• Title/Summary/Keyword: Swallowing therapy

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Effect of Suprahyoid Muscle Resistance Exercise Using Kinesio Taping on Suprahyoid Muscle Thickness in Patients with Dysphagia after Subacute Stroke

  • Lee, Myunglyeol;Kim, Jinuk;Oh, Donghwan;Lee, Kuija
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.3
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    • pp.2135-2139
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    • 2020
  • Background: Recently, a new method of dysphagia rehabilitation using Kinesio taping (KT) has been attempted and demonstrated an immediate increase in the activation of the suprahyoid muscle during swallowing in healthy adults. Objectives: To investigate the effect of dysphagia rehabilitation using KT on the thickness change of the suprahyoid muscle in patients with dysphagia after stroke. Design: Two-group pre-post design. Methods: In this study, 20 patients with dysphagia after stroke were enrolled and assigned to the experimental and control groups. The experimental group applied KT to the front of the neck and repeatedly swallowed against the tension of the tape. On the other hand, the control group performed repeated swallowing without applying KT. Patients in both groups had swallowed 50 times a day/5 times a week for 4 weeks. For evaluation, the volume of the geniohyoid, mylohyoid, and digastric muscle was measured before and after the intervention using portable ultrasound equipment. Results: As a result of comparing the two groups after the intervention, the experimental group showed more volume increase in mylohyoid (P<.05) and digastric muscle (P<.05) than the control group. Conclusion: This study proved that suprahyoid muscle resistance exercise using KT is effective in increasing the volume of the suprahyoid muscle.

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.

The Effect of Double Application of Functional Electrical Stimulation in Patients with Dysphgia after Stroke (뇌졸중 후 연하곤란 환자에서 기능적 전기자극 치료의 중복 적용 효과)

  • Yang, Chung-Yong;Shin, Byung-Cheul;Chong, Bok-Hee
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.1
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    • pp.111-123
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    • 2008
  • Objectives : The objective of this study was to investigate the outcomes of functional electrical stimulation (FES) which was applied twice a day in patients with dysphagia after stroke. Methods : Eleven patients with dysphagia after stroke were participated. The electrical stimulator with two channels was employed for forty minutes daily or forty minutes twice a day for fifteen days. Participants were divided into two groups by random method; The FES was performed twice a day for Twice-FES group (n=6), and once a day for Standard-FES group (n=5). For evaluation of dysphagia, the functional dysphagia scale by videofluoroscopic swallowing study, and swallow function scoring system by six clinical swallowing stage were assessed at pre- and post-treatment. Results : In both groups, there was a significant decrease of total functional dysphagia scales after FES treatment (p<0.05) and the results mainly affected the pharyngeal phase of deglutition. There was no significant difference between the two groups in total functional dysphagia scales, but the Twice-FES group had a decreased residue in oral cavity compared to the standard FES group. In both groups, there were significant improvements in swallow function scoring system (p<0.05). The twice-FES group had more high clinical swallowing stages. Conclusions : The results demonstrated that FES is a clinically effective intervention in treatment of stroke patients with dysphagia. Moreover, the treatment applied twice a day had relatively positive effects on the reduction of oral cavity residue and the improvement of clinical swallowing stage.

The effect of PAP on the swallowing improvement of adults with dysphagia : Case Reports (연하장애 환자의 PAP 장착 후 연하 개선에 관한 증례 보고)

  • Yang Ji-Hung;Shin Hyo-Keun;Kim Hyun-Gi
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.35-42
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    • 2003
  • PAP (Palatal Augmentation Prosthesis) may be given to the patients with dysphagia; especially, who cannot achieve tongue-palate contact. PAP fills hard palate area where the tongue cannot make contact and then the distance of tongue elevation is shortened. 1bat may be expected to improve swallowing and to prevent from aspiration. The purpose of this report is to show the effects of PAP in patients with dysphagia through the videofluoroscopic study. Oral-pharyngeal swallowing post PAP is analyzed in 2 cases; one is a person who had subarachnoid hemorrhage due to aneurysmal rupture, right hemiparesis, hydrocephalus and aphamia. And the other is a person who had squamous cell carcinoma on mouth floor and he had radical neck dissection and marginal mandibulectomy. In this report, the rate of aspiration, the transit time and length measurements of anatomical structure are examined in the each frame of videofluoroscopy. The results are as follows; 1) PAP decreased the aspiration in both cases. 2) In the cases of patients with PAP, the pharyngeal transit time was decreased.

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The Effect of Singing Intervention for Women Elderly with Dysphagia Risk (연하장애 위험 여성노인의 노래중재 적용 효과)

  • Yun, Ok-Jong;Lee, Young-Hee
    • Korean Journal of Adult Nursing
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    • v.24 no.4
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    • pp.380-389
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    • 2012
  • Purpose: This study was conducted to describe the risk of dysphagia and to evaluate the effects of a singing intervention for women elderly in community. Methods: One-group pre test-post test design was used. The subjects were 29 women over the age of sixty and residing in a local area. A singing intervention consisted of breathing, vowel production and singing. The one hour intervention occurred once a week for eight weeks. The variables of dysphagia risk, a swallowing test, and nutritional status were measured. Analysis was done by paired t-test. Results: There was a significant decrease in the score of dysphagia risk (p<.001). There were significant increases in the swallowing test scores [modified water swallowing test (p=.032), food test (p=.001)]. There were no significant differences in nutritional status (triceps skin fold thickness, mid arm muscle circumference). Conclusion: The findings support that a singing intervention can be helpful in reducing the risk of dysphagia may improve deglutition for the women elderly. These results suggest that this study may contribute to the use of a singing intervention for women elders with dysphagia risk.

Case of Multiple Systemic Atrophy Treated with Korean Medical Treatment and Rehabilitation Therapy (재활치료와 한방치료를 병행한 다발성 뇌신경계 위축증 1례)

  • Park, Jang-Kyung;Maeng, Yu-Sook;Lee, Seung-Bok;Kim, Dong-Il
    • The Journal of Korean Medicine
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    • v.32 no.2
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    • pp.118-125
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    • 2011
  • Multiple system atrophy (MSA) is an idiopathic and progressive neurodegenerative disorder. Up to now, treatment of MSA patients had not been reported in Oriental medicine and only rarely reported in Western medicine. We experienced a 75-year-old female diagnosed with MSA and had quadriparesis with dysphagia. She was admitted to the hospital and received herbal medication, acupuncture, moxibustion and rehabilitation therapy. After 2 months, her motor power and swallowing function on video fluoroscopic swallowing test significantly improved. This report shows that Oriental medicine may play a role in the treatment of MSA, and further study is merited.

Clinical Assessment of Temporomandibular Joint Dysfunction (측두하악 관절 장애의 평가)

  • Ryoo, Jae-Kwan;Kim, Jong-Soon
    • Journal of Korean Physical Therapy Science
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    • v.5 no.4
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    • pp.717-728
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    • 1998
  • The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

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Effect of Neuromuscular Electrical Stimulation Combined with Traditional Dysphagia Rehabilitation on Masseter Muscle Thickness and Bite Force in Stroke with Dysphagia Patient

  • Lee, Myunglyeol;Lee, Kuija;Kim, Jinuk
    • Journal of International Academy of Physical Therapy Research
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    • v.12 no.2
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    • pp.2365-2369
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    • 2021
  • Background: Patients with dysphagia after stroke are treated with neuromuscular electrical stimulation (NMES), but its effect on masseter muscle thickness and bite force in the oral phase is not well known. Objectives: To investigated the effect of NMES on masseter muscle thickness and occlusal force in patients with dysphagia after stroke. Design: Two group, pre-post design. Methods: In this study, 25 patients with dysphagia after stroke were recruited and allocated to either the experimental or the control groups. Patients in the experimental group were treated with NMES to the masseter muscle at the motor level for 30 minutes and were additionally treated with traditional swallowing rehabilitation for 30 minutes. In contrast, patients in the control group were only treated with traditional swallowing rehabilitation for 30 minutes. Masseter muscle thickness was measured using ultrasonography before and after intervention, and bite force was measured using an bite force meter. Results: The experimental group showed significant improvement in masseter muscle thickness and bite force compared to the control group. Conclusion: NMES combined with traditional dysphagia rehabilitation is effective in improving masseter muscle thickness and bite force in patients with dysphagia after stroke.

Changes in Side Effects and Fatigue of Cancer Patients Receiving Radiation Therapy (방사선치료를 받는 암환자의 급성 부작용과 피로의 변화)

  • Park, Kyeong-Soon
    • Asian Oncology Nursing
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    • v.2 no.1
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    • pp.72-82
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    • 2002
  • Purpose : To observe changes in side effects and fatigue of the cancer patients receiving radiation therapy on the head/neck and the chest over a period from the start to the end of the therapy, and to analyze correlation between side effects and fatigue. Method : Twenty seven patients receiving radiation therapy 5 days per week for longer than 6 weeks participated in the present study. Fatigue was measured for when healthy, before-, and after-therapy. Side effects was surveyed by structured questionnaire on the last day of each therapy. Result : The results of this study were as follows. 1. Major side effects of the head/neck patients were skin irritation, change of taste, sore throat and xerostomia, while the chest patients experienced fatigue, skin irritation, anorexia, difficulty swallowing and cough increased with therapy. 2. Although fatigue was significantly changed for when healthy and before-therapy (F=60.25, p <.05) and also for before- and after-therapy, no statistical significance was demonstrated in fatigue of both the chest head/neck patients (p> .05). 3. Fatigue and side effects showed high correlation form the 4-th week with after the therapy Conclusion : The present results could be of great use to develop systematic intervention technique, leading to practical help for patients, since side effects and fatigue change to a large degree depending on the disease and the timing and technique of the therapy.

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A Survey About Awareness and Necessity of Community Based Dysphagia Therapy of Community Dwelling Older Adults (지역사회 거주 노인들의 연하장애 인식과 중재 필요성)

  • Min, Kyoung Chul;Kim, Eun Hee;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.2
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    • pp.39-51
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    • 2022
  • Objective : This study aimed to investigate the awareness and experience of community-based dysphagia therapy and related education in community-dwelling older adults. Methods : A total of 89 older adults were recruited from a public health center in Gyeonggi-do. Awareness, experience, and related education regarding community-based dysphagia therapy were analyzed using descriptive statistics. Results : We analyzed 89 questionnaires. Awareness, treatment experience, and education regarding dysphagia were low; however, the importance and intention to participate were high. Respondents wanted education about proper chewing and safe swallowing, oral health, oral motor exercise, and participation in community-based dysphagia programs in public health centers. The reason for the lack of experience in dysphagia education and therapy is insufficient information and opportunities. The respondents had a good understanding of dysphagia symptoms. Conclusion : Dysphagia therapy maintains swallowing and eating functions as a life-long Activity of Daily Living, and is a very important area in community rehabilitation. Based on the results of this survey, the necessity and importance of community-based dysphagia were identified. It is time to provide correct information and develop a systematic education program for community-based dysphagia therapy. Occupational therapists need to play an active role in improving quality of life by early detection and providing proper intervention.