• 한국치위생학회지
• /
• 제23권2호
• /
• pp.105-113
• /
• 2023

Objectives: The purpose of this study is to verify the usefulness and practicality of the program in the daily life of the elderly by performing a three-dimensional tongue muscle exercise for the elderly to identify the dysphagia, swallowing ability, and tongue pressure. Methods: The subjects of the study were 29 elderly people aged 65 or older living in Busan, divided into a oral exercises group and tongue strength training program combined with oral exercises group, and operated 16 times for 8 weeks twice a week, and the pre and post-program evaluation was conducted in the 1st and 8th weeks. For variable selection, 7 general characteristics, 5 oral health-related characteristics, 5 Likert scale for swallowing disorder, repetitive swallowing ability test for swallowing power measurement, and tongue pressure measurement was used. Data analysis was conducted using SPSS window program 25.0 version (IBM), general characteristics and homogeneity tests, oral health-related characteristics and homogeneity tests were chi-square test, swallowing disorder, swallowing ability, and change in tongue pressure were paired t-test, Wilcoxon signed rank test, t-test, Mann-Whitney U test for swallowing disorder and changes in swallowing ability and tongue pressure, and Spearman's correlation for the relationship between swallowing disorder and swallowing ability and tongue pressure. Results: As a result of tongue strength training program combined with oral exercise, both relieve swallowing disorder and improve low eating and tongue pressure than oral exercise, and the difference in improvement effects of both relieve swallowing disorder, swallowing ability, and tongue pressure is higher. Conclusions: Based on the results of this study, it is believed that simple and practical oral muscle function reinforcement products and practical use are needed, and institutional devices to seek oral health promotion programs for the elderly are needed.

• PNF and Movement
• /
• 제13권3호
• /
• pp.163-168
• /
• 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.

• 대한물리의학회지
• /
• 제13권4호
• /
• pp.19-25
• /
• 2018

PURPOSE: This study was conducted to investigate the correlation between the activity of suprahyoid muscles, infrahyoid muscles and swallowing ability in stroke patients with dysphagia. METHODS: The subjects of this study were 120 patients who were diagnosed with CT or MRI stroke and had swallowing disorder at Daegu Metropolitan General Hospital from August 2014 to February 2017. The suprahyoid and infrahyoid muscle activity was measured in patients with dysphagia and the new videofluoroscopy swallowing studies scale (new VFSS scale) was used for evaluation of swallowing function. Correlation analysis was conducted using the measured data. RESULTS: The activities of suprahyoid muscles were 325.8 (%RVC) on average, while the average infrahyoid muscle activity was 302.65 (%RVC) and the average value of the new VFSS scale was 31.52. The total for oral organs was 3.62 on average and that for pharynx organs was 28.30 on average. The activity of the suprahyoid muscles showed a significant positive correlation with the activity of the infrahyoid muscles, but a significant negative correlation with the total oral phase, total pharyngeal phase and total new VFSS scale (p<.01). The activity of the infrahyoid muscles showed a significant negative correlation with the total oral phase, total pharyngeal phase, and total new VFSS (p<.01). CONCLUSION: Based on the results of this study, it is necessary for researchers to consider the infrahyoid and suprahyoid muscles when conducting swallowing rehabilitation.

• The Journal of Advanced Prosthodontics
• /
• 제7권1호
• /
• pp.8-14
• /
• 2015

PURPOSE. To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS. Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS. Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION. Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.

• 대한통합의학회지
• /
• 제1권4호
• /
• 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.

• 치위생과학회지
• /
• 제23권4호
• /
• pp.378-388
• /
• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• 재활복지
• /
• 제22권1호
• /
• pp.141-156
• /
• 2018

본 연구는 2011년 1월 1일부터 2012년 12월 31일까지 대학 병원에 입원 또는 재원중인 만성 뇌졸중 환자를 대상으로 이들의 삼킴 장애 양상이 시간에 따라 변화하는지를 비교하고자 하였다. 대상자는 맨 삼킴 능력 평가(Mann Assessment Swallowing Ability)에 의해 178점 이하의 점수를 보인 삼킴 장애 환자들로 이 기간 동안 최소 2회 이상의 비디오투시조영 삼킴 검사(videofluroscopic swallowing examination)를 수행한 환자 10명 이었다. 또한 이들의 삼킴 문제를 비교하기 위해 나이와 성별을 고려한 정상 성인 8명이 대조군으로 참여하였다. 시간에 따른 삼킴 장애 및 삼킴 기능을 비교하기 위해 만성 뇌졸중 환자의 구강통과시간, 인두통과시간, 후두폐쇄유발시간, 바륨 삼킴 검사(Modified Barium Swallowing Impairment Profile: $MBSImP^{TM(c)}$) 및 기능적 구강 섭취 척도(Functional Oral Intake Scale: FOIS)를 평가하였다. 삼킴 평가는 입원 후 일주일 이내에 이루어졌으며 기초선 평가 후 3 개월이 지난 뒤 재검사되었다. 연구 결과, 기초선 평가에서 만성 뇌졸중 환자는 정상인보다 지연된 삼킴 시간을 보였다(구강통과시간; z=-3.60, p<0.001, 인두통과시간; z=-2.77, p=0.004, 후두반응시간; z=-3.56, p<0.001). 만성 뇌졸중 환자군은 3개월 이후에도 비슷한 수준의 삼킴 시간을 보여 삼킴 효율성은 개선되지 않았음을 확인하였다. 반면, $MBSImP^{TM(c)}$와 FOIS 결과에서 구강 단계의 삼킴 기능과 구강 섭취 능력이 두 시점에 따라 통계적으로 유의한 차이가 있었다($MBSImP^{TM(c)}$; z=-2.02, p=0.04, FOIS; z=-2.27, p=0.02). 3개월 후에 뇌졸중 환자는 구강 기능 및 구강 섭취 능력이 호전된 것으로 나타났으며 이는 일부 삼킴 기능이 회복되었기 때문으로 해석된다. 본 연구는 만성 뇌졸중 환자의 삼킴 장애 양상을 규명하고 호전 가능성을 살펴보았다는 점에서 의의가 있으며 만성 뇌졸중 환자의 삼킴 문제를 관리하고 계획하는 기초 자료를 수립하였다.

• 재활복지공학회논문지
• /
• 제8권2호
• /
• pp.109-118
• /
• 2014

본 연구는 급성기 뇌졸중 환자에서 연하장애 재활치료를 받은 환자와 받지 않은 환자의 회복정도를 비교하기 위함이다. 뇌졸중으로 진단받고 연하장애를 가지는 환자(n=98)에서 치료를 받은 군과 받지 않은 군으로 나누어 실험군과 대조군사이 연하장애 재활치료중재전-후 비교 연구 설계에 의해 실험군(n=52)에는 8주간의 연하장애 재활치료를 시행하였고 대조군(n=46)에는 아무런 처치를 하지 않았다. 두 집단 모두를 대상으로 중재 전-후 Video Fluoroscopy Swallowing Study(VFSS), Dysphagia Outcome and Severity Scale(DOSS), Dysphagia Severity Scale(DSS), Functional Outcome Swallowing Scale(FOSS)로 평가를 하였으며 평가값의 변화량은 paired t-test 및 ANCOVA를 통해 분석 하였다. 실험군의 중재전-중재후의 점수 변화비교에서 DOSS를 제외한 나머지 평가도구에서 연하기능이 회복되었다(p<0.05). 대조군의 전-후의 점수 변화비교에서는 모든 평가도구에서 점수값의 변화가 통계학적으로 유의하여 연하기능의 유의한 변화가 있었다(p<0.05). 실험군과 대조군 각각의 2차 평가를 비교한 결과 DOSS를 제외한 나머지 평가도구에서 변화가 통계학적으로 유의한 수준을 보였다(p<0.05). 본 연구 결과 대상자들은 평균적으로 급성기 8주 동안 연하기능의 회복을 보였고, 대조군에서는 세 평가도구 모두에서 유의하게 평가항목간의 점수가 상승하였다. 대상군들의 전-후 검사값의 차를 비교하였을 때 대조군에서 더 높은 점수의 상승을 보여 시간의 경과에 따른 자연적 신경학적 회복을 시사했다.

• 재활치료과학
• /
• 제11권1호
• /
• pp.21-33
• /
• 2022

목적 : 본 연구는 치매환자의 삼킴장애 중재에 대한 체계적 고찰을 통해 치매환자의 특성에 따른 중재접근법과 효과에 대한 과학적 근거를 마련하고자 하였다. 연구방법 : 주요 검색 데이터베이스로 CINAHL, Cochrane CENTRAL, PsycINFO, PubMed, Science Direct를 사용하였으며 2010년 1월부터 2020년 5월까지 발표된 문헌을 수집하였다. 검색어는'Dementia', 'Alzheimer disease', 'Deglutition disorder', 'Swallowing disorder', 'Dysphagia'를 사용하였으며 최종 5편의 문헌을 선정하였다. 결과 : 중등도-중증 환자를 대상으로 한 연구가 1편, 중증 환자를 대상으로 한 연구가 4편 포함되었다. 중재 유형은 교정적 중재가 1편, 보상적 중재가 3편, 포괄적 중재가 1편이었다. 중등도-중증 환자를 대상으로 행동 및 심리관리를 포함한 보상적 중재가 사용되었다. 중증 환자를 대상으로는 경관식이에 대한 교정적, 보상적 중재 및 다학제적 중재를 포함한 포괄적 중재가 사용되었다. 각각의 연구에서 사용한 모든 중재 방법은 삼킴능력과 관련된 결과변수에 긍정적인 영향을 끼쳤다. 결론 : 본 연구에서는 치매환자의 진행단계에 따라 중재의 목적과 중재 요소가 달라지는 것을 확인하였다. 따라서 치매환자의 삼킴장애 중재는 치매환자의 진행단계를 고려하여 개인화된 중재를 시행했을 때 더욱 효과적임을 확인하였다. 이러한 결과는 치매환자의 삼킴장애를 위한 효과적 중재 설계에 방향을 제시해 줄 수 있을 것으로 사료된다.

• 디지털융복합연구
• /
• 제12권5호
• /
• pp.281-293
• /
• 2014

본 연구는 만 4-15세까지의 뇌성마비 아동을 대상으로 초기 섭식능력이 조음기관 구조평가와 말 명료도에 영향을 미치는 변인이 무엇인지 파악하고자 하였다. 총 30명의 경직형 뇌성마비 아동을 대상으로 아동의 섭식 능력에 대해 설문하여, 뇌성마비 아동의 조음기관 구조평가와 말 명료도 검사를 실시하였다. 조음기관 구조평가에 영향을 미치는 요인을 분석한 결과 음식삼키기 가능여부와 병원서 섭식에 대한 치료경험여부, 깨물어 씹기 가능여부, 유동식 섭취가능여부, 섭식에 특별한 방법과 도구 사용여부, 식사 중 문제행동여부, 가누기 시작시기에서 조음평가에 긍정적 영향을 미쳤다. 이상의 연구결과에서 보는 바와 같이 경직형 뇌성마비 아동의 초기 섭식능력이 조음기관 구조평가와 말 명료도에 영향을 미치는 것으로 나타났다.