Objective : This review aimed to provide information for clinical application by confirming the principles and characteristics of the tool through a review of tongue movement and measurement tools for patients with swallowing disorders. Results : We identified 15 tools used as tongue exercises and measurement tools in the field of dysphagia. According to principle, the tools were classified as either a bulb sensor, resistive sensor sheet, mouthpiece with sensor, or other techniques. The bulb sensor was easy to use but had limitations in fixing the position when measuring tongue pressure. The resistive sensor sheet could be measured at a more stable position than the bulb sensor. A mouthpiece with a sensor could be used in an individual's oral cavity such that the position was fixed when measuring the tongue pressure. Other techniques had the advantage of being wireless and capable of sensing light. Conclusion : Based on this literature review, it is necessary to facilitate the selection of the best tool for quantitative tongue measurement in dysphagia. The review can also be used to develop a Korean tongue movement tool model that can be used in hospitals and community centers.
Purpose: The purpose of this study was to develop a training program for swallowing and to test its effect on swallowing capacity and nutritional status among nursing home residents with stroke. Methods: A swallowing training program was developed by literature review, expert validation and a pilot test. A pretest and posttest quasi-experimental study design with nonequivalent control group was used to evaluate the effectiveness of the program. Swallowing training was conducted for thirty minutes, three times a week for 8 weeks. Swallowing capacity including dysphagia screening score, swallowing symptom questionnaire and tongue pressure, and nutritional status including body mass index and mid arm muscle circumference were measured at the baseline and at 8 weeks. Results: The exercised-based swallowing training program consisted of oromotor exercise, expiratory muscle strength exercise and effortful swallow. The participants were 77.2 years old on average. At the completion of 8-week program, the experimental group showed better scores in dysphagia screening (p=.039) and swallowing symptom questionnaire (p=.004) and a significant increase in tongue pressure (p=.003). Conclusion: The exercised-based swallowing training program was safely applied to nursing home residents with stroke and showed a significant improvement of swallowing capacity. Further studies are needed to identify its effect on the nutritional status.
Purpose: The mass of facial muscles can be increased through exercise, as is also the case for muscles in the extremities. This systematic review was conducted to investigate the effect of facial exercises on facial muscle strengthening and facial rejuvenation, focusing on recent studies. Methods: A literature search was performed using the PubMed, ScienceDirect, and Web of Science databases. The quality of the trials was evaluated according to the PEDro scale. In total, 11 studies were included in this review: four studies on facial exercise for facial rejuvenation and seven studies on strengthening the muscles of the face. Results: Facial exercises for facial rejuvenation increased the mechanical properties and elasticity of the skin of the face and neck, the thickness and cross-sectional area of the facial muscles, and the fullness of the upper and lower cheeks. Conclusion: A study aimed at strengthening facial muscles showed improvements in labial closure strength and tongue elevation strength. Despite the positive results for facial rejuvenation and muscle strengthening, the level of evidence was low. Therefore, in future research, it will be necessary to investigate the effects of facial exercise in a thoroughly controlled experiment with a sufficient sample size to increase the level of evidence.
Purpose: This study was conducted to prepare the fundamental data on oral hygiene of the elderly and to assess the behavior of oral hygiene, subjective oral health, oral health problem among the elderly, and to contribute to successful enhancement of life in their declining years. Methods: The author surveyed the behavior of oral hygiene, subjective oral health, oral health problem to 192 elderly at a health center of Busan using structured self- administered questionnaire from Nov. 2nd 2009 to Feb. 10th 2010. Collected data were analysed by SPSS WIN 18.0 statistical program for frequency, percentage production, ${\chi}^2$ (Chi-square) verification, t-test, One-way ANOVA, Logistic Regression. Results: The distribution of total subjects by oral health behaviors were 56.8% for "have ever trained how to tooth brushing", 76.6% for "correctly performed tooth brushing by himself ", 71.8% for "tooth brushing a day is two times and less", 87.5% for "it doesn't tooth brushing in meals and after" and 53.6% for "it doesn't use the facility for oral health", respectively. The distribution of total subjects by the state of perceived oral health were 51.0% for "feel the oral discomfort", 51.6% for "feel the comfortable chewing on starchy food", respectively. The mean point of perceived oral health by general characteristics of total subjects were statistically significant difference in sex, type of medical insurance, smoke, exercise, and chronic disease. The mean point of perceived oral health by oral health behaviors of total subjects were statistically significant difference in educational experience on tooth brushing, recognition for tooth brushing by himself, tooth brushing a day, and tongue cleaning. The risk factors of perceived oral health were type of medical insurance and chronic disease in general characteristics, tooth brushing in meals and after and tooth brushing a day, and tongue cleaning in oral health behaviors. Conclusion: The author recommend to the prevention of chronic disease, carry out the tooth brushing in meals and after, three times and over tooth brushing a day and tongue cleaning for oral health. and the author consider that it need to prepare the active countermeasure to oral health such as reeducation for oral health and supply to the tongue cleaner.
Purpose: The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release. Methods: The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth. Results: The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group. Conclusion: The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.
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.
Objectives: The purpose of this study is to investigate the diagnostic factors of Damjeok in the literature. Methods: This study used the databases of five (Mediclassics, RISS, KMbase, OASIS, CNKI) to analyze diagnostic factors of Damjeok. Literatures published by May 2023 were assessed and we classified 91 literatures dealing with diagnostic factors by 5 categories, 'characteristics', 'location', 'symptom', 'pulse wave & tongue feature', and 'eating habits & lifestyle'. Results: Damjeok is mainly formed at the stomach in the form of lump or hard seed, and it can be observed in other regions or even the whole body by its trait of floating. Damjeok mainly shows symptoms of the digestive system and also causes various symptoms associated with the respiratory system and infection, musculoskeletal system, urogenital system, neuropsychiatric system and cardiovascular system. Regarding pulse wave and tongue feature, a slippery wave and greasy coated tongue are typical features of Damjeok. Additionally, bad eating habits and a lack of exercise have been described as a factor that cause and aggravate Damjeok. Conclusions: The two most important factors in the diagnosis of Damjeok are abdominal stiffness by physical examination and digestive symptoms, and these correspond to the definition of a syndrome. Diagnostic factors based on literature evidence will provide clues to the clinical diagnosis of Damjeok syndrome.
Journal of the korean academy of Pediatric Dentistry
/
v.27
no.2
/
pp.246-250
/
2000
The oral screen is a functional appliance, suitable for the treatment of developing malocclusion associated with aberrant muscular patterns. The better muscle balance between tongue and the buccinator mechanism can be established, and the reestablishment of normal growth and development can be achieved. The oral screen can be used for the correction of the following conditions : (1) thumbsucking, tongue thrusting and lip biting, (2) mouth breathing, (3) mild distocclusion with premaxillary protrusion, (4) open bites in deciduous and mixed dentition, and (5) incompetent lips. The patient should wear the oral screen every night and also during the day whenever possible. The effects of oral screen can be elevated through lip seal exercise : the lips should be kept in contact all the time to improve the lip seal. In the presented two cases, the patients were considered mouth breathers and to have incompetent lips, and one patient with maxillary incisal protrusion and the other with open bite. They were instructed to wear the oral screen with lip seal exercise. After wearing the appliance for 1 and 2 years respectively, mouth breathing was decreased and lip length and strength were increased, the maxillary incisors were retruded and open bite reduced.
Cerebral palsy children represent abnormal vocalization pattern caused by respiration problem and paralyzed oral motor muscle that are the basics of speech production. Thus, this study examined the effect of respiration and articulator training programs on the basic ability of speech production in CP children. The subjects of this study were 4 children with 3 of spastic CP and 1 of ataxia CP. The respiration and articulator program was conducted in 30 sessions for 30 minutes each. Pre-test was administered twice before the program, ongoing test was administered every 5 session during the period of experiment, and post-test was administered twice. The program included speech production such as respiration training, lips, jaw, cheek, and tongue exercise, and velopharyngeal training, and related articulator training. The following results were obtained. First, all subject children were less than 5 seconds in maximum phonation time before the experiment and 2 were improved by more than 4$\sim$5 seconds during the experiment, but 2 had relatively low rising width. Second, while children with less than 30dB before the experiment became bigger in strength during the experiment, children with more than 35dB before the experiment showed a minor change. Subject child 4 had lower vocal strength in the post-test period. Finally, although each subject had individual difference in syllable diadochokinetic ability, the function was improved and the number of repetition in one respiration was also increased.
A 42-year old male patient was referred to the Department of Oral Medicine, Kyungpook National University Hospital due to the chief complaint of limite mouth opening. Three years ago, the patient was diagnosed as an infarction of both cerefellar hemispheres, acute obstructive hydrocephalus and acute epidural hematoma of frontal lobe at the department of neurosurgery.Both of the infarcted cerevellar hemispheres and the epidural hematoma of frontal lobe were removed with suboccipital and frontal craniectomu. After the brain surgery jaw opening range was decreased progressively and ultimately mouth opening became almost impossible. Spasmodic and rhythmic contractions of the masseter muscles occurred intermittently during daytime as well as sleeping. Food intake was available only through Levin -tube. Actibe jaw opening exercise was prescribed with the aids of tongue blades. A moist hot pack and indomethacin phonophesis were also applied 20 minutes three times a day to decrease discomfort muscle activities. After a month of treatments, the opening range was increased to 5mm at the premolar area and oral food intake was possibel. The L-tube was removed and the patient was discharged.
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