Multi-sensory stimulation coupling processing method in swallowing rehabilitation

Abstract

The invention relates to a multi-sensory stimulation coupling processing method in swallowing rehabilitation, which comprises the following steps: applying sensory stimulation lower than a subjective recognition threshold to a patient to activate a preparation state of a swallowing related neural pathway at a subconsciousness level so as to form a sensory subthreshold activation preparation mechanism; a micro-time difference dislocation output strategy is introduced into a plurality of sensory channels, so that taste stimulation, touch stimulation, olfactory stimulation and auditory stimulation are sequentially released in an offset time sequence, a sensory cross attribution effect is generated in the brain, and the activation intensity of multi-sensory collaborative stimulation on a swallowing reflex arc is enhanced; overlapping an atypical sensory stimulation factor on the basis of the dislocation output strategy, and guiding a center to reconstruct a swallowing control path in an interference manner, so as to activate an alternative nerve branch and form an alternative execution chain of a swallowing action; sensory stimulation is designed into a continuous chain structure with time rhythmicity, so that a previous stimulation forms a perception expectation for a next stimulation, and a patient is guided to enter a progressive sensory induction state.

Description

TECHNICAL FIELD

[0001] The present application relates to the field of swallowing rehabilitation, in particular to a multi-sensory stimulation coupling processing method in swallowing rehabilitation. BACKGROUND

[0002] The prior art such as Chinese patent document CN117064344A, a swallowing disorder treatment method and system of multi-modal stimulation, the main innovation of this scheme is to ensure the safety and data integrity in the process of swallowing disorder rehabilitation through multi-modal monitoring and early warning mechanism, especially using a camera and an information acquisition module for real-time image monitoring, so as to timely alarm when the camera or system is abnormal, and avoid misjudgment and risk in the process of swallowing training. However, there are obvious deficiencies and drawbacks in the actual rehabilitation application level: first, although this scheme emphasizes multi-modal, the multi-modal focuses more on the monitoring level, mainly video monitoring and signal acquisition, and does not introduce multi-sensory interaction and coupling stimulation in the true sense in the training method itself, such as cross-coupling and subliminal stimulation integration of taste, touch, smell, temperature sense and hearing. These are the core links of activating swallowing reflex and promoting neural pathway reconstruction for rehabilitation patients. In other words, this patent focuses on monitoring and early warning, rather than intervention and treatment depth;

[0003] Secondly, this scheme lacks the use of subliminal neural preparation state, and only uses conventional visible and sensible training stimulation combined with monitoring, which leads to easy adaptive fatigue of patients, increased neural response threshold, and decreasing effect after long-term training; Thirdly, this scheme does not involve fine-tuning of the timing of stimulation, and the stimulation is mainly parallel acquisition or synchronous presentation, lacking non-linear timing misalignment guidance, so it cannot effectively break through the fixed mode of swallowing reflex pathway; Fourthly, although this scheme introduces multi-modal information for judging the state of the patient, it essentially relies on the camera to obtain swallowing action images. This approach has great limitations when the actions in the pharynx and oral cavity cannot be directly observed, and the monitoring effect will be severely reduced once the camera is distorted or blocked; Fifthly, this technology mainly stays in finding abnormalities and prompting risks, and does not propose how to actively adjust the training strategy to promote the dynamic adaptability of patient swallowing rehabilitation; Sixthly, from the perspective of patient compliance, this scheme is more like an external supervision, and patients are prone to feel uncomfortable being monitored, lacking positive feedback in experience; Seventhly, the abnormal early warning emphasized by this scheme mainly solves the problems of equipment maintenance and monitoring stability, which has weak relationship with the neural mechanism and behavioral mechanism of swallowing rehabilitation.

[0004] In summary, the prior art focuses more on monitoring and lacks intervention depth, lacks subliminal pre-activation and micro-time error positioning mechanism, lacks atypical sensory factors and reflex chain construction, relies on single visual monitoring means and lacks physiological signals and sensory input combination, cannot dynamically reconstruct neural pathways, and lacks patient experience and long-term compliance. SUMMARY

[0005] The purpose of the present application is to provide a multi-sensory stimulation coupling processing method in swallowing rehabilitation, so as to solve some of the problems and deficiencies pointed out in the background art.

[0006] The present application solves the above-mentioned technical problems by adopting the following technical scheme: a multi-sensory stimulation coupling processing method in swallowing rehabilitation, comprising: activating the preparation state of the swallowing-related neural pathway at the subconscious level by applying sensory stimulation below the subjective recognition threshold to the patient, forming a subliminal sensory activation preparation mechanism; introducing a misplacement output strategy with a micro-time difference in multiple sensory channels, so that the taste, touch, smell, and hearing stimuli are released in sequence within the offset timing, thereby generating a sensory cross-attribute effect in the brain and enhancing the activation intensity of multi-sensory collaborative stimulation on the swallowing reflex arc;

[0007] On the basis of the misplacement output strategy, an atypical sensory stimulation factor is superimposed to guide the central nervous system to reconstruct the swallowing control path in a disruptive manner, thereby activating the alternative neural pathway and forming an alternative execution chain of swallowing action; the sensory stimulation is designed to have a continuous chain structure with time rhythm, so that the perception of the previous stimulation forms an expectation for the next stimulation, guiding the patient to enter a progressive sensory induction state.

[0008] Further, in the subliminal sensory activation preparation mechanism, the applied sensory stimulation is a stimulation signal with opposite direction and opposite attribute, so as to construct a perception conflict and induce the central nervous system to activate the swallowing action in a stress mode; in the misplacement output strategy, the stimulation interval between different sensory channels is set as a time window that can cause a sensory cause illusion, so as to enhance the central nervous system's perception sensitivity to sensory collaboration.

[0009] Further, the atypical sensory stimulation factor includes a skin surface touch input simulating the direction of liquid flow, which is used to disturb the patient's spatial perception of the direction of liquid movement and induce active swallowing attempts; the touch input simulating the liquid flow is generated by a temperature difference stimulation sequence, and the temperature change amplitude is within ±1℃, which is used to enhance the spatial illusion effect of the touch receptors.

[0010] Further, the stimulation duration is set according to a non-uniform rhythm rule, which conforms to the 1 / f fluctuation characteristic; the terminal channel output signal of the continuous chain is a behavior blocking signal, including a burst of silence or a short-term uncomfortable touch, which is used to induce a compensatory swallowing response by inducing a sense of incompleteness in the central nervous system.

[0011] Further, the reverse output mode in the staggered output strategy uses the cross-start of the main channel and the secondary channel to make the patient perceive the sequence of the channels, thereby activating the nonlinear neural reflex path; the near-threshold sour liquid used for taste channel stimulation has an acidity controlled in the range of pH 4.0-4.5 to stimulate the tongue acid receptor and induce saliva secretion, which is used to promote the preparation action of swallowing.

[0012] Further, the sequence of the start of the main channel and the secondary channel in the reverse output mode is repeatedly alternated within the same training cycle to build rhythm uncertainty of staggered sensory access, so as to induce short-term synaptic priority reconstruction of the neural pathway; the main channel and the secondary channel are sorted by the system based on the hyoid elevation amplitude in the last swallowing response before each round of start, and the channel with weak correlation is preferentially activated to force the central nervous system to rearrange the neural channel mapping.

[0013] Further, in the guidance process of the channel sequence, a signal inhibitory microstimulation is applied to the main channel within a short time after the output of the secondary channel to weaken the prior reaction path of the central nervous system to the main channel; when the main channel is the taste channel and the secondary channel is the touch channel, the secondary channel releases a low-frequency vibration signal to simulate the pre-action of swallowing, so as to disturb the sequence construction process of the central nervous system to the taste and action reaction.

[0014] Further, the near-threshold sour liquid is subjected to temperature co-modulation processing before release, and cold gas flow is applied at the same time as the sour taste input, so that the perception threshold of the sour taste stimulation is actively down-regulated in the low-temperature state, and a lower dose of stimulation is induced to activate saliva secretion.

[0015] Further, the release position of the sour liquid is the middle and rear area of the tongue, and the local cold touch input on the back of the tongue is combined to preferentially activate the salivary gland-tongue pharyngeal muscle group reflex chain related to the deglutition action; the sour liquid for sour taste stimulation is a non-traditional food acid type solution, which is decoupled from the chemical properties of food flavor, so as to avoid the activation of the taste memory path and strengthen the reflexive swallowing rather than the appetite-driven swallowing.

[0016] Further, the sour taste stimulation applied by the taste channel is released in two segments within 4-6 seconds, the first segment is used for acid preparation, and the second segment is triggered by the threshold value of the tongue saliva conductance value, which is used to improve the synchronization of stimulation and reaction; the reverse output mode adds a main channel repeated application of a weakened version of stimulation at the tail of the cycle but does not induce a response, which is used to establish a false memory in the central nervous system, so as to start the expected reflex in advance in the next training.

[0017] The beneficial effects of the present application: by constructing a multi-dimensional interaction mechanism with subliminal sensory pre-activation, channel out-of-sequence output, atypical stimulation intervention and rhythm chain induction as the core, the limitations of traditional single-channel, linear reflection training are effectively broken. The reverse output and channel out-of-sequence strategy adopted promotes the brain to perform nonlinear reconstruction on the sensory pathway, and under the guidance of the principle of neural plasticity, an alternative swallowing reflex path is formed, which improves the training response probability of patients with moderate to severe swallowing disorders. In addition, by introducing cold-acid synergistic regulation and posterior tongue region positioning stimulation, the synchronization of saliva secretion and hypopharyngeal preparation response is further enhanced, and precise intervention on the swallowing preparation period is realized.

[0018] Compared with traditional single taste or mechanical induction means, the non-uniform rhythm characteristics and stimulation chain tail illusion memory implantation mechanism constructed by the present application not only improve the patient's perception and expectation of swallowing behavior during training, but also significantly enhance the central stability and start-up sensitivity of the swallowing action through sensory conflict, rhythm interference and loop repeated activation mechanisms, thereby improving the effectiveness, plasticity and individualized adaptation degree of rehabilitation training, and having good clinical promotion prospects and neural rehabilitation value. BRIEF DESCRIPTION OF DRAWINGS

[0019] Figure 1 The present application is a multi-sensory stimulation coupled swallowing rehabilitation simplified flowchart.

[0020] Figure 2 The present application is a multi-sensory conflict-illusion rhythm swallowing rehabilitation function relationship diagram.

[0021] Figure 3 The present application is a rhythm alternating out-of-sequence sensory input and neural adaptation function diagram.

[0022] Figure 4 The present application is a multi-sensory coordination training process and function relationship diagram of Wang's swallowing rehabilitation in Example 1.

[0023] Figure 5 The present application is a segmented taste and priority reconstruction swallowing training flowchart of Wang in Example 2. DETAILED DESCRIPTION

[0024] The specific embodiments of the present application will be described in detail below with reference to the accompanying drawings.

[0025] The specific embodiments of the present application will be described in detail below with reference to the accompanying drawings. Figure 1The present application is a multi-sensory stimulation coupling processing method in swallowing rehabilitation, which realizes the reconstruction and enhancement of swallowing reflex ability by constructing a neural activation path based on multi-sensory collaborative input, and is suitable for the rehabilitation intervention of central, reflex or sensory regulation type swallowing disorders. Specifically, multi-channel sensory stimulation below the subjective recognition threshold of the patient is applied to the patient, which can include but is not limited to near-threshold taste stimulation (such as low-concentration sour liquid), micro-intensity touch (such as slight vibration in the throat area), extremely low-concentration olfactory signal (such as simulated food volatile odor), or low-volume simulated swallowing sound, etc. The intensity of the above stimulation is precisely controlled in the subthreshold interval that is difficult for the patient to perceive at the conscious level, so that the stimulation can activate the low-level neural pathways related to swallowing in the brain without consciously arousing perception, build a subthreshold sensory activation preparation mechanism, and enhance the excitability basis of the swallowing response chain; after the formation of the preparation mechanism, a micro-time difference misplacement output strategy is further introduced in multiple sensory channels, and the time difference is generally set to 20-200 milliseconds, which is used to realize the time offset release between different sensory inputs, so that the taste, touch, smell, and hearing stimuli received by the patient no longer appear synchronously, but are input in approximate sequence, thereby forming a sensory misordering and cross-attribute phenomenon in the brain integration perception process, and then breaking the linear reflex path formed by traditional single-channel stimulation, and inducing the change of the perception priority of the central to the multi-channel collaborative input; this cross-attribute mechanism helps to improve the neural collaboration strength between sensory channels, and enhances the reflex response integration ability of the brain to multi-sensory co-occurrence events, especially when the swallowing action is still in the fuzzy starting stage, the stimulation misplacement structure can accelerate the generation speed of the swallowing intention, and improve the overall activation efficiency of the swallowing reflex arc.

[0026] On the basis of the multi-sensory cross-attribute mechanism formed by the aforementioned mislocation output strategy, further superimposed non-typical sensory stimulation factors are set to break the original swallowing reflex path structure in the patient's brain in an interference manner, and then guide the central nervous system to reconstruct a new swallowing control path to replace the damaged or failed original path, so as to realize the alternative recovery of swallowing function; the non-typical sensory stimulation factors include but are not limited to simulated fluid direction tactile sensation signals generated during liquid swallowing, non-food related olfactory components, or temperature difference jump tactile sensation of the throat region, etc., wherein such stimulation does not have significant causal correlation for traditional induction of swallowing action, but can generate a new linkage reflex path through the central nervous system's integration processing of abnormal input, especially suitable for patients whose original path cannot be recovered after swallowing function is impaired; by combining the above-mentioned non-typical stimulation with the original mislocation sensory input, the brain actively performs alternative connection and synaptic link reconstruction of neural pathways under the interference of multi-channel input, thereby establishing an alternative execution chain, that is, a swallowing activation mode that does not depend on the original reflex channel, improving the path redundancy and function migration ability in the rehabilitation process; in addition, in order to avoid the unordered superposition of the above-mentioned multi-channel stimulation in the time structure and reduce the intervention effect, further arrange all sensory stimulations in a chain according to the rhythmic structure, that is, design the stimulation of each channel to be released in a specific time interval and order, forming a stimulation chain with the desired rhythm, the stimulation chain not only includes the combination relationship of synchronous stimulation and mislocation stimulation, but also introduces a sensory expectation triggering mechanism, that is, by controlling the persistence and convergence time of the previous sensory stimulation, a time sequence prediction model of the next channel stimulation is established in the central nervous system, so that the patient gradually forms active preparation and behavior prediction for swallowing action start in the perception chain advancement; this progressive sensory induction state can effectively improve the patient's participation, perception concentration and neural response intensity, and finally complete the reconstruction and activation of swallowing behavior under the condition of not relying on a single high-intensity stimulation.

[0027] Combining the drawings Figure 2, further in the activation of the preparatory mechanism under the sensory threshold, a combination of opposite direction and opposite attribute sensory stimulation signals is used to build a perception conflict state at the subconscious level, the opposite direction refers to the relative nature of the two types of sensory stimuli in spatial positioning, stimulus propagation path or sensory motor induction direction, such as applying cold touch that simulates liquid flowing downward in the throat area at the same time, applying upward micro-heat diffusion or vibration signals in the neck or mandible area, thereby producing a directional contradiction in spatial perception; the opposite attribute refers to the opposite sensory characteristics of the two stimuli, for example, cold and hot alternation, rough and fine change, soft and sharp perception contrast input, the combination of contradictory stimuli is applied within the intensity range below the perception threshold, so that the brain does not form a dominant perception and produces a fuzzy signal judgment at the implicit integration level, such conflict state can break the patient's original neural adaptability to the static environment, trigger the stress awakening response of the central nervous system, and then activate the reflex preparation path related to swallowing; after the establishment of the above conflict induction mechanism, in order to further enhance the sensitivity of the central nervous system to the coordination of multi-sensory input, a misplacement output strategy is introduced in the multi-channel sensory stimulation, the time interval between different sensory channels is set in the window where the sensory causal illusion is prone to occur, and the preferred range is 40-160 milliseconds, this time window can effectively create the patient's cognitive misjudgment of the sequence of sensory events at the brain level, and then form a causal confusion illusion, that is, the combination of sensory stimuli that have no causal relationship is mistakenly thought to have a cause-and-effect relationship, and the response strength of the target behavior after stimulus integration is enhanced; for example, under the time arrangement that the sour taste input is slightly later than the cold touch input, the patient will misjudge the sour taste as the result caused by the cold touch, thereby improving the contribution of the sour taste to the saliva reflex and swallowing preparation; this misplacement causal illusion mechanism not only strengthens the coupling degree between channels, but also improves the attention resource allocation ability of the central nervous system to the weak stimulus coordination mode, forming a higher input response density at the neural integration level.

[0028] In the process of constructing a multi-channel sensory stimulation combination, an atypical sensory stimulation factor is introduced to break through the traditional swallowing activation mechanism that only relies on taste or mechanical trigger. The atypical sensory stimulation factor specifically includes skin surface tactile input simulating the direction of liquid flow. The tactile input can be generated through a multi-point temperature control attachment unit or a micro-vibration output unit placed on the patient's neck, lower jaw or anterior larynx area, sequentially or continuously generating directional tactile signal flow. The signal flow simulates the dynamic trend of liquid sliding down from the oral cavity to the throat on the moving path on the patient's skin surface, thereby disturbing the patient's inherent spatial perception of liquid movement direction, making him produce a swallowing association without actual swallowing substance, and then inducing an autonomous swallowing attempt. The simulation of flow feeling is not generated by traditional continuous vibration or mechanical sliding, but by a temperature difference stimulation sequence. That is, multiple temperature control units in the tactile output area are controlled to apply slightly different temperature changes in a sequential activation manner to form a tactile illusion with a temperature gradient and a spatial advancement direction. In the preferred embodiment, the temperature difference is controlled within ±1℃, and the temperature sensing advancement process from top to bottom or from front to back is completed within 1-2 seconds to ensure that the temperature change produces sufficient but not excessive spatial dynamic stimulation signals for the skin surface layer cold / hot receptors. This temperature-driven flow feeling simulation method has the advantages of non-invasive, non-compressive and low energy consumption, and can effectively stimulate the brain's implicit perception of liquid flow, thereby strengthening the neural preparation and execution intention of the swallowing action on both cognitive and reflex pathways. In the early stage of rehabilitation when the patient lacks obvious swallowing intention or actual pharyngeal input, this method is particularly useful in inducing autonomous swallowing response, activating residual swallowing pathways and improving behavioral reflex sensitivity.

[0029] In the design of the timing structure of the stimulation, a nonlinear rhythm control mechanism is introduced to improve the response depth and behavior driving strength of the central nervous system to the multi-channel stimulation chain. Specifically, the stimulation duration of each channel in the sensory stimulation chain is not set in equal intervals or uniform distribution mode, but is set according to a non-uniform rhythm rule, which conforms to the 1 / f fluctuation characteristic. That is, the high-frequency short stimulation and low-frequency long stimulation in the stimulation time sequence presents a pink noise distribution trend. The mathematical characteristic is that the power spectral density is inversely proportional to the frequency. In the preferred implementation, the stimulation time length in each training chain varies between 0.3-2.5 seconds according to the 1 / f trend, to simulate the inherent preference of the natural nervous system to the rhythm of external signal perception, thereby enhancing the physiological synchrony and attention coupling degree of the brain to the stimulation chain. After the above non-uniform rhythm chain completes the basic sensory input cycle, the terminal channel output signal in the continuous chain is set as a behavior blocking signal. The signal does not have the positive sensory characteristics of promoting swallowing, but is a disturbance type input designed to create a central nervous system perception defect. Preferably, it includes a burst of silence (i.e. sudden interruption of sensory input) or short-time discomfort touch (such as local tingling, tremor or low-frequency noise touch), which is used to create a stimulation failure or mismatch feeling at the critical point of the brain's expected chain completion, so that the central nervous system produces a reactive judgment of the non-closed behavior, thereby triggering a compensatory behavior execution mechanism.

[0030] In the staggered output strategy, a reverse output mode of cross-activation of the primary and secondary channels is introduced to break the patient's inherent prediction of the sensory channel order in multiple stimulation training, thereby creating a perception illusion of channel misordering. The primary and secondary channels can be set as taste and touch channels, olfactory and auditory channels, etc. according to the training target. The channel that is usually later in the physiological sequence (e.g. pharyngeal touch) is activated first, and then the stimulus of the dominant channel (e.g. oral taste) is released with a delay, so that the patient receives a channel order that violates the perception experience in time, thereby activating the nonlinear neural reflex pathway in the brain, which bypasses the original forward stimulation-response mechanism, promotes synaptic priority reconstruction and pathway dynamic remapping of the nervous system, improves the plastic response ability of the neural network, and has a strong adaptive reconstruction effect on patients with impaired swallowing reflex chain. In the above reverse output mode, the taste channel preferably uses a near-threshold acidic liquid as the stimulation medium, specifically controlling the acidity in the weak acid interval of pH 4.0-4.5, which is below the subjective taste dominant perception threshold but sufficient to activate the tongue acid receptor. The acidic liquid is released by short-term infiltration through the middle and back of the tongue, stimulating the acid-sensitive ion channels (such as ASICs and PKD2L1) of the glossopharyngeal nerve terminal, thereby inducing salivary gland secretion response and activating the physiological preparation process before swallowing. When combined with reverse tactile input, the acidic stimulation can effectively improve the depth of awakening of the pre-swallowing state, enhance the integration priority of multi-sensory cross-stimulation at the central level, open a low-threshold response window for the subsequent action execution pathway, and realize the behavior transition from passive reflection to active attempt in the swallowing rehabilitation process.

[0031] Combining the drawings Figure 3 On the basis of the reverse output mode, the starting order of the primary and secondary channels is repeatedly alternated within the same training cycle to construct a misordered sensory input mode with uncertain rhythm, to continuously disturb the central sequence expectation of the channel time sequence, thereby inducing dynamic reconstruction of synaptic priority of the neural pathway on a short time scale. Specifically, the primary and secondary channels can be any combination of two sensory input paths, such as taste and touch channels, olfactory and auditory channels, etc. Before the start of each round of stimulation, the system analyzes the hyoid bone elevation amplitude data recorded in the patient's last swallowing response in real time. The hyoid bone elevation amplitude, as a biomechanical parameter reflecting the swallowing execution intensity and neural pathway effectiveness, is used to infer the response efficiency of the current sensory channel. The system determines the neural correlation degree between the channels based on this, and preferentially selects the channel with weak correlation degree in the previous round as the starting priority in the current round, to artificially disrupt the nervous system's continuous dependence on the efficient channel, forcing the central nervous system to rearrange the channels and replace the pathways during sensory stimulation mapping, i.e. breaking the fixed coupling mode of the original strong channel-strong response, guiding the central to establish redundant mapping relationship and nonlinear integration mechanism between multiple input paths, and realizing neural adaptive training under functional reconstruction.

[0032] In the guiding process of channel disorder, in order to strengthen the reconstruction ability of the central nervous system to the order of sensory input, an operation strategy of applying signal inhibitory microstimulation to the main channel in a short time after the output of the secondary channel is designed, in order to consciously weaken the path dependence of the central prior reaction to the main channel. The microstimulation is a subthreshold signal with intensity lower than the behavior excitation threshold, which has the nature of disturbance rather than promotion. The purpose is to make the main channel with high response priority lose the reflection dominance in a short time, so as to force the central nervous system to adjust the weight distribution of the input of each sensory channel. Specifically, when the main channel is the taste channel and the secondary channel is the touch channel, the touch input signal of the secondary channel is preferentially released in the stimulation sequence. The touch input is realized by low-frequency vibration, and the frequency range is 20-40Hz, which simulates the premonitory action feeling of the laryngeal or neck muscle when the swallowing behavior is about to start. This vibration signal acts on the superficial touch receptor through the vibration output device attached to the skin of the laryngopharyngeal region, and generates a motion anticipation signal similar to the impending swallowing behavior in the central nervous system. Then, before the main channel releases the taste stimulus such as sour liquid, the system outputs a short and weak interference touch or temperature jump signal to the area corresponding to the taste channel (such as the middle of the tongue). This signal does not directly induce salivation or swallowing response, but interferes with the activation ability of the original taste path, so that the central nervous system makes a false judgment of path delay or response failure, thereby promoting the brain to rebuild the causal order and coupling relationship between taste and action response in the middle training stage, and realizing the remodeling of the swallowing reflex chain with multiple paths, low dependence and replaceability.

[0033] In order to improve the activation efficiency of acid taste stimulus in the taste channel to salivation, and at the same time reduce the risk of subjective discomfort and adaptive threshold increase of patients, the temperature sensing co-modulation processing technology of near threshold acid liquid is introduced, that is, the tongue surface is in a low temperature microenvironment by releasing acid liquid and synchronously acting on the oral cavity area by accurately controlled cold gas flow, so as to actively reduce the perception threshold of acid taste stimulus. The cold gas flow is preferably a directional gas flow processed by a temperature control module, and its temperature is controlled in the range of 18-20℃, which acts on the middle to back region of the tongue surface to form a local cold feeling zone. The acidity of the acid liquid is controlled in the range of pH 4.0-4.5, which is in the near threshold range, that is, it only has weak taste perception or is not enough to trigger obvious response without temperature sensing cooperation. By cooperating with the cold gas flow, TRPM8 type cold receptors and acid-sensitive ion channels (such as ASICs) are activated at the same time, so as to improve the physiological significance of acid sensing signal at the neural integration level, thereby inducing equivalent or even enhanced salivation response with lower concentration and lower dose of acid taste input, avoiding the problems of patient rejection, neural desensitization or taste fatigue caused by traditional high-intensity acid taste stimulation, and realizing the mild activation and continuous adjustment of the swallowing preparation action in the subthreshold sensory environment.

[0034] In the design of taste channel stimulation, the release position of the sour liquid is set in the middle-back region of the tongue, preferably covering an area of about 5-10 mm on both sides of the middle line of the tongue dorsum, which is highly related to the distribution of sensory endings of glossopharyngeal nerve, and helps to directly activate the salivary gland associated with the swallowing movement - glossopharyngeal muscle group reflex chain; at the same time, in order to enhance the directional guiding effect of taste stimulation on the swallowing center, the local cold touch input on the tongue dorsum is superimposed at the same time of the release of the sour liquid, the cold touch blows the cold gas with a temperature of 18-20°C to the dorsal surface of the back of the tongue through a micro air flow device to activate the local TRPM8 receptor to build the cross integration of cold sensation and sourness, improve the priority of the central perception of this area, and enhance the reflex awakening effect on the preparation path of swallowing; further, in order to avoid the traditional acid taste stimulation triggering the flavor association of patients based on dietary experience, the acid stimulation liquid does not use common food acid types (such as citric acid, acetic acid, etc.), but uses a synthetic weak acid solution with chemical properties decoupled from food acid flavor, such as metaphosphoric acid or low-concentration sodium lactate compound solution, which has low volatility, low olfactory involvement and no appetite guiding effect, its sour stimulation focuses on the electrophysiological activation of taste ion channel rather than the overall flavor path, thereby avoiding the memory dependence of the patient's brain on the "food-swallowing" path and strengthening the neural activation mode centered on "reflex stress-swallowing".

[0035] In the process of acid taste stimulation release in the taste channel, a time sequence segmentation and physiological feedback coupling mechanism is used to enhance the neural synchronicity between stimulation and swallowing response, including controlling the single acid taste stimulation process within a 4-6 second time window, and dividing it into two release segments: the first segment lasts for 1.5-2 seconds, which is the initial injection stage of low-concentration acid liquid, used to activate the taste receptors on the tongue and establish the acid sensation preparation state, the stimulation is not enough to independently induce saliva secretion or swallowing action, mainly for the central nervous system to establish perception expectation; the second segment is to determine the release time according to the change of the patient's tongue saliva conductance value in real time, when the tongue surface conductance value reaches the set threshold (which is related to the individual's initial saliva state), the system triggers the release of the second segment of the stimulation liquid, the acidity of this stage can be slightly higher than that of the first segment, the purpose is to apply the main stimulation at the most active moment of physiological preparation state, so as to realize the precise timing between sensory input and neural reflex response, greatly improve the stimulation efficiency and reduce the response delay caused by individual differences; in addition, based on the reverse output strategy of the main channel and the secondary channel cross start, a repeated weakening stimulation of the main channel is inserted at the tail of each training cycle, which is lower than the induction response threshold in intensity, and the release time is delayed by about 3-4 seconds and does not induce swallowing response, the purpose is to build an incomplete stimulation memory at the neural level, so that the central nervous system produces a defective feedback experience, and actively mobilizes the neural prediction mechanism related to the main channel before the start of the next training, to start the reflex path preparation state in advance, and thus realize faster perception-execution switching speed in the training process.

[0036] Example 1:

[0037] Combined with appendix Figure 4 In this embodiment, the patient, Mr. Wang, is a 65-year-old male who suffered mild medullary injury due to stroke. He exhibited delayed swallowing response and slow initiation of swallowing preparation. After three months of rehabilitation training using traditional methods such as pharyngeal stimulation with ice cotton balls and tongue acid induction, the effect tended to plateau. He still needed assistance with drinking water and voice prompts to complete active swallowing in his daily life.

[0038] To break the inertia of his neural reflex pathway, the system employed a subthreshold sensory activation preparatory mechanism and an atypical sensory factor superposition strategy. In one training session, the system applied two sets of sensory stimulation signals with opposite directions and reversible attributes to Wang: on the one hand, a 32°C mild temperature stimulus was released through a heat-sensitive stimulation patch attached to his left cheek, while simultaneously, a 18°C ​​cold stimulus was applied to the area in front of his right ear using a directional, slightly cool airflow. The temperature difference was controlled at 14°C, and due to the symmetrical placement of the left and right sides, a spatial opposition of directions and reversible hot and cold attributes were created. Wang did not have a clear subjective perception of either stimulus, but fNIRS monitoring showed that his brainstem temperature sensation center activity increased within approximately 1.8 seconds after application. The current bilateral blood oxygen fluctuation cross-increase indicates that although the nervous system has not explicitly recognized it, it has initiated an internal mediation mechanism for sensory conflict, forming a preparatory state activation at the subconscious level. At this time, the system synchronously executes the misaligned output strategy. 450 milliseconds after the release of hot and cold sensory stimuli, 0.4 ml of near-threshold citric acid solution with pH 4.2 is released into the anterior part of the tongue through the taste channel. Immediately after a delay of 230 milliseconds, a light tapping vibration simulating the direction of swallowing is applied to the neck through the tactile channel. This interval falls within the psychological window for inducing causal illusion (300±100 ms). The patient subjectively reports that the vibration is caused by taste, indicating that the central nervous system has integrated the two and strengthened its causal association.

[0039] Furthermore, to promote active swallowing attempts, the system introduced atypical sensory stimulation factors. Specifically, three temperature-controlled micro-vibration modules were used in the tactile channel to simulate the flow of liquid from the jaw along the neck to the sternocleidomastoid muscle. Each module was activated sequentially for 0.6 seconds, with the temperature difference controlled within ±0.9℃. Wang reported feeling a little water flowing down, and then unconsciously made a small swallowing motion with anterior displacement of the hyoid bone. The cervical sEMG recorded a swallowing complex amplitude of 72μV (84% of the patient's daily active swallowing response intensity), indicating that the stimulation chain had triggered a near-equivalent active swallowing attempt. The above process was repeated three times within 90 seconds. In the second round, when the tactile temperature difference increased to ±1.2℃, Wang exhibited discomfort and tried to avoid the stimulation. Based on this, the system controlled the subsequent temperature difference within ±0.8℃.

[0040] Wang was in the fourth week of rehabilitation, system upgrade using 1 / f fluctuation rhythm (i.e. frequency and intensity fluctuation inverse proportion of non-uniform distribution law) to build a multi-sensory stimulation chain, first with auditory channel as the main start signal source, in the 0th second, play white noise with micro-rhythm fluctuation of human voice samples, the average duration is 2.2 seconds, standard deviation is 0.9 seconds; in its after delay about 370 ms, the system in the tactile channel inject low frequency (23 Hz) neck vibration signal and superimposed ±0.7℃ temperature difference simulation liquid flow, last about 1.5 seconds; then in 1.2~1.9 seconds interval, in the taste channel, 0.5ml of pH4.2 citric acid solution is injected into the front-middle part of the tongue, and at the end of it, a cold gas jet is superimposed to reduce the local temperature, cooperate with the early temperature cross, form weak dominant sensory illusion, induce increased salivation.

[0041] According to the system record, the value of the tongue surface saliva conductance of Wang increased from the original 3.2μS to 5.7μS before and after the taste stimulation, and reached the peak value in about 2.6 seconds. At this time, the system suddenly inserted a behavior blocking signal at the 3.0th second, that is, the auditory channel played a sudden silence (0.5 seconds completely silent), and the tactile channel stopped vibrating and applied a short-term interference signal (such as a light tap with a strength of 0.8N in the hyoid area). Such output signal simulates a kind of "perception fracture" of incomplete behavior, forcibly breaks the brain's expectation of continuous action, induces compensatory neural response, that is, the central nervous system of Wang generates an alternative response path of incomplete behavior, thereby triggering a spontaneous swallowing action. The whole process lasts about 6 seconds. The sEMG of Wang shows that the response amplitude of the hyoid elevator muscle group reaches 82μV, which is significantly higher than that of the group without terminal blocking signal (the average is only 57μV), and the hyoid elevation delay is only 1.6 seconds, indicating that the compensation response path is activated successfully.

[0042] At the same time, in this stimulation chain, the system adopts the reverse output strategy of main channel-secondary channel cross start. Specifically, in the first round, the taste channel is the main channel (T1) and the tactile channel is the secondary channel (T2), T1 starts at the 1.1th second, and T2 starts 260ms later. In the second round, it is reversed, T2 starts first, at the 1.0th second, and then T1 applies the sour liquid injection 350ms later. The system uses biological feedback loop to compare the swallowing response parameters of Wang under the two sequences. The results show that the trigger frequency is higher (2 times of spontaneous swallowing in 3 rounds) in the T2→T1 (reverse) path, while there is no obvious induced response in the T1→T2 (forward) path. In the T2→T1 path, the average hyoid elevation angle of Wang reaches 22.5°, which is better than the 16.3° of the forward output group, indicating that the channel disorder triggers the activation of the nonlinear neural path, effectively intervening the fixation trend of the original response path.

[0043] The 1 / f fluctuation rhythm stimulation chain spectrum is mainly concentrated in the range of 0.2 Hz~1.4 Hz, and the average α wave band (8~13 Hz) of central nervous recording is improved by 12.8% during the training process, which can be inferred that the brain enters a stronger perceptual pre-activation state; and the channel start interval of the misplacement output strategy in the three rounds of training is 370ms, 280ms, and 410ms respectively, all of which are within the window area (200~500ms) of the induced sensory cause illusion in psychology, and Wang's feedback is "I feel that the sound and the sour taste are connected" and "I seem to know the next step will have a taste", which verifies that the central nervous system has activated the prediction mechanism of sensory coordination, and improved the subjective expectation and neural integration depth of the training.

[0044] Example 2:

[0045] Combined with the Figure 5 After Wang completed the preliminary training based on 1 / f rhythm fluctuation stimulation chain and spatial flow tactile simulation, the rehabilitation system entered the neural priority reconstruction phase, and the goal of this phase was to break through the rigid sequence response mode of his neural pathway through sensory channel misordering and synaptic intervention. The system first constructed a training pair based on the taste channel (primary channel) and the tactile channel (secondary channel), and set up a cross-start mechanism, that is, the starting order of the channels was randomly determined in each training cycle. The system monitored Wang's hyoid bone lifting amplitude through real-time sEMG signal as a physiological response indicator, and if the lifting amplitude was more than 20% lower than the baseline mean value (54μV), the channel that was not activated in the last round would be started first in the next round to strengthen its coupling mapping with the swallowing action and break the central nervous system's dependence on a stable path. For example, in the third round of training, the system detected that the hyoid bone lifting was 47μV after the tactile channel was activated, which was lower than the threshold, so the system adjusted the fourth round starting order to start the taste channel first, and set the taste channel to release 0.3ml of sour liquid with pH 4.3 in the middle of the tongue, and then delay 500ms to apply simulated pre-laryngeal vibration by the tactile channel, so as to establish a new path association.

[0046] In the channel disorder implementation, to weaken the central prior response path of the taste channel, the system introduces an inhibitory micro-stimulation mechanism, that is, within 150 ms after the tactile channel (secondary channel) output, a mild low-frequency electric pulse (amplitude 0.3 mA, frequency 18 Hz, duration 200 ms) of non-taste-related but electrically stimulating nature is applied through the taste channel. The stimulus is below the nerve action potential threshold and does not form a dominant perception, but can form an inhibitory effect after the excitation of the nerve ending, resulting in a temporary desensitization of the taste channel. The measured results show that Wang's subjective score of sour taste decreases by about 17% within 1 second after stimulation, and neural imaging suggests that the electrical activity of the taste cortex is slightly delayed (delayed by about 280 ms), thus realizing the "disorder + weakening" double mechanism intervention. In this process, the tactile channel first releases a low-frequency vibration signal (frequency 11 Hz) to simulate the throat lifting feeling in the swallowing precursor, making Wang feel the "about to swallow" expectation state, and then the main channel sour taste stimulus is followed up to release, forming an abnormal order of moving first and then tasting. After 10 training times, Wang's swallowing reaction time under this order decreased from an average of 4.2 seconds to 2.8 seconds, and the electromyographic preparation window before swallowing action was shortened by 480 ms, showing a significant central path reconstruction effect.

[0047] In the twelfth training phase of Wang, the rehabilitation system entered the reflex chain deep activation module, which was designed to further improve the induction efficiency of involuntary swallowing response by lowering the taste threshold and optimizing the stimulation position. This stage introduced near-threshold acid liquid temperature co-modulation technology and non-memory taste stimulation scheme on the back of the tongue. In this training, the system chose to use a pH value of 4.4 non-taste citric acid solution (belonging to non-traditional food acid), which does not contain food aroma-related volatile esters or sugar ratios, and its main chemical components are citric acid and trace sodium lactate. After being released to the back of Wang's tongue (about 3.5 cm from the tip of the tongue, close to the base of the tongue) by a micro-pump, the system simultaneously sprayed a small amount of cold air flow (air speed 0.3 m / s, duration about 800 ms) of 5°C±0.5°C upward to the dorsal area of the tongue, aiming to lower the acid taste threshold of the taste receptor through temperature modulation, so that low-concentration acid liquid can also trigger the reflex activity of the sublingual gland and the glossopharyngeal muscle.

[0048] According to the preclinical data, Wang's sour taste threshold at room temperature (22°C) is about pH 4.0, that is, when the acidity is lower than this value, it will trigger a significant salivary reflex. However, after introducing cold air conditioning, the system actually measured his subjective threshold to drop to pH 4.5, indicating that his taste receptor sensitivity has increased, and the response threshold has been pushed to a lower stimulus amount. In this training, although the concentration of the sour liquid is low, under the cold air conditioning, Wang's salivary secretion increased significantly within about 1.6 seconds after stimulation, with the salivary flow rate increasing from the baseline value (0.14 ml / min) to 0.37 ml / min, an increase of 164%. The hyoid electromyogram showed that high-amplitude electromyographic fluctuations appeared within 560 ms after stimulation, with the maximum lifting amplitude increasing to 61 μV, and the activation time shortening by about 0.9 seconds.

[0049] In addition, to avoid the interference of traditional taste memory on the reflex swallowing pathway, the acid liquid used does not contain common food acid (such as acetic acid, malic acid) flavor factors, and its release position is specifically avoided from the tip of the tongue and the dense area of taste buds, effectively avoiding the pleasant eating association caused by flavor, and in clinical observation, Wang has no obvious facial avoidance or appetite for this acid liquid, and the response is more purely physiologically driven, which meets the purpose of reflex channel reconstruction in swallowing rehabilitation.

[0050] In the fifteenth stage of Wang's rehabilitation training, the system officially enabled the double-section acid taste stimulation + weakening repeated memory induction module based on his physiological feedback in the previous stage. The core design intention of this module is to further improve the synchronicity and activation ability of the swallowing reflex. By precisely controlling the rhythm and timing of taste stimulation, the central nervous system establishes an expectation of the upcoming swallowing demand, shortens the neural conduction pathway, and enhances the response sensitivity. The system first sets the taste channel acid stimulation to a segmented release mode, with the total stimulation time controlled at 5 seconds. The first segment is an acid preparation period, lasting about 2 seconds, using a low-concentration citric acid solution with pH 4.6, and releasing 0.2 ml of the solution slowly to the back of the tongue. The main function is to start the taste channel but not to provide enough reflex intensity. During this stage, the change in tongue surface salivary conductivity is monitored synchronously, with the baseline value being about 85 μS / cm per minute. The system sets the salivary conductivity threshold to rise by 10% (i.e., reaching 93.5 μS / cm) as the trigger condition for the second segment of stimulation. Once the threshold is met, the system immediately enters the second segment of stimulation release. This segment is the main effective stage, with the acid concentration increasing to pH 4.2 and the dose being 0.25 ml, which is injected within 1.5 seconds. After stimulation, Wang produces an active swallowing reflex within about 600 ms, with the peak lifting amplitude of the hyoid electromyogram being 69 μV, which is significantly higher than the previous cycle of 55 μV. The response delay is shortened to within 1.2 seconds, indicating that the reflex synchronicity has been significantly improved.

[0051] On this basis, to guide the establishment of the desired feedback memory, in the tail of each complete stimulus cycle (about 3 seconds after the end of the main stimulus) introduced a weak version of the main channel repeat stimulus, that is, to apply 0.1ml, pH4.6 weak sour liquid, the dose and stimulus intensity are not enough to trigger the actual response, only in the neural pathway to establish an incomplete action expectations, the stimulus is not accompanied by any tactile or auditory signals, resulting in the central incomplete perception of the completed behavior. According to the system records, Wang after receiving three rounds of such training, the next cycle of swallowing initiation response occurs in advance, the saliva conductance value has begun to rise before the main stimulus starts (breakthrough 90μS / cm from baseline about 800ms in advance), indicating that the central nervous system has been preprocessed under the expected conditions. Hyoid EMG data show that in the second day of training, the average swallowing reflex initiation delay is shortened to 0.85 seconds, the peak intensity is maintained between 68~72μV, with good physiological stability and predictability.

[0052] The above shows and describes the basic principles, main features and advantages of the present application. Those skilled in the art should understand that the present application is not limited to the above examples, and the above examples and descriptions in the specification are only to illustrate the principles of the present application. Without departing from the spirit and scope of the present application, various changes and improvements can be made to the present application, and these changes and improvements all fall within the scope of the claimed present application. The scope of protection of the present application is defined by the appended claims and their equivalents.

Claims

1. A multi-sensory stimulation coupling treatment method in swallowing rehabilitation, characterized in that... include: By applying sensory stimulation below the subjective recognition threshold to the patient, the preparatory state of swallowing-related neural pathways is activated at the subconscious level, forming a subthreshold sensory activation preparatory mechanism. A staggered output strategy with micro-time difference is introduced into multiple sensory channels, so that gustatory, tactile, olfactory and auditory stimuli are released sequentially within the offset time sequence, thereby generating a sensory cross-attribution effect in the brain and enhancing the activation intensity of the swallowing reflex arc by multi-sensory synergistic stimulation. Based on the aforementioned misaligned output strategy, atypical sensory stimulation factors are superimposed to guide the central nervous system to reconstruct the swallowing control pathway in an interfering manner, thereby activating alternative neural branches and forming an alternative execution chain for swallowing actions; sensory stimulation is designed as a continuous chain structure with temporal rhythm, so that the previous stimulus creates a perceptual expectation for the next stimulus, guiding the patient into a progressive sensory induction state.

2. The multi-sensory stimulation coupling treatment method in swallowing rehabilitation according to claim 1, characterized in that... In the aforementioned subthreshold sensory activation preparation mechanism, the applied sensory stimuli are two stimuli signals with opposite directions and reversible attributes, in order to construct a perceptual conflict and thereby induce the central nervous system to reflexively activate the swallowing action; in the aforementioned misaligned output strategy, the stimulation interval between different sensory channels is set as a time window that can induce sensory causal illusions, so as to enhance the central nervous system's perceptual sensitivity to sensory synergy.

3. The multi-sensory stimulation coupling treatment method in swallowing rehabilitation according to claim 1, characterized in that... The atypical sensory stimuli include tactile input from the skin surface that simulates the direction of liquid flow, used to perturb the patient's spatial perception of the direction of liquid movement in order to induce an active swallowing attempt; the tactile input that simulates liquid flow is generated through a temperature difference stimulation sequence with a temperature change range within ±1℃, used to enhance the spatial illusion effect of the tactile receptors.

4. The multi-sensory stimulation coupling processing method in swallowing rehabilitation according to claim 1, characterized in that... The duration of the stimulation is set according to a non-uniform rhythmic distribution, conforming to the 1 / f fluctuation characteristic; the terminal channel output signal of the continuous chain is a behavioral blocking signal, including sudden silence or short-term uncomfortable tactile sensation, used to trigger the incomplete perception of central behavioral completion, so as to induce a compensatory swallowing response.

5. The multi-sensory stimulation coupling treatment method in swallowing rehabilitation according to claim 1, characterized in that... The misaligned output strategy employs a reverse output method that cross-activates the main channel and the secondary channel, causing the patient to perceive a channel misorder, thereby activating a nonlinear neural reflex pathway. The taste channel stimulation uses a near-threshold acidic liquid with acidity controlled within the pH range of 4.0 to 4.5 to stimulate the acid receptors on the tongue and induce saliva secretion, which is used to promote swallowing preparation.

6. The multi-sensory stimulation coupling processing method in swallowing rehabilitation according to claim 5, characterized in that... In the reverse output method, the activation order of the main channel and the secondary channel is repeatedly alternated within the same training cycle to construct the rhythm uncertainty of disordered sensory access, so as to induce short-term synaptic priority reconfiguration of neural pathways. Before each round of activation, the main channel and the secondary channel are ranked by the system based on the hyoid bone elevation amplitude in the previous swallowing response, and the weaker associated channels are activated first to force the central nervous system to generate a neural pathway mapping rearrangement.

7. The multi-sensory stimulation coupling treatment method in swallowing rehabilitation according to claim 5, characterized in that... During the channel disorder guidance process, a signal inhibitory microstimulation is applied to the main channel shortly after the secondary channel outputs, in order to weaken the central nervous system's prior response path to the main channel; when the main channel is a taste channel and the secondary channel is a tactile channel, the secondary channel first releases a low-frequency vibration signal to simulate swallowing aura, in order to disrupt the central nervous system's sequential construction process of taste and motor responses.

8. The multi-sensory stimulation coupling treatment method in swallowing rehabilitation according to claim 5, characterized in that... The near-threshold sour liquid is subjected to temperature-sensing co-modulation treatment before release. A cold gas flow is applied at the same time as the sour taste is input, so that the perception threshold of sour taste stimulation is actively lowered at low temperature, inducing a lower dose of stimulation to activate saliva secretion.

9. The multi-sensory stimulation coupling treatment method in swallowing rehabilitation according to claim 8, characterized in that... The sour liquid is released in the middle and back of the tongue, and combined with local cold touch input on the back of the tongue, it is used to preferentially activate the salivary gland-glossopharyngeal muscle reflex chain related to swallowing. The sour liquid is a non-traditional food acid solution, whose chemical properties are decoupled from food flavor, so as to avoid the activation of the taste memory pathway and strengthen reflexive swallowing rather than appetite-driven swallowing.

10. The multi-sensory stimulation coupling treatment method in swallowing rehabilitation according to claim 9, characterized in that... The sour stimulation applied to the taste channel is released in two segments within 4-6 seconds. The first segment is used to prepare for the sour sensation, and the second segment is triggered by the threshold of the electrical conductivity of the tongue surface saliva to improve the synchronicity of the stimulus and response. The reverse output method adds a weakened version of the stimulus to the main channel at the end of the cycle but does not induce a response. This is used to establish an illusion memory in the central nervous system, so as to start the expected reflex in advance in the next training.

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