• The Journal of the Korea Contents Association
• /
• v.17 no.4
• /
• pp.63-71
• /
• 2017

The purpose of current investigation was identified to the effects of swallowing training with surface electromyography biofeedback on swallowing function and dietary level, satisfaction in acute stroke patients with dysphagia. Sixteen acute stroke patients with dysphagia was participated in our study. All stroke paitents were allocated in randomly to experiemental group(n=8) and control group(n=8). Both group received traditional dysphagia therapy during 30min/day, five per week, for four weeks. experimental group was perfomed swallowing training with surface electromyography biofeedback, additionally 30 min/day, and control group received only swallowing training, additionally 30 min/day. Assessments evaluated Functional Dysphagia Scale(FDS) and Penetration-Aspiration Scale(PAS) for measure of swallowing function, and Functional Oral Intake Scale(FOIS) assessed for measure of dietary level. satisfaction assessed by using Visual Analog Satisfaction Scale(VASS). In results, after intervention both group improved significant on swallowing function, and dietary level, compared to before intervention(p<0.05). After intervention, satisfaction of both group was not significant difference(p>0.05). In comparison of change score between two group, experimental group improved significantly than control group in dietary level(p<0.05). Swallowing training with surface electromyography biofeedback may be a effective dysphagia therapy to improve on dietary level in acute stroke patients with dysphagia.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.11 no.9
• /
• pp.909-916
• /
• 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 the Korea Contents Association
• /
• v.16 no.11
• /
• pp.605-613
• /
• 2016

This study was investigated to effect of tongue strength and accuracy training (TSAT) on tongue strength, swallowing function, quality of life in chronic stroke patients with dysphagia. Eighteen chronic stroke patients with dysphagia participated in this study, and were allocated randomly to experimental(n=9) and control group(n=9). both group conducted to traditional dysphagia therapy, and experimental group was carried out additionally TSAT. TSAT performed using Iowa Oral Performance Instrument(IOPI), and was set up to 50%, 75%, 100% of maximum isometric tongue strength. Two groups received the treatment for five per weeks, eight weeks. Outcome measurements performed that Maximum Isometric Strength(MIS) was assessed by using IOPI for measure the tongue strength, and Swallowing Function Test(SFT) was used to assess the swallowing function. Swallowing-Quality of Life(SWAL-QOL) was used to evaluate quality of life related to swallow. In results of study, experimental group in comparison of change score between two group significantly improve than control group in anterior and posterior MIS, and SFT. SWAL-QOL was not significantly difference in both group. Based on thin study results, TSAT may be a effective intervention to improve on tongue strength, and swallowing function in chronic stroke patients with dysphagia.

• 재활복지
• /
• v.21 no.2
• /
• pp.217-231
• /
• 2017

We have to consider two parts of the evaluation and treatment for the patients with head and neck burns. The primary consideration is swallowing function for nutrition supply for them and the next is speech function for efficient communication and aesthetic impression of them. The purpose of this study is to summarize the preliminary questions of Communication Screening Protocols which can help understand comprehensively on swallowing disorder, motor speech disorder and voice disorder of patients with head and neck burns. We divided the evaluation into 4 evaluation areas including 'oral mechanism', 'respiration/voice', 'articulation', and 'swallowing' by referring to overseas studies dealing with various communication disorders caused by burns, and prepared the final questionnaires by conducting the content validity verification by five expert (speech & language pathologist). The range of Content Validity Index was shown relatively appropriate with .50~.84. There was a conflict of opinions in experts whether the items in the areas of respiration/voice and swallowing may be appropriate, whereas there was no different view of the oral mechanism and articulation area. Through the different characteristics of communication difficulties of patients with head and neck burns, we expect it will be modified appropriately according to the patients through evaluation of burn patients by type and severity.

• Proceedings of the Korea Contents Association Conference
• /
• 2014.11a
• /
• pp.189-190
• /
• 2014

뇌경색, 뇌 신경장애 및 뇌졸중환자 중 급성기 환자는 의식이 없어 연하기능장애로 인한 흡인성 폐렴을 유발하기 때문에 비위관(nasogastric tube)을 삽입하고 영양공급을 한다. 재활훈련 후 회복기에 침상선별검사를 시행하지만 임상적 검사를 통해서는 무증상흡인은 발견할 수 없다. 그래서 연하장애로 비위관을 삽입한 연하재활치료 중인 환자 10명을 대상으로 VFSS를 시행하여 식이재료에 따른 삼킴 정도, 자세에 따른 삼킴을 재활의학과전문의가 평가 후, 흡인이 있거나 삼킴 곤란 등이 있으면 연하재활치료를 시행하여 환자의 상태에 따라 약 30일 ~ 50일후에 재평가를 시행한 후 흡인이 없을 시 비위관을 제거 하였다. 이때 VFSS 영상을 기능적 연하곤란척도를 이용, 분석하여 부여된 점수를 통계 산출 하였는데 비위관 유지군은 $49.79{\pm}9.431$을 보여 흡인의 위험을 나타내며, 비위관 제거군은 $11.20{\pm}1.932$로 흡인의 위험성이 낮아 비위관 제거관련 의미 있게 낮은 점수를 보였다. 두 군의 유의성을 평가하기 위해 Mann-Whitney test를 시행한 결과 p<0.001로 통계적으로 유의하다고 평가하였다. 결론적으로 VFSS는 구강, 인두, 식도의 구조적 이상과 움직임을 가장 효과적으로 평가, 기도흡인여부를 즉시 확인 및 환자에게 적합한 식이나 연하자세를 결정할 수 있어 비위관 제거를 위한 연하평가에 가장 확실한 표준검사로 제안할 수 있다.

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.1
• /
• pp.111-119
• /
• 2019

PURPOSE: The aim of this study was to determine how biofeedback training with Shaker exercise effects the activation of the cervical myocardial muscle in stroke with swallowing disorder. METHODS: From June 2018 to September 2018, 30 patients who were hospitalized at C hospital and K hospital in Daegu, and K hospital in Gumi were surveyed to meet the criteria for selection. The participants were classified into three groups, and Shaker exercise was applied three times a day, five times a week, for four weeks; visuoauditory biofeedback group (VABG), visual biofeedback group (VBG), and self-exercises group (SG). In addition, the suprahyoid muscle activity was performed three times (before intervention, after intervention, and after two weeks). RESULTS: The pre and post-test comparisons, revealed a significant difference between the three groups (p<.01); VABG had the highest suprahyoid muscle activity. The post-test and follow-up test produced similar results in, the three groups (p>.05). The mean comparison showed the smallest difference in VABG, indicating that muscle persistence was the best. CONCLUSION: Shaker exercise has an effect on suprahyoid muscle activation. Biofeedback training, which provides an input of multi-sensory information in swallowing disorder treatment is recommended because it has the greatest effect when combined with visuoauditory biofeedback.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.11
• /
• pp.7394-7402
• /
• 2015

The purpose of this study was to investigate the status of studies on swallowing rehabilitation interventions for stroke patients that had been conducted in the past 5 years (2010-2014) in Korea and to examine their findings. A literature search was conducted through RISS, National Assembly Library, and KISS, and 12 papers were analyzed. Four articles were from nursing science, and 8 from other disciplines. Qualitative evaluation of the articles was conducted by using an evaluation framework that was designed by the researcher, which took into account the checklist presented by the Scottish Intercollegiate Guideline Network (2013). In the results of the qualitative evaluation on the papers, 4 studies scored 7 out of 10 points, 6 studies scored between 5 and 6 points, and 2 studies scored 4 points. Intervention sessions were conducted for 25 minutes, on average, each at a frequency of 4.1 sessions per week, for a total of 33.7 sessions. This study found that direct swallowing training and comprehensive intervention of respiratory and oral, including pharyngeal were effective in relieving difficulties in swallowing. In the future, such findings are expected to be used in nursing interventions for establishment of the basis for evidence-based nursing practice.

• Journal of the Korean Society of Radiology
• /
• v.9 no.1
• /
• pp.1-7
• /
• 2015

Acute phase patients who are unconscious and are suffering from cerebral infarction, cranial nerve disorders, or cerebral apoplexy are susceptible to aspiration pneumonia due to dysphagia. In these cases, a nasogastric tube is inserted to supply nutrients. Although bedside screening tests are administered during recovery after rehabilitation, clinical examinations may not be able to ascertain asymptomatic aspiration. Therefore, a video fluoroscopy swallowing study (VFSS) was performed in 10 patients with dysphagia after rehabilitation therapy; these patients had nasogastric tubes inserted, and a rehabilitation specialist assessed the degree of swallowing based on the patients' diet and posture. If aspiration or swallowing difficulties were observed, dysphagia rehabilitation therapy was administered. The patients were reassessed approximately 30-50 days after administration of therapy, based on the patients' condition. If aspiration is not observed, the nasogastric tube was removed. A functional dysphagia scale was used to analyze the VFSS images, and the scores were statistically calculated. The mean score of patients with nasogastric tubes was $49.79{\pm}9.431$, thereby indicating aspiration risk, whereas the group without nasogastric tubes showed a mean score of $11.20{\pm}1.932$, which indicated low risk of aspiration. These results demonstrated that a significantly low score was associated with nasogastric tube removal. Mann-Whitney's test was performed to assess the significance of both the groups, and the results were statistically significant with a P value <0.001. In conclusion, VFSS can effectively assess the movements and structural abnormalities in the oral cavity, pharynx, and esophagus. It can also be used to determine the aspiration status and ascertain the appropriate diet or swallowing posture for the patient. Therefore, VFSS can potentially be used as a reliable standard test to assess swallowing in order to determine nasogastric tube removal.

• Journal of The Korean Society of Integrative Medicine
• /
• v.1 no.4
• /
• pp.1-8
• /
• 2013

Purpose : This study was conducted for the purpose of finding out of effects Eating training on patients with swallowing disorder caused by stroke to their swallowing functions. Method : 29 subjects were selected and the divided into two groups. Group 1 is consist of 14 patients under eating training group and Group 2 is consist of 15 patients each group has five times per week. 30 minuted per time covering 12-week period. Selected patients can swallow them selves without aspiration and basically eating trainings involve Thermal Tactile Stimulation(TTS), Shaker exercise, tongue movements, laryngeal mobilization exercise. MASA(The Mann Assessment of Swallowing Ability)and VFSS(Videofluoroscopic Swallowing Study) was carried out to find out effects of training. And We use FDS(Functional Dysphagia Scale) for VFSS to more objective score. Result : Through the results of this study was increase in Eating performance skill actual eating training group than the practiceless group. Therefore, the actual eating training is to improve the swallowing function and It will be useful in clinical intervention for stroke patients. Conclusion : Through the results of this study was increase in Eating performance skill actual eating training group than the practice less group. Therefore, the actual eating training is to improve the swallowing function and It will be useful in clinical intervention for stroke patients.

• Journal of The Korean Society of Integrative Medicine
• /
• v.7 no.1
• /
• pp.27-36
• /
• 2019

Purpose : The purpose of this study figures out how the biofeedback exercise combined with a Shaker exercise and a jaw-opening exercise affects the suprahyoid muscle activation of stroke with a swallowing disorder. Methods : The study period was from June, 2018 to September, 2018, to 45 patients who were suitable for selection criteria. Participants were divided into three groups: a visuoauditory biofeedback group (VABG), and a visual biofeedback group (VBG), and a self-exercise group (SG). The three groups were divided into the Shaker exercise and the jaw-opening exercise, and the biofeedback training by themselves. Three groups performed an intervention three times a day, five times a week, and four weeks long. Also, suprahyoid muscle activity was measured with a pre-test, a post-test and a follow-up test. Results : To know the suprahyoid muscle activity after the intervention, there were statistically significant differences between the pre-test and the post-intervention (p< .01). All three groups showed the improvement with the mean comparing followed by VABG, VBG and SG. Comparing between the post- test and the follow-up test, all three groups showed the reduction of suprahyoid muscle activity with the mean comparing, followed VABG, VBG and SG. Conclusion : It found that it was more effective when providing a double-sensory biofeedback than when training with a single-sensory biofeedback. Therefore, it is necessary to provide a multi-sensory input when applying the biofeedback in rehabilitation of the swallowing disorder.