Current projects

Investigators

• Prof. Maggie-Lee Huckabee
• Esther Guiu Hernandez

Aim of study

This project will evaluate the validity and reliability of HRM. The first study will validate this technique against Videofluoroscopy (VFSS). Secondly, reliability will be assessed for the measures to determine the inter- and intra-rater reliability for existing, published measures of pharyngeal HRM. These recommendations will then be applied to answer a critical clinical-care questions relevant to patients with dysphagia secondary to stroke. This will have a direct impact on clinical practice, both locally and abroad.

Recruiting

We are currently recruiting healthy participants. We are seeking men and women aged 18+. If you are interested in more information phone 03 364 2074.

Investigators

• Paige Thomas
• Professor Maggie-Lee Huckabee

Aim of study

This project will investigate the effect of repeated measures of tongue endurance in healthy individuals. This will help to create norms that can be used in testing lingual endurance and levels of fatigue in disordered individuals. A tongue force pressure transducer will be used to measure the amount of pressure generated when pushing the tip of the tongue to the roof of the mouth. The study will also investigate the validity of sEMG as a measure of lingual endurance by comparing this measure to the tongue force generated. Gaining information on muscle fatigue will help us to ensure that the therapy is at an appropriate level and detect changes which are caused by disease.

Recruiting

We are currently recruiting healthy participants. We are seeking men and women in four age groups, 20-39, 40-59, 60-79 and 80+. If you are interested in more information please contact Paige on email paige.thomas@pg.canterbury.ac.nz or phone 03 364 2307.

Investigators

• Emma Wallace
• Professor Richard Jones
• Professor Maggie-Lee Huckabee

Aim of study

• Study I: Evaluation of the decibel level, as an objective measure of cough strength during patients’ Video-fluoroscopic Swallowing Study (VFSS)
• Study II: Evaluation of the decibel level, as an objective measure of cough strength in response to the Cough Reflex Test

Coughing is an important airway defence mechanism. To be effective, adequate cough sensitivity and cough strength are required. Patients with dysphagia are at risk of having impaired cough sensitivity and/or cough strength and as a result, are vulnerable to aspiration and consequential aspiration pneumonia (AP). The Cough Reflex Test (CRT) is a reliable, objective assessment of cough sensitivity in patients with dysphagia. However, a clinically practical, objective measure of cough strength is yet to be developed. The data from these two studies will provide information about cough strength (measured acoustically) using a clinically applicable, inexpensive and practical method. This may facilitate clinicians to reliably identify those at most risk of aspiration pneumonia at bedside. It will also improve clinicians lack of reliability and confidence in making decisions about cough strength following cough reflex testing, as identified by Miles and Huckabee (2013).

Recruiting

We are currently recruiting in-patients and out-patients who have been referred for VFSS for Study I. We are planning to recruit 16 patients with dysphagia and 16 healthy individuals for Study II.

Investigators

• Katharina Winiker
• Professor Maggie-Lee Huckabee
• Dr Kristin (Lamvik) Gozdzikowska
• Dr Phoebe Macrae

Aim of study

This research project aims to evaluate how much control healthy individuals can have over reflexive parts of their swallowing. The study investigates if healthy adults can learn to change pressure at the “upper oesophageal sphincter” (UES) through intensive training using high resolution manometry as a visual feedback modality. It is important to better understand how the brain controls swallowing; this knowledge may help to plan treatment for patients with swallowing difficulties.

Recruiting

The study is no longer recruiting participants.

Investigators

• Katharina Winiker
• Professor Maggie-Lee Huckabee
• Dr Kristin (Lamvik) Gozdzikowska
• Dr Phoebe Macrae

Aim of study

This research project studies biomechanics of pharyngeal swallowing. It focusses primarily on the opening of the upper esophageal sphincter (UES), which is critical for bolus transport from the pharynx into the esophagus. Further, airway protection is a crucial event in pharyngeal swallowing to prevent bolus from entering the airway during swallowing. This study investigates how the movements of the larynx and hyoid bone during swallowing contribute to UES opening and airway protection. An increased understanding of pharyngeal biomechanics is the foundation for diagnosis and treatment of impaired swallowing.

Recruiting

Recruitment of healthy adults (minimum age of 20) will start soon. We are seeking to recruit 24 participants in total, six people in each of the following age groups; 20-40, 40-60, 60-80, 80+ years.

Investigators

• Paige Thomas
• Michelle Westley
• Sara Moore
• Professor Maggie-Lee Huckabee

Aim of study

Recent research has demonstrated that there are benefits of strength training to aid swallowing in patients with Motor Neurone Disease (MND). Concerns remain regarding the fatiguing effect of such tasks on this population. This study will investigate the possible benefits of skill training for preservation of swallowing function in people with MND. This study will employ the Biofeedback in Strength and Skill Training (BiSSkiT) protocol in patients with MND in order to determine feasibility of this as a useful appropriate to intervention. This small pilot study of 10 participants will lead to a larger randomised controlled trial of strength vs skill training, if positive results are obtained.

Recruiting

We are currently recruiting participants with a diagnosis of Motor Neurone Disease. Participants may have swallowing impairment but must still be able to eat a dry cracker.

Investigators

• Seh Ling Kwong
• Dr Phoebe Macrae
• Professor Maggie-Lee Huckabee

Funding

Rose Centre for Stroke Recovery and Research

Aim of study

Impairment in UES function disrupts passage of food from the throat to the esophagus. As another option to medical procedures or traditional swallowing exercises that work indirectly on the UES, behavioural balloon dilatation has been proposed by Japanese researchers. In this procedure, the patient repeatedly swallows a balloon catheter that can be inflated to stretch the UES and consequently improve UES muscle function directly. The aim of this study is to develop a standard protocol to perform behavioural balloon dilatation and determine its efficacy as a treatment approach for impairment in UES opening.

Recruiting

This study is currently in the planning stages. We are proposing to recruit 16 participants with swallowing difficulties due to UES dysfunction.

Investigators

• Su Hui Lim 
• Dr Phoebe Macrae
• Professor Maggie-Lee Huckabee

Funding

Rose Centre for Stroke Recovery and Research

Aim of study

Reduced airway protection (reduced/ absent cough reflex) can increase an individuals’ risk of chest infection. Reduced cough reflex sensitivity is known to be associated with chest infection in stroke patients. This study aims to evaluate the potential for cough reflex sensitivity shifting in healthy individuals through intensive and hierarchically presented stimulation. If we can demonstrate that cough sensitivity can be altered due to external sensory stimulation, this will provide the foundation for development of sensory rehabilitation approaches for absent cough reflex.

Recruiting

This study is currently in the planning stages. We are planning to recruit 20 healthy participants.

Investigators

• Karen Ng 
• Professor Richard Jones
• Professor Maggie-Lee Huckabee

Funding

Commonwealth Scholarship and Fellowship Plan, Rose Centre for Stroke Recovery and Research

Aim of study

The aim of this study is to investigate how healthy people swallow when they use maximal, regular, and minimal levels of effort. Electrodes attached to the skin underneath the chin will measure muscle activity. This will help us design a treatment protocol for people who have trouble swallowing (e.g., after a stroke).

Recruiting

The study is no longer recruiting participants.

Investigators

• Karen Ng 
• Professor Richard Jones
• Professor Maggie-Lee Huckabee

Funding

Commonwealth Scholarship and Fellowship Plan, Rose Centre for Stroke Recovery and Research

Aim of study

This study aims to measure strength and skill of the muscles involved in swallowing, in people with and without swallowing difficulties. Activity of the muscles used for swallowing will be measured using surface electrodes and displayed on a computer screen. Skill will be measured as the ability to coordinate timing and force of swallowing to achieve a target on a computer screen, while strength will be measured as maximum force of muscles involved in swallowing. Improved diagnosis and understanding of swallowing problems after a stroke will allow for more targeted and effective treatment methods to be developed in the future.

Recruiting

This study is currently recruiting participants aged 50 and above. We are seeking 40 healthy participants, 60 participants who have swallowing difficulties after a stroke, and 20 participants who have swallowing difficulties due to inclusion body myositis, oculopharyngeal dystrophy, or myotonic dystrophy. Please email karen.ng@pg.canterbury.ac.nz if you are interested in participating.

Investigators

• Kerstin Erfmann
• Professor Richard Jones
• Dr Phoebe Macrae
• Professor Maggie-Lee Huckabee

Funding

Rose Centre for Stroke Recovery and Research at St George’s Medical Centre

Aim of study

Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation. When applied over the cerebellum, this technique has been shown to enhance motor skill-learning in limb rehabilitation. However, at present, it is unknown if these effects are similar for corticobulbar-related motor functions, like swallowing. The aim of this study is to determine stimulation parameters that enhance motor learning in swallowing that will be used to guide the development of effective swallowing rehabilitation protocols.

Recruiting

The study is no longer recruiting participants.

Investigators

• Esther Guiu Hernandez
• Dr Paul Gaynor
• Professor Richard Jones
• Professor Maggie-Lee Huckabee

Collaborators

UC Department of Electrical Engineering

Aim of Study

The aim of this project is to continue the development of an impedance based biofeedback instrument to help in the rehabilitation of patients who suffer from swallowing disorders by replacing the current tool, pharyngeal manometry. This involves adding wireless communication to the existing design and designing a smart device app to communicate with the system. The second part is to experiment with different elements of the hardware design to improve the feedback presented to the patient.

Recruiting

In progress, not currently recruiting external participants.