• Title/Summary/Keyword: 연하장애평가

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The Importance of Video Fluoroscopy Swallowing Study for Nasogastric Tube Removal in Rehabilitation Patients (재활치료환자의 비위관(nasogastric tube)제거에 따른 비디오 투시연하검사(VFSS)의 중요성 평가)

  • Jung, Myoyoung;Choi, Namgil;Han, Jaebok;Song, Jongnam;Kim, Weonjin
    • Journal of the Korean Society of Radiology
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    • v.9 no.1
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    • pp.1-7
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    • 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.

Comparative Analysis of Orofacial Myofunctional in Adults and Eldery People (성인과 노인의 구강근기능 영향요인 분석)

  • Kim, Seol-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.303-310
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    • 2019
  • The purpose of this study was to compare the oralmyofunctions (occlusal force, tongue pressure, lip force) of adults and elderly people. And analyzed the factors affecting oral health related quality of life and dysphagia. The study was conducted on 73(over 20 years of age) Residing in Daejeon and Nonsan From December 2017 to May 2018. The data was analyzed using one-way ANOVA, pearson's correlation and multiple regression. The masticatory strength of each age group evaluated the right and left posterior occlusal forces. the elderys group (8.93, 10.80) were lower than adults group(12.51, 14.61) and middle age group(11.63, 14.75)(p>0.05). The tongue pressure was statistically significant lower in eldery group(37.43) than the adult group(60.55), middle-aged group(50.61) (p=0.000). In addition lip force was significantly lower in eldery group(8.57) than adult(12.01), middle-aged(11.37)(p= 0.000). The tongue pressure was positively correlated with the number of natural teeth(r=.566, p<.05), and the lip force (r=.497, p<.05). The quality of life quality related to oral health and dysphagia was tongue strength(p<0.05). It is necessary to recognize the risk of declining oral muscle function caused by aging. especially tongue strength is associated with quality of life and dysphagia. In order to improve the quality of life related to oral health in the aged society, the necessity of regular oral administration and oral muscle training was proposed.

The effect of Early Feeding Therapy by Oral Motor Facilitation Technique(OMFT) on Feeding development of Prader-Willi Syndrome baby - Based on the Development : Case study (구강운동촉진기술(OMFT)을 적용한 조기 연하재활치료가 프래더 윌리 아동의 섭식 발달에 미치는 영향 - 발달에 근거하여 : 사례 보고)

  • Min, Kyoung-Chul;Kim, Bo-Kyeong
    • Journal of Convergence for Information Technology
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    • v.12 no.1
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    • pp.180-188
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    • 2022
  • Goal of this study is to identify effect of Oral Motor Facilitation Technique(OMFT) on feeding development, tube weaning of PWS baby. Subject was 8months old PWS girl. 2 times of OT, 1 times of OMFT per weeks were provided from July, 2020 to June, 2021. Feeding development and skills was increased and could eat food by mouth after OMFT treatment. Especially, she could eat food by her mouth after 3mts of OMFT and age-appropriated food intake, chewing function, drinking by straw was increased. Through this case study, early detecting and treatment for feeding development of PWS is very important. OMFT is good treatment protocol for increasing feeding development and oral motor skills of PWS.

Effect of Oral Motor Facilitation Technique on Oral Motor Function in Stroke Patients (구강운동촉진기술(Oral Motor Facilitation Technique)이 뇌졸중 환자의 구강운동기능에 미치는 효과)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.135-151
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    • 2023
  • Objective : This study was conducted to confirm the effect of the oral motor facilitation technique (OMFT) on oral motor function in stroke patients. Methods : This study was conducted on 72 stroke patients with dysphagia were included. Thirty-six patients were randomly assigned to the experimental and control groups were randomly classified into 36 patients each using a random table, and a two-group pre-post test was designed. The experimental group underwent OMFT, and the control group underwent traditional dysphagia therapy for 30 min, once a day, 5 times a week for 4 weeks, for a total of 20 sessions. The Comprehensive Orofacial Function Scale (COFFS) was used to evaluate oral motor function. Repeated-measures analysis of variance (ANOVA) was performed to confirm the effect of the period, and an independent t-test was performed to analyze the difference in change between the two groups. Results : Total COFFS scores improved in both groups. The experimental group showed significant changes in mandibular and lip movements, cheek blows, and tongue movements. In addition, there were significant differences depending on the intervention period in terms of masticatory distribution, food spillage, swallowing of solid and liquid foods, and voice changes. There were significant differences in the mandibular opening and closing categories between the two groups. Conclusion : OMFT is effective in improving oral motor function in stroke patients with dysphagia and can be used as basic evidence in clinical practice.

요전완유리피판을 이용한 연구개 결손부 재건후 기능평가

  • 박해섭;김민식;선동일;유우정;김형태;박영학;조승호
    • Proceedings of the KSLP Conference
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    • 1998.11a
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    • pp.188-188
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    • 1998
  • 구강후부암은 흔히 연구개, 설근부 등을 침범하여 연구개의 절제가 동반되고 이에 따른 발성, 연하 등에 장애를 남기게 된다. 이의 재건을 위해 다양한 피판술이 고안되고 있으며 그 중 요전완유리피판은 피판이 얇고 유연하여 입체적 형태의 재건이 용이하며 감각신경을 포함하여 재건할 수 있고 장장근인대를 포함시킬 경우 연구개의 역동적인 기능까지 재건할 수 있는 등의 장점으로 최근 많이 이용되고 있다. (중략)

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Effect of Oral Motor Facilitation Technique (OMFT) and Neuromuscular Electrical Stimulation (NMES) Applied to a Patient With Wallenberg's Syndrome: A Case Study (발렌버그 증후군(Wallenberg's Syndrome) 환자에게 적용한 구강운동촉진기술(OMFT)과 신경근전기자극치료(Neuromusclular Electrical Stimulation; NMES) 효과: 단일 사례 연구)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.4
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    • pp.69-83
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    • 2022
  • Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

Relation between Gross Motor Function and Eating and Drinking Ability, Oral Motor Function in Cerebral palsy (뇌성마비 아동의 대동작 기능과 먹고 마시기 기능, 구강운동기능의 상관관계 연구)

  • Min, Kyoung-Chul;Moon, Yong-Seon;Seo, Sang-Min
    • Journal of Convergence for Information Technology
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    • v.11 no.8
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    • pp.168-175
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    • 2021
  • Goal of this study is to perform the correlation about Gross motor function, eating-drinking function, and oral motor function, to identify necessity for invervention of feeding disorders on severity of the function of children with cerebral palsy. Subjects were 61 children diagnosed with cerebral palsy. The subject were evaluated for oral motor function, feeding function by GMFCS, EDACS, OMAS. The results of this study showed a significant correlation between gross motor function, eating and drinking functions, and oral motor functions. That is, the more severe the deterioration of the motor function, the lower the functional level of eating and drinking and oral motor function deterioration. In evaluating and treating the eating activity of children with cerebral palsy through this study, it seems necessary to check the eating and drinking function and oral motor function according to the gross motor function.

Development of Comprehensive Oro-Facial Function Scale (포괄적 구강안면기능척도(Comprehensive Oro-Facial Function Scale; COFFS)의 개발)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.1
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    • pp.69-85
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    • 2022
  • Objective : This study aimed to develop a Comprehensive Oro-Facial Function Scale (COFFS) that can evaluate oro-facial function in patients with dysphagia. Methods : To verify the item composition and reliability of the COFFS, preliminary items were collected by selecting and analyzing four previous studies, and the Content Validity Ratio (CVR) was derived through a second survey of experts. Cronbach's 𝛼 was calculated for the internal validity of the evaluation items, and the test-retest reliability and inter-rater reliability were calculated using the internal classification coefficients (ICC). Results : The content validity ratio of all items was 0.67; in the case of Cronbach's 𝛼 value for each domain, 0.849 for communication domain, -0.224 for the oro-facial structure and shape, 0.831 for the ability to perform orofacial movements, and 0.946 for mastication and swallowing function. The test-retest reliability was 0.974 and the inter-rater reliability was 0.937, showing high reliability. Conclusion : In this study, the evaluation tool of COFFS was finally selected from 34 items in four areas and developed on a 3-5 point scale according to the evaluation items. In future studies, additional research is needed to prove its validity through correlation with other evaluation tools that measure oro-facial function.

An Evaluation of Usefulness of FEES Method using Full HD Video that Improves Diagnostic Value of VFSS (Full HD 동영상을 이용한 FEES법이 VFSS의 진단적 가치를 향상 시키는 유용성에 대한 평가)

  • Kim, Young-Ran;Kim, Young-Il
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.678-685
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    • 2016
  • Deglutition inspection has been the gold standard for inspection of dysphagia using a penetration device of the division of radiology to date. However, inspection using an endoscope has facilitated diagnosis of dysphagia in recent days. In this study, we compared the results of VFSS alone with those of VFSS combined with FEES to determine if the detection rate of penetration, aspiration, and pharyngeal residue increased. This study evaluated at 130 persons who underwent both VFSS and FEES from December 2013 through March 2014, and used VFSS (FELAVISION, SHIMADZU) and FESS (EVIU LUCERA CV-260SL, OLYMPUS) as devices. After preparing barium diluted solution, yogurt that diluted barium and rice that diluted barium in 2.5 ml, 5 ml, 10 ml by modifying Logemann's protocol in part, and having subjects take the solution, this study confirmed pharyngeal residue, penetration, aspiration etc. VFFS and FEES using full HD video revealed aspiration in 36 of the 130 patients in both inspections. Additionally, aspiration was discovered in 36 patients upon VFFS, but in 41 upon FESS. Although FEES was more sensitive at diagnosing dysphagia, the two inspection methods are complementary, so diagnostic value will be greatly improved when the endoscope operating method and accurate fluoroscopic inspection are combined.

Glottic and subglottic airway obtruction

  • 김영모
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.113-113
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    • 2003
  • 성문과 성문하부의 기도 폐쇄는 위치 정도 원인 기간 등은 환자에 따라 다르고 그 치료방법 역시 다양하다. 주 원인으로는 기관내 삽관, 각종 외상 및 화상 등 을 들 수 있다. 이러한 질환의 치료 목적은, 기관내 튜브나 기관 캐뉼러 를 통하지 않고 비강을 통하여 자연스럽게 호흡할 수 있도록 기도를 유지 하면서 발성이 가능하고 기고 흡인 없이 연하가 가능하도록 하며 기침 반사가 원활하게 되도록 하는데 있다. 치료목적의 달성을 위하여 협착의 경우, 단계 즉 초기 단계 또는 성숙단계 여부, 위치, 정도, 범위 환자의 연령 전신상태 등을 술전에 잘 평가하고 수술도중의 소견과 술자의 경험이나 기호에 따라 적절한 치료법을 선택하여 치료해야 한다. 후두 외상에 의한 기도 문제는 다른 외상에 비해 흔하지 않은데 이는 연골의 유연성과 후두의 가동성 그리고 후두가 하악과 흉골사이에 위치하여 외상시 보호받게 되는 해부학적 특성에 기인한다. 여러 요인으로 인하여 진단이 늦어질 수도 있는데 이러한 경우 심각한 증상이 초래 되거나 치료가 의 시기가 지나 후두 또는 기관 협착, 발성장애등의 후유증이 유발 될 수 있다.

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