Method and apparatus for assisting deglutition

Abstract

Methods and systems for artificially stimulating user deglutition without substantial aspiration are provided. Methods and systems include artificially stimulating user deglutition according to various specialized programs, including passive user secretion maintenance programs, active feeding programs, proprioceptive feedback programs, and others.

1 . A method of stimulating user deglutition without substantial aspiration, the method comprising:
 providing a portable system born by a user for controlling a component of a complete swallowing act, the system including a controller, a signal generator, and an electrode array including at least one electrode, the signal generator in communication with the electrode array;   subcutaneously positioning the electrode array in stimulating communication with deglutition musculature; and   artificially stimulating user deglutition via the signal generator and electrode array according to a passive user secretion maintenance program adapted to automatically, periodically stimulate deglutition of user secretions without substantial aspiration of the user secretions.   
     
     
         2 . The method of  claim 1 , further comprising:
 stimulating user deglutition according to an active feeding program adapted for stimulating deglutition of at least one of food and drink without substantial aspiration.   
     
     
         3 . The method of  claim 2 , wherein the system further comprises a user input adapted to receive a feeding request prompt from a user, the method further comprising:
 receiving a feeding request prompt at the user input; and   operating the signal generator according to the active feeding program in response to the feeding request information.   
     
     
         4 . The method of  claim 2 , further comprising:
 continuing to stimulate user deglutition according to the active feeding program for a duration selected by the user with the user input.   
     
     
         5 . The method of  claim 4 , further comprising automatically interrupting continuous deglutition stimulation selected by the user after a predetermined period of time. 
     
     
         6 . The method of  claim 2 , further comprising changing a stimulation intensity of the active feeding program to a user stimulation intensity desired by the user based upon information received from the user input. 
     
     
         7 . The method of  claim 1 , further comprising:
 automatically sensing that the user is in a substantially reclined position, wherein the portable system automatically operates according to the passive user secretion maintenance program in response to the user assuming the substantially reclined position.   
     
     
         8 . A method of stimulating user deglutition without substantial aspiration, the method comprising:
 providing a portable system born by a user for controlling a component of deglutition, the system including a controller, at least one stimulating electrode, and a signal generator;   subcutaneously positioning the at least one stimulating electrode in stimulating communication with deglutition musculature;   selecting a desired deglutition program from a plurality of specialized deglutition programs maintained by the controller based upon a characteristic of a bolus to be consumed by a user; and   operating the system according to the selected deglutition program.   
     
     
         9 . The method of  claim 8 , wherein the bolus characteristic includes at least one of bolus volume and bolus consistency. 
     
     
         10 . The method of  claim 8 , wherein the bolus characteristic includes whether the bolus is liquid-like or solid-like. 
     
     
         11 . The method of  claim 8 , wherein one or more of the specialized deglutition programs include a group of pre-determined, sequential, and overlapping pulse trains. 
     
     
         12 . The method of  claim 11 , wherein one or more of the group of pre-determined, sequential, and overlapping pulse trains includes a signal ramp at a beginning of the at least one pulse train. 
     
     
         13 . The method of  claim 11 , wherein at least one of the group of pre-determined, sequential, and overlapping pulse trains includes at least one asymmetric, biphasic waveform. 
     
     
         14 . A method of stimulating user deglutition without substantial aspiration, the method comprising:
 providing a portable system born by a user for controlling at least a component of deglutition, the system including a controller, an electrode array, and a signal generator in communication with the electrode array;   subcutaneously positioning a first portion of the electrode array in stimulating communication with deglutition musculature;   subcutaneously positioning a second portion of the electrode array in stimulating communication with sensory mucosa of at least one of a mouth and a throat of the user;   stimulating the sensory mucosa with the electrode array to provide the user with tactile, sensory feedback; and   stimulating the deglutition musculature with the electrode array to cause user deglutition without substantial aspiration.   
     
     
         15 . The method of  claim 14 , wherein the electrode array includes a first electrode and a second electrode, the first electrode being positioned in stimulating communication with the deglutition musculature and the second electrode being positioned in stimulating communication with sensory mucosa of the at least one of the mouth and the throat of the user. 
     
     
         16 . A method of stimulating user deglutition without substantial aspiration, the method comprising:
 providing a portable system born by a user for controlling at least a component of deglutition, the system including a controller, a signal generator, and an electrode array including at least one electrode;   subcutaneously positioning the electrode array in stimulating communication with deglutition musculature;   stimulating the deglutition musculature via the electrode array with a subthreshold, baseline signal prior to user deglutition; and   stimulating the deglutition musculature via the electrode array with a stimulating signal following stimulation with the subthreshold, baseline signal, the stimulating signal causing a component of user deglutition to be artificially stimulated.   
     
     
         17 . The method of  claim 16 , wherein the subthreshold, baseline signal and the stimulating signal are coordinated according to a predetermined time delay between initiation of the baseline signal and initiation of the stimulating signal to assist the user in timing autonomous deglutition efforts with artificial stimulation of the component of user deglutition. 
     
     
         18 . The method of  claim 16 , wherein the subthreshold, baseline signal places the deglutition musculature of the user in a state of partial activation prior to at least one of:
 full activation of the partially activated deglutition musculature via autonomous user stimulation; and   full activation of the partially activated deglutition musculature via the stimulating signal.   
     
     
         19 . A system for assisting user deglutition without substantial aspiration, the system comprising:
 an electrode array adapted to be subcutaneously positioned in stimulating communication with deglutition musculature;   a sensor array adapted to be subcutaneously positioned for providing deglutition information;   a signal generator electronically connected to the electrode array for providing a stimulating signal to the electrode array; and   a controller electronically connected to the sensor array for receiving the deglutition information and electronically connected to the signal generator to prompt operation of the signal generator in delivering the stimulating signal to cause a component of deglutition to occur, wherein the controller is adapted to actively modify the stimulating signal delivered by the signal generator based upon the received deglutition information.   
     
     
         20 . The system of  claim 19 , wherein the deglutition information is selected from the group consisting of: hyolaryngeal complex position information, overall user body position information, upper esophageal opening force information, upper esophageal displacement information, intrapharyngeal pressure information, larynx position information, system position information, user chin position information, user head position information, user torso position information, deglutition muscle length information, and combinations thereof. 
     
     
         21 . The system of  claim 19 , wherein the sensor array includes at least one of an accelerometer, a force gauge, a strain gauges, an EMG sensor, a displacement sensor, a piezoelectric ultrasonic transducer, a pressure sensors, and combinations thereof. 
     
     
         22 . The system of  claim 19 , wherein the controller is programmed to:
 store a plurality of specialized deglutition programs; and   select a desired deglutition program from the plurality of specialized deglutition programs based upon a characteristic of a bolus to be consumed by a user.   
     
     
         23 . The system of  claim 22 , wherein the bolus characteristic includes at least one of bolus volume and bolus consistency. 
     
     
         24 . The system of  claim 22 , wherein the bolus characteristic includes whether the bolus is liquid-like or solid-like. 
     
     
         25 . The system of  claim 22 , wherein at least one of the specialized deglutition programs includes a group of predetermined, sequential, and overlapping pulse trains. 
     
     
         26 . The system of  claim 25 , wherein at least one of the group of predetermined, sequential, and overlapping pulse trains includes a signal ramp at a beginning of the at least one pulse train. 
     
     
         27 . The system of  claim 25 , wherein at least one of the group of predetermined, sequential, and overlapping pulse trains includes at least one asymmetric, biphasic waveform.