Development of a Musculoskeletal Model of Hyolaryngeal Elements for Understanding Pharyngeal Swallowing Mechanics

Featured Application The potential application of this study is to provide a key tool to help researchers and clinicians understand how neuro, muscular, and skeletal systems are involved in swallowing. It would contribute to the clinical decision-making process in treating dysphagia associated with neuromuscular disease. A detailed understanding of muscle activity in human swallowing would provide insights into the complex neuromuscular coordination underlying swallowing. The purpose of this study was to introduce musculoskeletal analysis to investigate muscle activities involved in swallowing as there are limitations on studying comprehensive muscle activation patterns by conventional methods such as electromyography (EMG) measurement. A musculoskeletal model of swallowing was newly developed based on the skeletal model made from CT data of a healthy volunteer. Individual muscle forces were predicted in pharyngeal swallowing by inverse dynamics' computations with static optimization, in which the typical trajectories of the hyoid bone and thyroid cartilage analyzed from videofluoroscopic (VF) data of the volunteer were used. The results identified the contribution of individual muscles in pharyngeal swallowing in relation to the movements of the hyoid bone and thyroid cartilage. The predicted sequence of muscle activity showed a qualitative agreement with salient features in previous studies with fine wire EMG measurements. This method, if validated further by imaging and EMG studies, enables studying a broader range of neuromuscular coordination in swallowing. The proposed method offers an avenue to understanding the physiological mechanisms of swallowing and could become useful to evaluate rehabilitation effects on dysphagia.