortened UES relaxation duration were found in the patient group compared with the control group (p &lt; 0.05). Furthermore, the subglottic pressure significantly decreased in patients (p &lt; 0.05), while no significant difference was found in TB maximal pressure between groups (p &gt; 0.05). In addition, in the patient group, VP maximal pressure (rs = \u22120.439; p = 0.015), UES relaxation duration (rs = \u22120.532; p = 0.002), and the subglottic pressure (rs = \u22120.775; p &lt; 0.001) were negatively correlated with the PAS score, while UES residual pressure (rs = 0.807; p &lt; 0.001) was positively correlated with the PAS score (p &lt; 0.05), the correlation between TB maximal pressure and PAS score (rs = \u22120.315; p = 0.090) did not reach statistical significance. Conclusions: The biomechanical characteristics in tracheostomized patients with aspiration following ABI might manifest as decreased VP maximal pressure and subglottic pressure, increased UES residual pressure, and shortened UES relaxation duration, in which VP maximal pressure, UES relaxation duration, subglottic pressure, and UES residual pressure were correlated with aspiration.<\/jats:p>","DOI":"10.3390\/brainsci13010091","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T05:02:30Z","timestamp":1672808550000},"page":"91","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Biomechanical Characteristics of Swallowing in Tracheostomized Patients with Aspiration following Acquired Brain Injury: A Cross-Sectional Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Xiao-Xiao","family":"Han","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou 510630, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6265-4806","authenticated-orcid":false,"given":"Jia","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou 510630, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhan-Ao","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou 510630, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Mei","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of mechanical and automotive engineering, South China University of Technology, No. 381, Wushan Road, Tianhe District, Guangzhou 510641, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou 510630, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Mei","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou 510630, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zu-Lin","family":"Dou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou 510630, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1080\/21681163.2016.1152567","article-title":"Improvements resulting from respiratory-swallow phase training visualized in patient-specific computational analysis of swallowing mechanics","volume":"6","author":"Tran","year":"2018","journal-title":"Comput. Methods Biomech. Biomed. Eng. Imaging Vis."},{"key":"ref_2","first-page":"7819","article-title":"Evidence-based bundled care for patients with dysphagia after severe traumatic brain injury: A randomized controlled trial","volume":"13","author":"AYan","year":"2021","journal-title":"Am. J. Transl. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1161\/STROKEAHA.122.038867","article-title":"Immunodepression, Infections, and Functional Outcome in Ischemic Stroke","volume":"53","author":"Westendorp","year":"2022","journal-title":"Stroke"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.17245\/jdapm.2017.17.1.1","article-title":"Pneumonitis and pneumonia after aspiration","volume":"17","author":"Son","year":"2017","journal-title":"J. Dent. Anesth. Pain Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e053244","DOI":"10.1136\/bmjopen-2021-053244","article-title":"Scoping review to identify and map non-pharmacological, non-surgical treatments for dysphagia following moderate-to-severe acquired brain injury","volume":"11","author":"Eskildsen","year":"2021","journal-title":"BMJ Open"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1080\/17437199.2012.733914","article-title":"Acquired brain injury: Combining social psychological and neuropsychological perspectives","volume":"8","author":"Walsh","year":"2014","journal-title":"Health Psychol. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5875","DOI":"10.1007\/s10072-022-06191-9","article-title":"Research progress of clinical intervention and nursing for patients with post-stroke dysphagia","volume":"43","author":"Fang","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"986","DOI":"10.4187\/respcare.07107","article-title":"Airway Management and Ventilator-Associated Events","volume":"64","author":"Dexter","year":"2019","journal-title":"Respir. Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2554","DOI":"10.1044\/2021_AJSLP-20-00377","article-title":"Predictors of Aspiration and Silent Aspiration in Patients with New Tracheostomy","volume":"30","author":"Marvin","year":"2021","journal-title":"Am. J. Speech Lang. Pathol."},{"key":"ref_10","first-page":"423","article-title":"Exploration and approach to artificial airway dysphagia","volume":"36","year":"2012","journal-title":"Med. Intensiv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1177\/000348940311200207","article-title":"Physiologic effects of open and closed tracheostomy tubes on the pharyngeal swallow","volume":"112","author":"Gross","year":"2003","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1177\/000348949610500401","article-title":"Subglottic air pressure: A key component of swallowing efficiency","volume":"105","author":"Eibling","year":"1996","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s00405-018-5240-9","article-title":"A systematic review of current methodology of high resolution pharyngeal manometry with and without impedance","volume":"276","author":"Winiker","year":"2019","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1148\/rg.2019180070","article-title":"Videofluoroscopic Evaluation of Normal and Impaired Oropharyngeal Swallowing","volume":"39","author":"Lorduy","year":"2019","journal-title":"Radiographics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1109\/JSTSP.2019.2959267","article-title":"Improved subglottal pressure estimation from neck-surface vibration in healthy speakers producing non-modal phonation","volume":"14","author":"Lin","year":"2020","journal-title":"IEEE J. Sel. Top. Signal Process."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"255.E1","DOI":"10.1016\/j.jvoice.2017.10.023","article-title":"Evaluation of the supraglottic and subglottic activities including acoustic assessment of the opera-chant singers","volume":"33","author":"Petekkaya","year":"2019","journal-title":"J. Voice"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1152\/japplphysiol.00316.2003","article-title":"Lung volume effects on pharyngeal swallowing physiology","volume":"95","author":"Gross","year":"2003","journal-title":"J. Appl. Physiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1007\/s00455-011-9389-2","article-title":"Deglutitive subglottic air pressure and respiratory system recoil","volume":"27","author":"Gross","year":"2012","journal-title":"Dysphagia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1097\/01.mlg.0000205168.39446.12","article-title":"Direct measurement of subglottic air pressure while swallowing","volume":"116","author":"Gross","year":"2006","journal-title":"Laryngoscope"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1002\/lary.27006","article-title":"Relationship between degree of obstruction and airflow limitation in subglottic stenosis","volume":"128","author":"Lin","year":"2018","journal-title":"Laryngoscope"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"45706","DOI":"10.1038\/srep45706","article-title":"Computational fluid dynamics simulation of the upper airway response to large incisor retraction in adult class I bimaxillary protrusion patients","volume":"7","author":"Zheng","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1007\/s00455-022-10418-4","article-title":"Use of Pharyngeal High-Resolution Manometry to Evaluate Dysphagia in Adults with Motor Neurone Disease: A Scoping Review","volume":"37","author":"Diver","year":"2022","journal-title":"Dysphagia"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1177\/000348941011900602","article-title":"High-resolution manometry of pharyngeal swallow pressure events associated with head turn and chin tuck","volume":"119","author":"McCulloch","year":"2010","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s00455-017-9809-z","article-title":"Reflections on Clinical and Statistical Use of the Penetration-Aspiration Scale","volume":"32","author":"Steele","year":"2017","journal-title":"Dysphagia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.physbeh.2016.08.005","article-title":"Calculation of upper esophageal sphincter restitution time from high resolution manometry data using machine learning","volume":"165","author":"Jungheim","year":"2016","journal-title":"Physiol. Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1177\/0003489416629978","article-title":"Preliminary evaluation of functional swallow after total laryngectomy using high-resolution manometry","volume":"125","author":"Lippert","year":"2016","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_27","first-page":"1","article-title":"Anatomy and physiology of velopharyngeal closure and insufficiency","volume":"76","author":"Raol","year":"2015","journal-title":"Adv. Otorhinolaryngol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Pe\u00f1a-Ch\u00e1vez, R.E., Schaen-Heacock, N.E., Hitchcock, M.E., Kurosu, A., Suzuki, R., Hartel, R.W., Ciucci, M.R., and Rogus-Pulia, N.M. (2022). Effects of Food and Liquid Properties on Swallowing Physiology and Function in Adults. Dysphagia, ahead of print.","DOI":"10.1007\/s00455-022-10525-2"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1111\/joa.12365","article-title":"Analysis of human soft palate morphogenesis supports regional regulation of palatal fusion","volume":"227","author":"Danescu","year":"2015","journal-title":"J. Anat."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S1474-4422(18)30255-2","article-title":"PHAST-TRAC investigators. Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): A prospective, single-blinded, randomised trial","volume":"17","author":"Dziewas","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/CCM.0000000000000705","article-title":"Dysphagia\u2014A common, transient symptom in critical illness polyneuropathy: A fiberoptic endoscopic evaluation of swallowing study","volume":"43","author":"Ponfick","year":"2015","journal-title":"Crit. Care Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e143777","DOI":"10.1172\/JCI143777","article-title":"Brain-gut axis dysfunction in the pathogenesis of traumatic brain injury","volume":"131","author":"Hanscom","year":"2021","journal-title":"J. Clin. Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1080\/02699050500487571","article-title":"Metabolism and nutrition in patients with moderate and severe traumatic brain injury: A systematic review","volume":"20","author":"Krakau","year":"2006","journal-title":"Brain Inj."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1038\/ajg.2017.81","article-title":"Ability of high-resolution manometry to determine feeding method and to predict aspiration pneumonia in patients with dysphagia","volume":"112","author":"Park","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s00455-002-0082-3","article-title":"Role of the pharyngeal branch of the vagus nerve in laryngeal elevation and UES pressure during swallowing in rabbits","volume":"18","author":"Fukushima","year":"2003","journal-title":"Dysphagia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.anl.2016.08.004","article-title":"Mano-videoendoscopic assessment in the evaluation of the pharyngeal contraction and upper esophageal sphincter function in dysphagic patients","volume":"44","author":"Karaho","year":"2017","journal-title":"Auris Nasus Larynx"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"G84","DOI":"10.1152\/ajpgi.00145.2016","article-title":"A human model of restricted upper esophageal sphincter opening and its pharyngeal and UES deglutitive pressure phenomena","volume":"311","author":"Jiao","year":"2016","journal-title":"Am. J. Physiol. Gastrointest Liver Physiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"34","DOI":"10.5056\/jnm16028","article-title":"Failed deglutitive upper esophageal sphincter relaxation is a risk factor for aspiration in stroke patients with oropharyngeal dysphagia","volume":"23","author":"Lee","year":"2017","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Barker, J., Martino, R., and Yau, T.M. (2022). Changes in Cardiac Function During a Swallow Exercise Program in Patients with Coronary Artery Disease. Dysphagia, ahead of print.","DOI":"10.1007\/s00455-022-10477-7"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1004013","DOI":"10.3389\/fnins.2022.1004013","article-title":"Biomechanical mechanism of reduced aspiration by the Passy-Muir valve in tracheostomized patients following acquired brain injury: Evidences from subglottic pressure","volume":"16","author":"Han","year":"2022","journal-title":"Front. Neurosci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1111\/jgs.13933","article-title":"Effects of device-facilitated isometric progressive resistance oropharyngeal therapy on swallowing and health-related outcomes in older adults with dysphagia","volume":"64","author":"Rusche","year":"2016","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/s00455-007-9089-0","article-title":"Standardized instrument for lingual pressure measurement","volume":"23","author":"Hewitt","year":"2008","journal-title":"Dysphagia"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/13\/1\/91\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T17:57:04Z","timestamp":1760119024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/13\/1\/91"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,3]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["brainsci13010091"],"URL":"https:\/\/doi.org\/10.3390\/brainsci13010091","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,3]]}}}