• Journal of the Korean Society of Radiology
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• v.4 no.3
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• pp.19-25
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• 2010

Dysphagia is common and serious problems in post-stroke patients. The post-stroke dysphagia with aspiration is associated with dehydration, malnutrition, pneumonia, sepsis and death. Up to date, gag reflex and choking history used to decide the aspiration in clinical. The purpose of this study was to evaluate the aspiration and to choice the proper meal formation using by video fluoroscpic swallowing study(VFSS) with post-stroke dysphagia patients. 58 post-stroke patients and ten normal person participated to perform the VFSS with liquid type, puding, yoplait, rice mixed with barium(Ba). Two rehabilitation medicine doctors and a radiological technologist analysed the phase(oral, pharyngeal, esophageal phase)with video film, and checked the pharyngeal transition time(PTT). 38 patients showed abnormality in pharyngeal phase, 13 patients in oral and pharyngeal phase, 3 patients in oral phase, and 2 patients in pharyngeal and esophageal phase. 43 patients(65.2%) occured the aspiration, but 23 of 43 patients improved by the chin tuck position. Aspiration occured 34 patients in liquid type, 2patients in rice gruel and nothing in boiled rice. After VFSS, 13 of 23 patients change the intaking pathway from nasogastric tube(NGT) to oral, On the contrary with 3 of 42 patients from oral to NGT. Consequently VFSS is clearly effective to evaluate the aspiration with post-stroke dysphagia patients.

• Journal of radiological science and technology
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• v.44 no.1
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• pp.9-14
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• 2021

With the recent advances in radiological science, there was radiographic techniques development and several researches to diagnosing dysphagia. We proposed the new Imaging technology based on Near Infrared radiation (NIR) for video fluoroscopic swallowing study (VFSS). To reduce the risk of the VFSS examination for swallowing rehabilitation, multi-NIR camera system comprised. Based on the multi-NIR camera imaging system, Computational simulation was conducted to identify the potential of the multi-NIR camera imaging system as a clinical tool (screening system). As a result of the simulation applied in this study, the proposed system has a potential to be a clinical solution although there is a few of limitations. we believe that it will be a good tool to support the VFSS as a screening technology in clinical fields.

• The Journal of the Korea institute of electronic communication sciences
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• v.11 no.9
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• pp.909-916
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• 2016

The purpose of this study is to investigate the effect of swallowing training of high viscosity bolus for swallow function of stroke patients with dysphagia. This study subjects, acute stroke 18 patients, which were recruited to receive treatment in inpatient at general hospital, located in Kyunggido. Subjects were randomly allocated in experimental group and control group. Experimental group performed swallowing training of high viscosity bolus, while control group conducted Traditional dysphagia therapy. Both groups received treatment 30 minutes a day five times a week for four weeks. The assessment was conducted FDS(: Functional Dysphagia Scale), PAS(: Penetration Aspiration Scale), ASHA NOMS(: American Speech-language-hearing Association National Outcomes Measurements System Swallowing Scale) to compare swallow function for both group. Both groups showed significant improvements after intervention in all measures(p<.05). Change score between the two groups showed a significant improvement on experimental group than control group in FDS(p<.05). Swallowing training of high viscosity bolus could have a positive impact on swallow function for acute stroke patients with dysphagia.

• The Journal of Korean society of community based occupational therapy
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• v.5 no.1
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• pp.23-34
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• 2015

Objective : The purpose of this study is to investigate the effect of self swallowing exercise program with neuromuscular electrical stimulation(NMES) on swallowing function. Methods : Subjects who were diagnosed in dysphagia were randomly divided into the control group or experimental group. Both group were received NMES during 60 minutes with traditional swallowing therapy during 30 minutes. Additionally the experimental group was received self swallowing exercise during 30 minutes. We invested subject's characteristics through medical chart. We used VDS(Videofluoroscopic Dysphagia Scale) and PAS(Penetration Aspiration Scale) for assessing the swallowing function. Results : There were not significantly different in both group's pre swallowing function. The control group was significantly improved on pyriform sinus residue, aspiration, and VDS total score(p<.05). The experimental group was significantly improved on vallecular residue, pyriform sinus residue, and VDS total score(p<.05). Both group's difference of pre and post swallowing function were not significantly different. Conclusion : Self swallowing exercise and traditional swallowing therapy with NMES and traditional swallowing therapy with NMES are positive effect on swallowing function. The self swallowing exercise is not effective factor.

• 재활복지
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• v.22 no.4
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• pp.43-58
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• 2018

Swallowing disorders that can affect nutrient intakes and quality of life are commonly shown among the elderly as well as patients with neurogenic disorder. This study verifies the reliability and validity of the Swallowing Disturbance Questionnaire (SDQ), a subjective swallowing disability assessment tool, modified for Koreans' eating habit and cultural sentiment, against 105 stroke patients, in order to help identify early swallowing problems of the elderly. Reliability of internal consistency in the Korean version of SDQ is .601, test-retest reliability is .97, and concurrent validity is .956. Based on 8 points of cut-off score, 46.8% of sensitivity and 81.6% of specificity. Comparing the results of video fluoroscopic study (VFSS), an objective swallowing disorder test with those of Korean version of SDQ, negative predictive value (NPV) and positive predictive value (PPV) was shown as 81% and 53%. The Korean version of SDQ is expected to be a useful testing tool to discriminate swallowing disorders in stroke patients. It has great clinical significance in that swallowing difficulties shown by subjects can be sorted out to request a diagnostic assessment before clinical evaluation by a rehabilitation therapist or ruling out unnecessary exposure to additional tests by accurately identifying stroke patients without swallowing problems.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.60 no.9
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• pp.454-462
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• 2017

Background and Objectives The present study aimed to investigate the effects of penetration/aspiration (P/A) on voice acoustic parameters. Subjects and Method Twenty-seven patients were analyzed with the videofluoroscopic swallowing study (VFSS) and then divided into two groups based on the modified Penetration and Aspiration Scale results. Ten patients (5 males and 5 females) were included in the Non-P/A group, and 17 patients (12 males and 5 females) in the P/A group. Stroke was the major cause of swallowing disorders. Three sustained /a/ vowels recorded in pre- and post-VFSS were analyzed. Mann-Whitney U-test was used to compare acoustic values before and after VFSS, and the receiver operating characteristics (ROC) curve with combination of significant parameters was also conducted. Results Among acoustic parameters, the length of analyzed sample (p=0.010), number of segments computed (p=0.018), total number detected pitch periods (p=0.017), and second formant (p=0.013) in pre- and post-VFSS were significantly different between Non-P/A and P/A groups. In the P/A group after VFSS, the means of these significant parameters decreased. According to ROC combined with four significant parameters, the probability of predicting P/A condition was 84% (p=0.005), the sensitivity was 80%, and the specificity was 80%. Conclusion Voice acoustic analysis can reflect voice changes by penetration/aspiration and the combination of significant parameters can also detect swallowing disorders. Therefore, voice analysis can be a reliable screening tool for patients with swallowing disorders.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.1
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• pp.294-300
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• 2011

This study was performed to examine the presence of dysphagia and analyze characteristics of the symptoms in cerebrovascular accident(CVA) patients without awareness of dysphagia. A questionnaire for this study was given to CVA patients who had visited P rehabilitation medical center in Busan. Eleven patients (4 males and 7 females) who answered no awareness of dysphasia were given to VFSS, functional dysphasia scale, and NCSE. Descriptive statistics and Pearson correlation analysis were performed by SPSS 12.0. All of subjects without awareness of dysphasia showed characteristics of dysphasia symptoms. Prominent dysfunctions were problems in oral phase and delay of swallowing reflex in pharyngeal phase. For the aspect of cognition, they showed lower score in construction, memory, and similarity than other NCSE items. There was highly significant correlation between orientation, judgment and delay of swallowing reflex. Verbal comprehension and residual materials in oral cavity showed closed correlation. CVA patients without awareness had dysphagia with high probability. The early evaluation of dysphagia should be performed in CVA patients in order to prevent complications due to CVA, so it is necessary to increase the effectiveness of rehabilitation therapy.

• 재활복지
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• v.22 no.1
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• pp.141-156
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• 2018

The purpose of this study was to examine changes in the swallowing function with chronic stroke patient. Ten chronic stroke patients with dysphagia followed up for 3 months. Eight normal age match subjects were also participated. A total of 18 participated in this study and they were classified into two groups (stroke patient group and normal control group). Participants underwent videofluoroscopic swallowing examination. The swallowing function was evaluated over time. Oral transit duration, pharyngeal transit duration, laryngeal response duration, Modified Barium Swallowing Impairment Profile ($MBSImP^{TM(c)}$), and Functional Oral Intake Scale (FOIS) were applied. Chronic stroke patient group were showed significantly longer oral transit duration, pharyngeal transit duration and laryngeal response duration than normal control group at baseline. After 3 months in stroke patient group, the mean oral components score of MBSImP (1~5) significantly decreased and the mean score on FOIS increased compared to baseline. In conclusion, oral swallowing function and oral intake function improved by the 3 month evaluation. These results describe changes in swallowing function with chronic stroke patients over time and provide basic informations to understand dysphagia.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.36-44
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• 2019

Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.