Journal of The Korean Society of Integrative Medicine (대한통합의학회지)

Korean Society of Integrative Medicine (대한통합의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of Short Neck Flexion Exercise in Proprioceptive Neuromuscular Facilitation and Neuromuscular Electrical Stimulation on Swallowing Function in Patients with Chronic Stroke

고유수용성신경근촉진법의 짧은 목 굽힘 운동과 신경근전기자극치료가 만성 뇌졸중 환자의 삼킴 기능에 미치는 효과

  • 김경돈 (동주대학교 물리치료과)
  • Received : 2017.08.25
  • Accepted : 2017.10.31
  • Published : 2017.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : The purpose of this study was to examine the effects of short neck flexor strengthening in proprioceptive neuromuscular facilitation and neuromuscular electrical stimulation on swallowing function in patients with chronic stroke and to provide basic data for swallowing rehabilitation in stroke patients. Method : The study involved 30 chronic stroke patients who visited ${\bigcirc}{\bigcirc}$ General Hospital in Daegu Metropolitan City between March and July, 2017. The subjects were randomly assigned to either an experimental group (n=15) or a control group (n=15). Both groups underwent traditional swallowing rehabilitation therapy for 30 minutes five times a week over a six-week period. The experimental group performed short neck flexor exercises, which are part of the proprioceptive neuromuscular facilitation, for 30 minutes three times a week over a six-week period. The control group performed neuromuscular electrical stimulation for 30 minutes three times a week over a six-week period. Based on its results, changes in the patients' swallowing function and degree of food intake were analyzed. Result : In terms of the ASHA NOMS scale and new VFSS scale, the experimental group and the control group showed statistically significant changes in ten sub-items and six sub-items, respectively. Statistically significant differences in one sub-item were found between the groups. Conclusion : PNF-based short neck flexion exercise appear to be effective at improving swallowing function of stroke patients with dysphagia.

Keywords

References

  1. 김경돈(2015). 고유수용성신경근촉진법 목 굽힘 운동이 만성 뇌졸중 환자의 삼킴 기능에 미치는 영향. 대구대학교 대학원, 박사학위 논문.
  2. 김두규, 이수정(2009). 상부 식도괄약근의 이완부전으로 인한 연하장애 환자의 Shaker운동과 전기자극치료의 효과 -사례연구-. 대한연하재활학회지, 1(1), 55-60.
  3. 김은정, 홍재란(2012). 식사 훈련 시 신경근전기자극 치료가 뇌졸중 환자의 삼킴 기능에 미치는 효과. 한국고령화건강정책학회지, 4(1), 65-71.
  4. 김정환, 이건재, 김상준(2007). 연하 곤란을 동반한 뇌 병변 환자들에서 설골 상부 근육의 전기 자극 치료. 대한뇌졸중학회지, 9(2), 134-141.
  5. 문태흥(2013). Shaker 운동과 신경근 전기자극 치료가 삼 킴 기능에 미치는 효과. 인제대학교 대학원, 석사학위 논문.
  6. 박은정(2013). 뇌졸중 환자의 연하장애에 대한 전기자극 치료와 전통적 재활치료의 비교. 한국고령친화건강정책학회지, 5(2), 19-27.
  7. 배성수, 구봉오, 김용천 등(2003). 물리치료학개론. 5판, 서울, 대학서림.
  8. 백남종, 김일수, 김정환 등(2005). 비디오 투시 연하 검사에 기초한 기능적 연하곤란척도의 임상적 타당도. 대한재활의학회지, 29(1), 43-49.
  9. 우희순, 장기연, 차태현 등(2009). 국내 작업치료사의 연하장애 재활치료 실태조사. 대한작업치료학회지, 17(3), 67-77.
  10. 윤용순, 임진택, 윤석봉 등(2006). 뇌졸중 환자의 연하곤란에 대한 기능적 전기자극의 효과. 대한재활의학회지, 30(5), 417-423.
  11. 은성종, 김성길, 홍재란(2010). 뇌졸중 후 연하장애 환자에서 비디오 투시 연하 조영검사의 유용성. 한국방사선학회지, 4(3), 19-25.
  12. 이순현, 원영식(2015). 고유수용성신경근촉진법을 이용한 목근육 강화운동이 삼킴 장애환자에게 미치는 영향: 단일사례연구. 대한고유수용성신경근촉진법학회지, 13(3), 163-168.
  13. 장기연, 차태현(2009). 연하장애 재활의 개요. 대한연하재활학회지, 1(1), 1-7.
  14. Adler SS, Beckers D, Buck M, et al(2000). Activities of daily living. In PNF in practice. Berlin, Springer.
  15. Benton L(1981). Functional electrical stimulation: a practical clinical guide. Rancho Los amigos Hospital Rehabilitation Engineering Centre.
  16. Binder-Macleod SA, Halden EE, Jungles KA(1995). Effects of stimulation intensity on the physiological responses of human motor units. Med Sci Sports Exerc, 27(4), 556-565.
  17. Binder-Macleod SA, Snyder-Mackler L(1993). Muscle fatigue: clinical implications for fatigue assessment and neuromuscular electrical stimulation. Phys Ther, 73(12), 902-910. https://doi.org/10.1093/ptj/73.12.902
  18. Buckley DC, Kudsk KA, Rose B, et al(1987). Transcutaneous muscle stimulation promotes muscle growth in immobilized patients. J Parenter Enteral Nutr, 11(6), 547-551. https://doi.org/10.1177/0148607187011006547
  19. Delitto A, Strube MJ, Shulman AD, et al(1992). A study of discomfort with electrical stimulation. Phys Ther, 72(6), 410-421. https://doi.org/10.1093/ptj/72.6.410
  20. Easterling C, Kern M, Nitschke T, et al(2000). Restoration of oral feeding in 17 tube fed patients by the Shaker Exercise. Dysphagia, 15, 105.
  21. Freed ML, Freed L, Chatburn RL, et al(2001). Electrical stimulation for swallowing disorders caused by stroke. Respir Care, 46(5), 466-474.
  22. Groher ME, Crary MA(2009). Dysphagia: clinical management in adults and children. Missouri, Groher & Crary.
  23. Keymling M(1994). Technical aspects of enteral nutrition. Gut, 35(1 Suppl), S77-80. https://doi.org/10.1136/gut.35.1_Suppl.S77
  24. Kiger M, Brown CS, Watkins L(2006). Dysphagia management: An analysis of patient outcomes using $VitalStim^{TM}$ therapy compared to traditional swallow therapy. Dysphagia, 21(4), 243-253. https://doi.org/10.1007/s00455-006-9056-1
  25. Kim HM, Choi KH, Kim TW(2013). Patients' radiation dose during videofluoroscopic swallowing studies according to underlying characteristics. Dysphagia, 28(2), 153-158. https://doi.org/10.1007/s00455-012-9424-y
  26. Kim KD, Lee HJ, Lee MH, et al(2015). Effects of neck exercises on swallowing function of patients with stroke. J Phys Ther Sci, 27(4), 1005-1008. https://doi.org/10.1589/jpts.27.1005
  27. Klein DA, Stone WJ, Phillips WT, et al(2002). PNF training and physical function in assisted-living older adults. J Aging Phys Act, 10(4), 476-488. https://doi.org/10.1123/japa.10.4.476
  28. Kuhlemeier KV(1994). Epidemiology and dysphagia. Dysphagia, 9(4), 209-217. https://doi.org/10.1007/BF00301912
  29. Langmore SE, Miller RM(1994). Behavioral treatment for adults with oropharyngeal dysphagia. Arch Phys Med Rehabil, 75(10), 1154-1160. https://doi.org/10.1016/0003-9993(94)90094-9
  30. Lee KW, Kim SB, Lee JH, et al(2014). The effect of early neuromuscular electrical stimulation therapy in acute/subacute ischemic stroke patients with Dysphagia. Ann Rehabil Med, 38(2), 153-159. https://doi.org/10.5535/arm.2014.38.2.153
  31. Logemann JA(1998). The evaluation and treatment of swallowing disorders. Current Opinion in Otolaryngology & Head and Neck Surgery, 6(6), 395-400. https://doi.org/10.1097/00020840-199812000-00008
  32. Logemann JA, Rademaker A, Pauloski BR, et al(2009). A randomized study comparing the Shaker exercise with traditional therapy: a preliminary study. Dysphagia, 24(4), 403. https://doi.org/10.1007/s00455-009-9217-0
  33. Park CL, O'Neill PA, Martin DF(1997). A pilot exploratory study of oral electrical stimulation on swallow function following stroke: an innovative technique. Dysphagia, 12(3), 161-166. https://doi.org/10.1007/PL00009531
  34. Power ML, Fraser CH, Hobson A, et al(2006). Evaluating oral stimulation as a treatment for dysphagia after stroke. Dysphagia, 21(1), 49-55. https://doi.org/10.1007/s00455-005-9009-0
  35. Snyder-Mackler L, Delitto A, Bailey SL, et al(1995). Strength of the quadriceps femoris muscle and functional recovery after reconstruction of the anterior cruciate ligament. A prospective, randomized clinical trial of electrical stimulation. J Bone Joint Surg Am, 77(8), 1166-1173. https://doi.org/10.2106/00004623-199508000-00004
  36. Wright RE, Boyd CS, Workman A(1998). Radiation doses to patients during pharyngeal videofluoroscopy. Dysphagia, 13(2), 113-115. https://doi.org/10.1007/PL00009554