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Postural changes are commonly used treatment to prevent the elderly from the risk of aspiration pneumonia. However, the evidence-based studies regarding effectiveness of this treatment remains unclear since no systematic method exists to measure constantly changing postures without disturbing usual eating behaviors. In this paper, using IMU system attached to a smart-phone based wearable technology, we analyzed data of the neck orientation angles obtained from the dysphagia patients and healthy adults during their mealtime and attempted to see if the obtained data can show differences regarding the dynamics of the angles.The result shows the possibilities to use the device to monitor neck orientations while the dysphagia patients eating their meals in daily lives.

Aspiration pneumonia is a life-threatening disease for the elderly. To prevent its risk, regular swallowing assessment is necessary; however, current screening tools for swallow assessment are not widely available and medical experts are insufficient. As a portable assessment tool, we have been developing a smartphone-based realtime monitoring device (GOKURI) which can evaluate swallowing ability based on swallow sounds. For better detection accuracy of the system, we integrated a deep learning model which was developed based on the swallowing anatomy. In this paper, we provide a detailed analysis to see how the swallow sounds detected by the deep learning-based monitor correspond to the actual swallow activities. Also, as an example of practical application of the system, we analyzed the changes of the swallow abilities over time by recording swallow sounds twice for the same participants at a nursing home. To minimize the risk of aspiration pneumonia, caregivers need to understand the disability levels of the patient's swallows so that safe feeding assistance can be provided. The result of this paper implies the possibility of using GOKURI as a daily swallowing monitor with minimum interventions.

For the elderly with dysphagiais, postural changes are a popular method to reduce the risk of aspiration pneumonia. Among them, the reclining position, a postural change set by the bed angles, has been widely used in practical settings. However, setting the reclining positions is difficult since all beds do not have a system to measure angles especially at the nursing facilities and patient's homes. Moreover, a anatomically critical angle is the one created by the larynx and the pharynx against the horizontal line, but we cannot check them without a medical equipment, such as X-ray or Videofluoroscopy (VF).We have been developing a smart-phone based wearable technology which can measure the neck angles automatically in realtime. In this research, we conducted a study to compare the IMU measured angles with the larynx and pharynx angles from the VF images, and analyzed if IMU can measure these angles properly. Additionally, we compared three angles with: 1) bed angles, 2) neck angles measured by IMU, and 3) bed angles set by a dysphagia treatment specialist, to show how different neck angles were set in the bedside practice. We will also discuss the IMU's future applications to keep the elderly eat safely in the community.

As many of the elderly are prone to dysphagia, preventing aspirations during mealtime assistance is a huge concern, especially for institutions operated with limited staff. Two of the main course of actions that are taken usually to prevent aspiration are the altering of bolus consistency and altering of the swallowing posture. To assist prevention of pneumonia, we have been developing a smartphone-based wearable technology that can evaluate swallowing ability in real-time. In this paper we will introduce modified version of Swallwoscope adding a posture detection system and a remote swallowing activity visualisation system to our previous work. We will evaluate the accuracy of the proposed posture detection system and also evaluate the feasibility of our device to determine bolus consistency. We plan to integrate these components in a network-based framework to share the relevant medical information within the community to enhance safety and pleasure of eating.