• Title/Summary/Keyword: post-stroke dysphagia

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Effect of Kinesiology Taping on Hyolaryngeal Complex Movement in Stroke Patient with Dysphagia

  • Hong, Junyong;Oh, Donghwan;Park, Jisu;Jung, Youngjin
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.2
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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.

A Study on the Nutritional Status, Symptoms, and Information Needs in Stroke Patients with Dysphagia (연하장애가 있는 뇌졸중 환자의 영양상태, 자각증상 및 정보요구도)

  • Kim, Na-Hyun;Kwon, Young-Sook;Kim, Myung-Ae;Lee, Keung-Hee;Kwak, Hye-Weon
    • Journal of Korean Biological Nursing Science
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    • v.13 no.1
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    • pp.72-80
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    • 2011
  • Purpose: The purposes of this study were to reveal the nutritional status and symptoms related to dysphagia and to identify the information needs of the patient with post-stroke dysphagia for self care. Methods: Fifty one subjects were selected among patients being admitted from 3 tertiary hospitals. Data were collected using questionnaires, interview, and medical record. Data analysis was done using descriptive statistics with SPSS. Results: 1) The mean hemoglobin, serum albumin, and hematocrit level of the subjects were $11.2{\pm}1.8g/dL$, $3.2{\pm}0.6g/dL$, and $33.5{\pm}2.3%$, respectively. 2) The most common symptom due to dysphagia was 'slurred speech (86.3%)', followed by 'less flexible in tongue and mouth movement (80.4%)', 'difficulty chewing and swallowing (74.5%)'. 3) The highest score of information needs for patients/caregivers was to know which foods are suitable for dysphagic patients or not ($2.67{\pm}0.48$ of 3.0 score). They also want to know how to swallow safely ($2.65{\pm}0.59$), to administer medication safely ($2.63{\pm}0.59$), and to learn rehabilitative techniques ($2.61{\pm}0.57$). Conclusion: These findings would be useful information for staffs to do multidisciplinary approach and they would be necessary for stroke patients to manage their symptoms.

Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients (수정된 연하곤란사정도구와 비디오 연하영상 조영술의 흡인 위험 예측비교)

  • Moon, Kyung-Hee;Sohn, Hyun-Sook;Lee, Eun-Seok;Paek, Eun-Kyung;Kang, Eun-Ju;Lee, Seung-Hee;Han, Na-Ri;Lee, Meen-Hye;Kim, Deog-Young;Park, Chang-Gi;Yoo, Ji-Soo
    • Journal of Korean Academy of Nursing
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    • v.40 no.3
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    • pp.359-366
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    • 2010
  • Purpose: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. Methods: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. Results: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. Conclusion: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

The Effect of SSP Electrical Stimulation Applied to Acupoints Impact on the Swallowing Function of Stroke Patients (경혈점에 적용한 은침전기자극이 뇌졸중 환자의 삼킴기능에 미치는 영향)

  • Gong, Kwang-Sik;Na, Su-Young
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.11 no.1
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    • pp.45-52
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    • 2013
  • Purpose : The goal of this study is to estimate the effect of SSP electrical stimulation applied to acupoints as conducted in oriental medicine on the swallowing function of patients with swallowing difficulties caused by stroke. Methods : Twenty-two hemiplegic stroke patients with swallowing difficulties were divided into an intervention-only group (Group I; n=11) and an intervention-SSP electrical stimulation group (Group II; n=11). Therapeutic intervention was performed on participants in the intervention-only group and the intervention-SSP electrical stimulation group, for 20 minutes per session, three times per week, for four weeks. In this study, SSP electrical stimulation to the acupoints (Cheondol, Yomchon, Budol, Pungji, and Sanyinjian) of stroke patients with swallowing difficulties was applied, and to investigate the effects of SSP electrical stimulation, Clinical dysphagia scale (CDS) and ultrasonography assessment was used to measure pre and post-intervention scores. Results : In the clinical dysphagia scale assessment, the post-intervention score for group II had significant enhancement unlike group I. In the ultrasonography assessment, the hyolaryngeal movement in group II showed significant increase in the swallowing function unlike group I. Conclusion : From the above results, significant effects came from SSP electrical stimulation of 3Hz, biphasic wave, continuous current when applied to the acupoints as conducted in oriental medicine to improve the swallowing function of stroke patients.

Effects of Swallowing Training Program for Nursing Home Residents with Stroke (요양시설 거주 뇌졸중 노인을 위한 연하 훈련 프로그램의 효과)

  • Kim, Haesook;Lim, Kyung-Choon
    • Journal of muscle and joint health
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    • v.30 no.3
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    • pp.230-241
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    • 2023
  • Purpose: This study aimed to verify the effects of a swallowing training program on swallowing function and depression for nursing home residents with dysphagia after stroke. Methods: This is a quasi-experimental study with non-equivalent control group pre-post test design. The program (oro-facial muscle strengthening exercises, swallowing exercises, expiratory muscle strengthening exercises, and brain stimulation exercises) applied to the experimental group three times per week for eight weeks, 40-45 minutes for each intervention. The final data from 42 people (21 experimental and 21 control) were analyzed by SPSS/WIN 25.0 using descriptive statistics. 𝜒2 test, t-test, Wilcoxon rank sum test, and Friedman test. Results: The experimental group was significantly improved than control group in oro-facial muscle strength, swallowing symptoms (Z=-2.22, p=.026), and oral intake function level (Z=-2.00, p=.046). However, there was no significant difference between two groups in depression. Conclusion: This study is meaningful in that it reorganized and mediated a swallowing training program as a safe, non-invasive exercise that nurses can implement in a nursing facility with limited medical personnel and it could be easily followed by older adults.

Effect of Oral Motor Facilitation Technique on Oral Motor Function in Stroke Patients (구강운동촉진기술(Oral Motor Facilitation Technique)이 뇌졸중 환자의 구강운동기능에 미치는 효과)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.135-151
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    • 2023
  • Objective : This study was conducted to confirm the effect of the oral motor facilitation technique (OMFT) on oral motor function in stroke patients. Methods : This study was conducted on 72 stroke patients with dysphagia were included. Thirty-six patients were randomly assigned to the experimental and control groups were randomly classified into 36 patients each using a random table, and a two-group pre-post test was designed. The experimental group underwent OMFT, and the control group underwent traditional dysphagia therapy for 30 min, once a day, 5 times a week for 4 weeks, for a total of 20 sessions. The Comprehensive Orofacial Function Scale (COFFS) was used to evaluate oral motor function. Repeated-measures analysis of variance (ANOVA) was performed to confirm the effect of the period, and an independent t-test was performed to analyze the difference in change between the two groups. Results : Total COFFS scores improved in both groups. The experimental group showed significant changes in mandibular and lip movements, cheek blows, and tongue movements. In addition, there were significant differences depending on the intervention period in terms of masticatory distribution, food spillage, swallowing of solid and liquid foods, and voice changes. There were significant differences in the mandibular opening and closing categories between the two groups. Conclusion : OMFT is effective in improving oral motor function in stroke patients with dysphagia and can be used as basic evidence in clinical practice.

A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine (사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰)

  • Oh, Hyunjoo;Lee, Jeongyun;Lee, Hyeri;Lee, Junhee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.2
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

A Scoping Review of Acupuncture Points for Post-Stroke Sequelae: Focusing on the Electroacupuncture (뇌졸중 증상별 경혈 활용에 대한 주제범위 문헌고찰: 전침을 중심으로)

  • Lee, Hwa Yeon;Kim, Song-Yi;Choi, Su-Hyeon;Song, Ho Sueb
    • Korean Journal of Acupuncture
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    • v.38 no.4
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    • pp.197-208
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    • 2021
  • Objectives : The aim of this study was to conduct a scoping review focusing on acupuncture points information applied in experimental studies using electroacupuncture for stroke. Methods : First, we set the research question of this study to identify which acupuncture points were studied for various symptoms of post-stroke sequelae in clinical and animal experiments. For this purpose, among the records searched through EMBASE, experimental studies including acupuncture points used in electroacupuncture treatment for stroke were selected as inclusion criteria for this study. The acupoints information used in each experiment was extracted from the included studies according to the type of study design and symptoms of stroke sequelae, and quantitative analysis was performed. Results : A total of 973 studies using acupuncture treatment, of which 429 papers including electroacupuncture were analyzed. Most of the animal experiments were conducted on general conditions instead of specific symptoms of stroke, and in clinical studies, electroacupuncture studies were conducted on symptoms such as hemiplegia and spasticity, cognitive and mental problems, dysphagia, shoulder problems, and depression that occur after stroke. Acupuncture points such as GV20, ST36, LI11, and LI4 were mainly used regardless of stroke symptoms. Except for these acupuncture points, GV26, GV14, GV16, and GV24 were frequently used in animal experiments, and TE5, LI15, LI10, and LR3 were widely used in clinical studies. Conclusions : Although this study extracted and analyzed only the frequent acupuncture points in the electroacupuncture study for stroke. However, in the future, it is necessary to be able to secure the evidence for acupuncture treatment elements through comparative studies between different acupuncture points or other elements constituting electroacupuncture.

A Case Study of Chengsimyeonja-tang-gamibang Treatment of a Patient with a Pontine Hemorrhage, with Quadriparesis, Dysarthria, and Dysphagia (청심연자탕 가감방으로 호전된 교뇌 출혈 이후 발생한 양측 반신부전마비, 연하곤란, 언어장애 치험 1례)

  • Yang, Jee-yun;Jeong, Taek-su;Jeon, Gyeong-ryung;Ok, So-yoon;Sun, Jong-joo
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.217-225
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    • 2017
  • Objectives: This case study evaluated the effectiveness of Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) in a patient with a pontine hemorrhage and quadriparesis, dysarthria, and dysphagia. Methods: A patient diagnosed with a pontine hemorrhage was treated with Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) acupuncture, and moxibustion. The manual muscle test (MMT), modified Barthel index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Mini Mental State Examination-Korea (MMSE-K), and Articulatory Functional Ability of Achievement Scale were administered. Results: Improvements in the MMT, MBI, NIHSS, mRS, and K-MMSE were observed after the treatment. The MMT grade increased from Rt. 3/3- and Lt. 3/3- pretreatment to Rt. 4/4 and Lt. 4+/4+ post-treatment. The MBI increased from 10 to 50 post-treatment. The NIHSS decreased from 24 to 6 post-treatment, and the mRS fell from 5 to 4 post-treatment. Finally, the MMSE-K increased from 0 to 24 post-treatment. The Articulatory Functional Ability of Achievement Scale also improved. Conclusion: This study shows that Chengsimyeonja-tang-gamibang can be used to treat the symptoms of patients with a pontine hemorrhage.

Research Trends of CV23 Electroacupuncture: A Literature Review Focusing on PubMed and Domestic Studies (염천(CV23)의 전침치료 연구 동향 : Pubmed와 국내논문을 중심으로)

  • Chae-Rim Yoon;Su-Hyun Choi;Nahyun Jeong;Dahee Jeong;Yoohyun Sim;Hae-in Jeong;Na-Yeon Ha;Jinsung Kim
    • The Journal of Internal Korean Medicine
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    • v.45 no.4
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    • pp.663-680
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    • 2024
  • Objectives: The purpose of this study was to analyze the research trends of electroacupuncture (EA) at CV23. Methods: Studies published until July 2024 were searched on PubMed and domestic databases (OASIS, ScienceON, RISS, KISS, KCI, KMbase, and DBpia) using the keywords "CV23", "lianquan", "electroacupuncture", "염천", "전침", and "전기자극". Results: A total of 16 studies were selected. There were 6 randomized controlled trials, 1 case report, and 9 experimental studies. Of the 16 papers selected, 15 examined the effect of EA at CV23 on improving swallowing function. Clinical studies found that EA at CV23 was effective in improving dysphagia, aphasia, and drooling symptoms through mechanisms such as increased hyolaryngeal movement, normalization of pathologically elevated NO, ET, and improvement of excitement of the swallowing motor cortex. According to experimental studies, EA at CV23 activates the brain region associated with swallowing function, promotes the swallowing reflex by increasing neurotransmitters, improves electromyography of the swallowing muscles, and improves blood flow around CV23. Conclusion: Electroacupuncture at CV23 may be an effective and safe method for post-stroke dysphagia, post-stroke aphasia, and post-stroke drooling. In the future, research should be conducted in different diseases and high-quality studies should be conducted.