• PNF and Movement
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• v.13 no.3
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• pp.163-168
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• 2015

Purpose: The current study seeks to identify the effect of neck muscle strengthening exercise using proprioceptive neuromuscular facilitation (PNF) on the swallowing ability of patients diagnosed with dysphagia due to stroke. Methods: As a single case study, the current research conducted neck muscle strengthening exercise using PNF on the patient with dysphagia for 40 minutes, four times per week for a six-week period. At the same time, typical rehabilitation therapy for dysphagia was provided. This type of therapy included food-swallowing and the relation of the muscles surrounding the neck. The functional dysphagia scale and the penetration-aspiration scale were used to assess swallowing ability. Results: After the therapy, the functional dysphagia scale and the penetration-aspiration scale decreased by 18 points and 3 points, respectively, which proves the effectiveness of this type of therapy for dysphagia. Conclusion: The results of the current study indicate that neck muscle strengthening exercise using PNF reduces penetration-aspiration in patients with dysphagia, and that PNF can be clinically utilized to improve the swallowing ability of dysphagic patients.

• 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.

• Korean Journal of Bronchoesophagology
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• v.19 no.1
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• pp.19-24
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• 2013

Objective The objective was to evaluate changes in swallow safety and dietary status after the transcutaneous injection of botulinum toxin into the upper esophageal sphincter in a series of outpatients with dysphagia. Methods Patients who were at risk for aspiration and who had an unsuccessful trial of swallowing therapy were admitted to the study. All patients showed significant pooling of fluids in the pyriform sinus. All patients were treated in the office; none had previous esophageal dilatation. The upper border of the cricoid cartilage was identified using standard electromyogram procedures and botulinum toxin was injected. Outcomes were assessed using the penetration-aspiration scale, NIH swallowiwng safety score, patients' short-term and long-term subjective impressions of their ability to swallow, and change in dietary status. Results Ten patients underwent an instrumental evaluation of swallowing function. Of the 10 patients, 9 showed an overall improvement in their ability to take an oral diet safely. The penetration-aspiration scale, NIH swallowiwng safety score, patients' short-term and long-term subjective impressions of their ability to swallow, and change in dietary status were significantly improved after office-based botox injection. Conclusion Office-based EMG guided botox injection to the cricopharyngeus muscle is a simple, safe, and effective tool for dysphagia patients. Injection of Botox in the office should be considered when the dysphagia pattern is aspiration after swallow.

• Therapeutic Science for Rehabilitation
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• v.13 no.3
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• pp.85-100
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• 2024

Objective : This case study aimed to explore dysphagia symptoms in post-cardiac transplantation patients and evaluate the effectiveness of dysphagia rehabilitation therapy in an occupational therapy clinic. Methods : A patient with post-cardiac transplant dysphagia underwent videofluoroscopic swallowing studies to assess the Functional Dysphagia Scale (FDS), Penetration-Aspiration Scale (PAS), and Dysphagia Outcome and Severity Scale (DOSS). Assessments were performed three times at two-week intervals. The treatment, administered from July 19 to August 21, 2023, included eight sessions of 30 minutes each. Treatments included corrective techniques (tongue-hold maneuver, chin tuck against resistance, mendelsohn maneuver, effortful swallowing, and respiratory muscle exercise) and compensatory strategies (chin-tuck position, multiple swallowing, modification of volume, and viscosity), alongside caregiver education. Results : The FDS scores decreased from 50 to 30, PAS scores improved from 5 to 3, and DOSS scores improved from Stage 2 to Stage 4. Conclusion : Dysphagia rehabilitation therapy improved swallowing function in a post-cardiac transplantation patient. However, further studies are required to confirm these findings.

• Physical Therapy Korea
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• v.21 no.3
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• pp.63-72
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• 2014

The purpose of this study was to investigate the effects of Proprioceptive Neuromuscular Facilitation (PNF) on the swallowing function of stroke patients. Twelve-week PNF (facial, tongue, and breathing exercise) was applied in the experimental group consisting of 12 subjects, and a general swallowing exercise program was applied to the control group consisting of 12 subjects. In addition, the signs of improvement in the stroke patients (N=24) swallowing function were examined by conducting a video fluoroscopic swallowing study. The data were analyzed using the SPSS ver. 21.0 program, which was also utilized to gain statistical information (percentage, mean, and standard deviation), and paired t-test was conducted. As a result of the analyses, the following conclusions were arrived at. The 12-week PNF significantly improved the functional dysphagia scale, penetration-aspiration scale, pharyngeal transit time, swallowing response time, residue in valleculae, and residue in pyriform sinuses enhanced swallowing functions of the stroke patients (p<.05). In conclusion, the PNF intervention in the swallowing function of the stroke patients was found to be an effective exercise program.

• 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.

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

• Journal of Korean Physical Therapy Science
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• v.26 no.2
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• pp.13-23
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• 2019

Background: The purpose of this study was to provide the basis for the treatment intervention by identifying the treatment effect when rehabilitation intervention is applied to patients with dysphagia due to stroke and by comparing the results of the treatment mediation according to the differences of the treatment methods and frequency. Design: Randomized Controlled Trial. Methods: 30 people diagnosed with dysphagia due to stroke were divided in accordance with the differences in treatment mediation techniques and treatment frequency- traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group and only neuromuscular electrical stimulation group/ 5 times per week group and 2 times per week group, and ten weeks of treatment intervention was performed. Paired t test was employed to show the efficacy of treatment intervention, Independent sample t test was used to compare the results according to difference and number of treatment intervention techniques. Results: There was a significant positive effect of treatment on traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group, only neuromuscular electrical stimulation group, 5 times per week group and 2 times per week group (p<0.05). There was no statistically significant difference in treatment effect between traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group and only neuromuscular electrical stimulation group (p<0.05). There was no statistically significant difference in treatment effect between 5 times per week group and 2 times per week group (p<0.05). Conclusion: There was no significant difference according to the technique or number of treatments of swallowing rehabilitation treatment interventions, but it was confirmed that rehabilitation intervention for dysphagia showed positive treatment effect.

• 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.