Implementation of new 3D printed & advanced materials sensors for the bio analysis of dysphagia patients

Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach, a lack of pharyngeal sensation or various other inadequacies of the swallowing mechanism. Dysphagia is a common secondary symptom of many diseases, for example, 50-75% of stroke patients suffer from Dysphagia. In 2018, Stroke of the Nation, stated over 100,000 people suffer stroke yearly in the UK, with 1.2 million stroke survivors. This equates to 600,000- 850,000 dysphagia sufferers within the stroke cohort alone (pre-SARS-CoV-2/COVID 19). Viscgo estimates 187,000 UK yearly aspirational pneumonia cases. Adverse outcomes lead to avoidable illness and prolonged hospitalisation. Incorrect intervention can impede treatment, increase cost, length of hospitalisation stays and increase risk of severity or death.

Current state of art to treat dysphagia include video fluoroscopy, a fiberoptic endoscopic evaluation of swallowing (FEES) test and diagnostic tools which are prohibitively expensive, inconclusive, and impractical to use regularly. Descriptor categorisations, which are inaccurate, time-consuming and require multiple components and dexterity (which also leads to user conflict), are intended for training only and are not recorded.

Currently, speech and language therapists perform specific assessments when treating patients suffering from dysphagia. These assessments include recording and evaluation using tests (video fluoroscopy and FEES) that are then evaluated via a process of multiple pathways. These pathways are determined from results which are purely observational and therefore open to interpretation and as such are subjective. There are hundreds of different tests (and combination of these tests) currently used. Examples of tests include the turning of the patients head to one side and observing the swallowing function in the throat (eg speed of swallow, coughing or spluttering) or the nurse applying a compression against the patients throat and observing them whilst they swallow. These tests are all crude and without reliable outcome measures.

Viscgo has developed a step change approach to dysphagia. They have developed a sensor capability that can be placed on the patients throat in order to quantitively and reproducibly assess the patients swallowing function.

This PhD project will further develop this wearable technology by investigating the use of smart piezoelectric sensor arrays that have the capability to gain functional data to assist in the determination of physiology against food and drink related dependencies. In addition, this throat sensor technology will have the potential to also actively stimulate local and specific muscles involved in swallowing, thus offering a potential treatment to rehabilitate patients suffering from stroke induced dysphagia.

There are numerous beneficiaries of this Advanced Biomedical Materials CDT. Firstly and of short term impact are the PhD students themselves. They will receive extensive research specific and professional/transferable skills training throughout the 4 years of the programme. They will have access to state of the art facilties and world leading academics, industry and clinicians. The training and potential placements are designed to maximise the impact of their research in terms of dissemination and movement of their research along the translation pathway.

Longer term benefits are that this distinct cohort will become the future UK Biomedical Materials leaders and be able to use their bespoke training and network within the cohort to collaborate on future worldwide funding opportunities and drive UK research in this area.

UK and international academics will benefit as they will gain the next generation of highly skilled postdoctoral researchers with knowledge and expertise not only in their specific research area but of industry, regulatory and clinical aspects.

UK and international industry will benefit - in the short term they will gain academic based research to further develop products and in the longer term have a pool of highly skilled graduates.

Clinicians will benefit from collaborative research and also the development of new and novel products to enhance the treatment of a variety of trauma and disease based needs from biomaterials.

The public will benefit as end users as patients that will have their quality of life improved from the products developed in the CDT and will be educated in novel technologies and materials to repair the human body. The UK economy will benefit from the reduced healthcare costs associated with the new and improved medical products developed in this CDT and subsequently from the trained graduates. The UK economy will also benefit from the increased revenue from medical sales products from the UK industrial partners we will be working with.

The impact of this CDT will be realised by direct academic, clinical and industrial engagement with the students allowing efficient and state of the at training and fast translation of developing products. Students will also be trained in knowledge exchange and will use these skills to disseminate their research to, and liaise with, the key stakeholders - the academic, industrial, clinical and public sectors. We will ensure widening participation routes are addressed in this CDT in order to include equality and diversity not only in our initial CDT student cohort but in future researcher generations to come.