• 대한지역사회작업치료학회지
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• 제5권1호
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• pp.23-34
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• 2015

목적 : 신경근 전기자극치료와 함께 적용된 자가 삼킴 운동이 삼킴 장애 환자의 삼킴 기능 향상에 미치는 효과를 알아보고자 하였다. 연구방법 : 2013년 5월부터 2015년 4월까지 서울 소재 A 종합병원에서 삼킴 장애로 진단받아 삼킴 재활치료가 의뢰된 입원 환자들을 대조군과 실험군으로 나누었다. 두 군 모두 VitalStim을 이용해 신경근 전기자극치료를 받는 60분 동안 30분간 삼킴 재활치료를 받았고, 실험군은 추가적으로 남는 30분간 자가 삼킴 운동 프로그램을 시행하였다. 중재는 3주간 주 5회 진행되었다. 의무기록 열람을 통해 대상자들의 일반적 정보를 조사하였고, 중재 전후 삼킴 기능의 변화를 알아보기 위해 비디오 투시 삼킴 장애 검사와 침습-흡인 척도를 시행하였다. 결과 : 중재 전 두 군의 삼킴 기능에 유의한 차이가 없었다. 중재 전후 대조군은 비디오 투시 삼킴 장애 척도 총점, 조롱박오목의 잔여물과 흡인에서 유의한 차이를 보였고, 실험군은 비디오 투시 삼킴 장애 척도 총점, 후두개계곡의 잔여물, 조롱박오목의 잔여물에서 유의한 차이를 보였다(p<.05). 중재 전후 대조군과 실험군의 삼킴 기능 차이를 비교한 결과 유의한 차이가 없었다. 결론 : 신경근 전기자극치료와 함께 적용된 삼킴 재활치료 또는 삼킴 재활치료와 자가 삼킴 운동이 삼킴 장애 환자의 인후두 기능 향상에 유의한 영향을 미침을 알 수 있었으나 추가적으로 적용된 자가 삼킴 운동이 유의한 변수로 작용하지 않음을 알 수 있었다.

• 한국전문물리치료학회지
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• 제21권3호
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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.

• 대한물리의학회지
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• 제13권2호
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• pp.89-95
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• 2018

PURPOSE: We aimed to study the effect of head-lift exercise on the neck strength and swallowing function in patients with stroke. METHODS: Our study included 20 patients with stroke hemiparesis. All patients were randomly allocated to either the head-lift exercise or the conventional swallowing therapy group, and each group included 10 patients. All patients underwent the exercise over a mean period of 30 min daily for 6 weeks. Neck strength and swallowing function were assessed prior to and 6 weeks following the training period. We used a paired t-test to compare the within-group change before and after the intervention. We used an independent t-test to compare the between-group difference. The statistical significance level was set at ${\alpha}=.05$ for all variables. RESULTS: The head-lift exercise group showed a significant within-group change in terms of the neck strength and swallowing function (p<.05). The conventional swallowing therapy group also showed a statistically significant change (p<.05). A statistically significant difference was observed between the head-lift exercise and the conventional swallowing therapy group with regard to the change in both, the neck strength and swallowing function after application of the intervention (p<.05). CONCLUSION: This study provides valuable information for future studies in this field. Further studies involving a wider range of patients and a longer experiment span are required to strengthen the results of our study.

• 대한물리의학회지
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• 제17권4호
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• pp.75-83
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• 2022

PURPOSE: This study was conducted to find out the effects of neurocognitive rehabilitation therapy on the swallowing function and quality of life of stroke patients. METHODS: Thirty patients were selected and randomly allocated into an experimental and a control group. Patients in the experimental group received 15 minutes of neurocognitive rehabilitation treatment combined with 15 minutes of traditional treatment. For the control group, patients received 30 minutes of traditional dysphasia treatment. The experiments were conducted for 30 minutes a day, five times a week, for four weeks. New VFSS and SWAL-QOL were administrated to evaluate the outcomes. RESULTS: Swallowing functions were significantly improved in the experimental group and the control group (p < .05), but there was no statistically significant difference in pre- and post-interventional swallowing between the groups (p > .05). The quality of life was also significantly improved (p < .05) for both groups, but there was a statistically significant difference between the two groups (p > .05). Third, a correlational analysis between swallowing function and quality of life revealed a moderate correlation between New VFSS and SWAL-QOL (p < .05). CONCLUSION: The results of this study suggest that swallowing therapy through neurocognitive rehabilitation treatment program could be helpful for improving swallowing function and quality of life in stroke patients. Although there was no statistically significant changes from traditional rehabilitation therapy, training in recognizing the senses in the oral cavity and external environment through neurocognitive rehabilitation therapy can be applied as one of the treatment options.

• 국제물리치료학회지
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• 제12권2호
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• pp.2338-2344
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• 2021

Background: The therapeutic exercise method using kinesiology taping (KT) has been reported to be effective in activating the suprahyoid muscle in healthy adults. However, its applicability and effectiveness are not known to the physically vulnerable elderly. Objectives: To investigate the effects of kinesiology taping on the activity of suprahyoid muscles in community-dwelling elderly people. Design: Repeated measure design. Methods: We enrolled 23 healthy elderly adults (age range 60-75 years) with no history of neurologic disease. Participants performed five consecutive spontaneous swallowing actions at 5-second intervals under three conditions (KT with 80% stretch, placebo-KT, and non-KT. Activation of the suprahyoid muscles during swallowing in the three conditions was measured using surface electromyography (sEMG). In addition, a 0-10 numerical rating self-report scale was used to evaluate the required effort and the resistance felt during swallowing. Results: KT with 80% stretch were significantly higher in sEMG mean value, peak value, required effort, and resistance felt during swallowing compared to other two conditions (P<.05, all). KT with 80% stretch required the most effort during swallowing and, consequently, has a positive effect on increasing suprahyoid muscle activation. Conclusion: Our results could be taken into consideration in therapeutic exercise method for suprahyoid muscle in dysphagia rehabilitation.

• PNF and Movement
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• 제13권3호
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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.

• 대한통합의학회지
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• 제1권4호
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• pp.1-8
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• 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.

• 한국융합학회논문지
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• 제13권5호
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• pp.9-19
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• 2022

본 연구에서는 체계적 고찰을 통해 노인의 삼킴 단계별 삼킴 기능을 평가하기 위해 표면 근전도 검사를 적용한 방법을 분석하여, 임상에서 노인의 삼킴 단계를 객관적으로 측정할 수 있도록 돕고자 하였다. 2011 ~ 2021년까지 Pubmed, Scopus, Web of Science (WoS)를 활용하여 선정기준에 부합하는 연구 7편을 선정하였다. 본 연구 결과, 노인과 성인을 실험군과 대조군으로 나누어서 분석하거나 노인만을 대상으로 삼킴단계를 표면근전도검사를 이용하여 분석하였다. 구강단계와 인두단계의 삼킴을 평가하기 위해 표면 근전도 검사를 사용하였으며, 표면 근전도 부착 부위는 각 단계별 관여하는 삼킴 근육에 부착하였다. 수집된 근전도 데이터는 대역통과필터와 노치필터를 사용하여 필터링되었고, 제곱평균제곱근, 진폭, 최대자발적 수축을 사용하여 분석하였다. 본 연구에서는 표면 근전도 검사가 단계별 삼킴 기능을 객관적이고 정량적으로 평가할 수 있는 도구로 사용될 수 있음을 알 수 있었다. 따라서 본 연구가 단계별 삼킴기능을 평가하기 위해 표면 근전도 검사를 융합한 다양한 연구를 활성화시킬 수 있기를 기대한다.

• 국제물리치료학회지
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• 제11권2호
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• pp.2052-2059
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• 2020

Background: Kinesiology taping (KT) is a method that helps immediately increase muscle activation, strength and joint stability by being attached to various skeletal muscles and structures of the body. Objectives: To investigate the effect of KT applied below the hyolaryngeal complex on the movement of the hyolaryngeal complex during swallowing in patients with dysphagia after stroke. Design: One-group, pre-post design. Methods: Twenty individuals with dysphagia after stroke participated in this study. KT was applied to the sternum and both clavicles from the hyolaryngeal complex. We analyzed the motion of the hyolaryngeal complex during swallowing with and placebo KT and KT using the Image-J software with videofluoroscopic swallowing study. In addition, a 0-to-10 numerical rating self-report scale was used to check the required effort and resistance felt during swallowing. Results: KT condition showed that the anterior and superior movement of the hyoid bone during swallowing was significantly lower than placebo KT (P<.05, all). Also, KT condition showed that the anterior and superior movement of the larynx during swallowing was significantly lower than placebo KT (P<.05, all). In result of statistical comparison between KT group and placebo KT group, the KT group showed significantly higher self-report scale score than the placebo KT group in terms of two category; the required effort and resistance felt (P<.05, all). Conclusion: This study demonstrated that KT applied below the hyolaryngeal complex inhibits the anterior and superior movement of hyoid bone and larynx during swallowing of patients with dysphagia after stroke.

• 대한통합의학회지
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• 제5권4호
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• pp.31-39
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• 2017

Purpose : The purpose of this study was to examine the effects of short neck flexor strengthening in proprioceptive neuromuscular facilitation and neuromuscular electrical stimulation on swallowing function in patients with chronic stroke and to provide basic data for swallowing rehabilitation in stroke patients. Method : The study involved 30 chronic stroke patients who visited ${\bigcirc}{\bigcirc}$ General Hospital in Daegu Metropolitan City between March and July, 2017. The subjects were randomly assigned to either an experimental group (n=15) or a control group (n=15). Both groups underwent traditional swallowing rehabilitation therapy for 30 minutes five times a week over a six-week period. The experimental group performed short neck flexor exercises, which are part of the proprioceptive neuromuscular facilitation, for 30 minutes three times a week over a six-week period. The control group performed neuromuscular electrical stimulation for 30 minutes three times a week over a six-week period. Based on its results, changes in the patients' swallowing function and degree of food intake were analyzed. Result : In terms of the ASHA NOMS scale and new VFSS scale, the experimental group and the control group showed statistically significant changes in ten sub-items and six sub-items, respectively. Statistically significant differences in one sub-item were found between the groups. Conclusion : PNF-based short neck flexion exercise appear to be effective at improving swallowing function of stroke patients with dysphagia.