• 대한한방내과학회지
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• 제40권2호
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• pp.236-245
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• 2019

Objectives: The aim of this study is to report the effects of Korean medical treatment with electroacupuncture on post-stroke dysphagia. Methods: Two stroke patients with dysphagia received Korean medical treatment including electroacupuncture for about six months and three months respectively. A Numerical Rating Scale (NRS), Video Fluoroscopic Swallowing Study (VFSS) were used to confirm efficacy of electroacupuncture therapy as outcome measurements. Results: After treatment, swallowing function was improved, and symptoms related to dysphagia were decreased. NRS, VFSS showed improvement in stroke patients with dysphagia. Conclusions: This study shows that Korean medical treatment with electroacupuncture can be useful for dysphagia.

• 대한한방내과학회지
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• 제18권1호
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• pp.62-68
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• 1997

Dysphagia generally has a good prognosis after stroke involving cerebral hemisphere or braibstem, but it could have serious consquence with dehydration leading to haemoconcentration, renal failure and aspiration leading to pneumonia. This preliminary report was written for main report. The main report will be written to give an objective guide post of management and treatment in stroke patient with dysphagia. The objective guide posts were follows as, 1. Close examination for relationship between dysphagia in stroke patients and other neurological deficits 2. Influence on the prognosis of dysphagia in stroke patients by the grade of dysphagia at admission time. 3. The realtionship between the site and size of brain damage and the grade and prognosis of dysphagia 4. The frequency and prognosis of dysphagia in stroke patients according to sex and age. 5. The rate and speed of recovery with dysphagia after stroke. 6. Frequency and process of complications, aspiration pneumonia, weight loss, sore, in stroke patient group with dysphagia.

• 성인간호학회지
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• 제25권2호
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• pp.113-124
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• 2013

Purpose: Purposes of this study were to develop a reliable and valid checklist to assess and manage post-stroke dysphagia and to identify its utilization. Methods: The first step was to develop checklist through systematic literatures reviews, to test the content validity from 11 clinical experts, and to test the construct validity and the internal consistency from 97 patients with post-stroke dysphagia. The second step was to identify clinical use of the checklist from the same 97 patients. Results: A total of 18 items compromised the assessment checklist and 64 items for intervention checklist. Internal consistencies of assessment checklist and intervention checklist were .84 and .98, respectively. In both checklists, level of utilization of general appearance was the highest, while that of early signs of aspiration was the lowest. The utilization levels of two checklists were significantly higher among patients who were less than 60 years old, and had liquid diet, facial paralysis, and previous history of aspiration pneumonia. Conclusion: We found that the checklists were reliable and valid. Further study is needed to develop specific strategies to improve nurses' use of assessment and intervention checklists for post-stroke dysphagia.

• 국제물리치료학회지
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• 제12권2호
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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.

• 동의생리병리학회지
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• 제22권1호
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• pp.199-203
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• 2008

This study was designed to report the effects of acupuncture on dysphagia of stroke patients. Six patients with post-stroke dysphagia were enrolled. Acupuncture therapy was performed on eight acupoints for four weeks. Oral transit time, pharyngeal transit time, and functional dysphagia scale on the basis of videofluoroscopic swallowing study were used for evaluation. Oral transit time, pharyngeal transit time, and functional dysphagia scale showed acupuncture had positive effects on post-stroke dysphagia. Especially, the effects were significant at the time of 2 hours after acupuncture. This results showed that acupuncture was useful method to improve dysphagia of stroke patients.

• 한국방사선학회논문지
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• 제4권3호
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• pp.19-25
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• 2010

연하장애는 뇌졸중 후 환자들에게 일반적으로 발생하지만 동시에 매우 심각한 증상이다. 기도 흡인을 동반한 뇌졸중 환자는 탈수, 영양실조, 폐렴, 폐혈증 심하면 사망에 이를 수 있다. 최근까지도 구개반사와 숨막힘 경험 등이 기도흡인을 결정하는 임상적 지표로 주로 사용되어져 왔다. 이 연구의 목적은 뇌졸중 후 연하장애 환자들을 대상으로 비디오투시 연하검사를 통해 기도흡인을 평가하고 적절한 식이 형태를 선택하는데 있다. 58명의 뇌졸중 환자와 10명의 정상군을 대상으로 하였고 액체, 푸딩, 요플레, 밥 등을 바륨과 혼합하여 투시를 실시하며 먹게하였다. 두명의 재활의학과 의사와 한 명의 방사선사가 위상(구강기, 인두기, 식도기)을 분석하였고, 식도 통과시간을 체크하였다. 인두기는 38명의 환자에서 비정상으로 나타났고, 13명의 환자가 구강기와 인두기에서, 3명의 환자는 구강기에서 2명의 환자는 인두기와 식도기에서 비정상적인 소견을 보였다. 전체 환자중 43명(65.2%)에서 기도흡인을 보였고, 그 중 23명은 턱을 치켜 올리는 자세를 취하여 개선이 관찰되었다. 흡인이 일어난 환자중 34명은 액체타입에서, 2명은 죽타입에서 흡인이 일어났고, 밥에서는 흡인이 없었다. 비디오투시 검사 결과를 통해 비위관을 통해 음식을 섭취하던 23명중 13명이 구강으로 섭취방법을 변경하였으며, 구강 섭취를 하던 43명중 2명은 비위관으로 섭취방법을 변경하였다. 결론적으로 비디오투시 연하조영검사는 뇌졸중 후 연하장애환자의 기도흡인을 평가하는데 매우 유용하다고 할 수 있다.

• 국제물리치료학회지
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• 제11권3호
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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.

• 동의생리병리학회지
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• 제28권3호
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• pp.280-287
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• 2014

The aim of this study was to collect and analyze clinical studies on electro-acupuncture therapies of post-stroke dysphagia to suggest the methods of the study about electro-acupuncture therapy. In this study, electronic searches were performed with searching sites. Searched words such as '중풍', '뇌졸중', '연하장애', '전침', 'stroke', 'dysphagia', 'deglutition disorders', 'electro-acupuncture' were used as a single keyword or in combinations. Through searching, 27 studies were selected and analyzed. In comparison of results before and after electro-acupuncture treatment, there were statistically significant improvement in 26 studies by using assessment such as video fluoroscopy swallowing study, swallowing water function test. The study of electro-acupuncture treatment for post-stroke dysphagia needs to be standardized and high-quality study models should be introduced.

• 대한한방내과학회지
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• 제26권2호
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• pp.353-359
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• 2005

Objectives: Dysphagia is a common in stroke patients. Dysphagia often affects the rehabilitation of stroke patients by increasing the risk of nutritional deficits and aspiration pneumonia. Despite the proliferation of physical therapies including swallowing training, much controversy remains regarding the application and benefit of them. Therefore, in this study, the clinical effect of moxibustion at Chonjung(CV17, Shanzhong) on post-stroke dysphagia were assessed using Swallowing Provocation Test(SPT). Methods: Dysphagia subjects were selected by Dysphagia Screening Test. Swallowing function was tested by Swallowing Provocation Test(sec). Direct moxibustion was applied to the acupoint, Chonjung, five times and Swallowing Provocation Test was performed before and after 30 minute. The Latency Time of Swallowing Reflex (LTSR) was checked by SPT. To find factors related with improving swallowing function, Cold-Heat and Excess-Deficiency Diagnosis were considered. Results: A total of 42 patient were included, but two of them were excluded due to severe coughing. Overall, the swallowing reflex improved significantly. In subgroup analysis on brain lesion, non-brain stem lesion patients significantly improved. Moxibustion was more effective in the cold group than in the heat group, but there were no differences between the Excess and the Deficiency groups. Conclusions: The result of this clinical study suggest that moxibustion at Chonjung(CV17, Shanzhong) is an effective treatment for the dysphagia patients after stroke, especially in non-brain stem lesion and the cold diagnosed patients.

• 한방재활의학과학회지
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• 제18권1호
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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.