DOI QR코드

DOI QR Code

머리들기 운동이 뇌졸중 환자의 연하 능력에 미치는 효과

The Effects of Head-lift Exercise on Swallowing Function in Patients with Stroke

  • 투고 : 2018.03.30
  • 심사 : 2018.04.18
  • 발행 : 2018.05.31

초록

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.

키워드

참고문헌

  1. Antunes EB, Lunet N. Effects of the head lift exercise on the swallow function: a systematic review. Gerodontology. 2012;29(4):247-57. https://doi.org/10.1111/j.1741-2358.2012.00638.x
  2. Beom JW, Han TR. Treatment of dysphagia in patients with brain disorders. J Korean Med Assoc. 2013;56(1): 7-15. https://doi.org/10.5124/jkma.2013.56.1.7
  3. Chang MY. Related factors to dysphagia of home stayed stroke patient. Nurse Academy of Seoul University Seminar. 2005;28-32.
  4. Clark HM, Shelton N. Training effects of the effortful swallow under three exercise conditions. Dysphagia. 2014; 29(5):553-63. https://doi.org/10.1007/s00455-014-9544-7
  5. Cohen DL, Roffe C, Beavan B, et al. Post-stroke dysphagia: a review and design considerations for future trials. Int J Stroke. 2016;11(4):399-411. https://doi.org/10.1177/1747493016639057
  6. Easterling C, Grande B, Kern M, et al. Attaining and maintaining isometric and isokinetic goals of the shaker exercise. Dysphagia. 2005;20(2):133-8. https://doi.org/10.1007/s00455-005-0004-2
  7. Easterling C, Kern M, Nitchke T, et al. Restoration of oral feeding in 17 tube fed patients by the shaker exercise. Dysphagia. 2000;15(2):105-9.
  8. Ferdjallah M, Wertsch JJ, Shaker R. Spectral analysis of surface electromyography (EMG) of upper esophageal sphincter-opeining muscle during head lift exercise. J Rehabil Res Dev. 2000;37(3):335-40.
  9. Gong WT, Cheung HJ, Lee KM. The effect of cervical stabilized exercise and joint mobilization on maximum muscle strength and static muscle endurance of cervical region. J Korean Data Infor Sci Soc. 2010;21(1):33-42.
  10. Hong DG, Kim SK, Yoo DH. Effect of a Shaker exercise on the swallowing function of stroke patients. J Korean Soc Occup Ther. 2012;20(3):55-66.
  11. Hudswell S, Von Mengersen M, Lucas N. The craniocervical flexion test using pressure biofeedback: a useful measure of cervical dysfunction in the clinical setting? Int J Osteopath Med. 2005;8(3):98-105. https://doi.org/10.1016/j.ijosm.2005.07.003
  12. Kim HD. A study on the analysis of muscle fatigue of neck muscle in Shaker's exercise. Master's Degree. University of Seoul. 2010.
  13. Kim HJ. Nutritional status of patients with nervous system disorders and methods for improving nutrition by supplying enteral nutririon. Master's Degree. Yonsei University. 2003.
  14. Kim JC, Jeon HS, Yi CH, et al. Strength and endurance of the deep neck flexors of industrial workers with and without neck pain. J Ergonomics Soc Korea. 2007; 26(4):25-31. https://doi.org/10.5143/JESK.2007.26.4.025
  15. Langmore SE, Pisegna JM. Efficacy of exercises to rehabilitate dysphagia: a critique of the literature. Int J Speech Lang Pathol. 2015;17(3):222-9. https://doi.org/10.3109/17549507.2015.1024171
  16. Leopold NA, Kagel MA. Prepharyngeal dysphagia in Parkinson's disease. Dysphagia. 1996;11(1):14-22. https://doi.org/10.1007/BF00385794
  17. Logemann JA, Rademaker A, Pauloski BR, et al. A randomized study comparing the shaker exercise with traditional therapy: a preliminary study. Dysphagia. 2009;24(4): 403-11. https://doi.org/10.1007/s00455-009-9217-0
  18. Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756-63. https://doi.org/10.1161/01.STR.0000190056.76543.eb
  19. McCullough GH, Kim Y. Effects of the Mendelsohn maneuver on extent of hyoid movement and UES opening post-stroke. Dysphagia. 2013;28(4):511-9. https://doi.org/10.1007/s00455-013-9461-1
  20. Mepani R, Antonik S, Massey B, et al. Augmentation of delutitive thyrohyoid muscle shortening by the Shaker Exercisel. Dysphagia. 2009;24(1):26-31. https://doi.org/10.1007/s00455-008-9167-y
  21. Mun TH. The effects of Shaker exercise and neuromuscular electrical stimulation (NMES) therapy on the swallowing function: on the post-stroke patients with dysphagia. Master's Degree. Inje University. 2013.
  22. Nathadwarawala KM, McGroary A, Wiles CM. Swallowing in neurological outpatients: use of a timed test. Dysphagia. 1994;9(2):120-9. https://doi.org/10.1007/BF00714599
  23. Oh BM, Lee KJ. Rehabilitation of the swallowing disorders. Seoul. Pacific Books. 2007.
  24. Palmer JB, Drennan JC, Baba M. Evaluation and treatment of swallowing impairments. Am Fam Physician. 2000;61(8):2453-62.
  25. Park YG, Cha TH, Jung MY. Rehabilitation dysphagia therapy for individuals with dysphagia. J Korean Dysphagia Soc. 2011;1(1):31-8.
  26. Pearson WG, Langmore SE, Zumwalt AC. Evaluating the structural properties of suprahyoid muscles and their potential for moving the hyoid. Dysphagia. 2011; 26(4):345-51. https://doi.org/10.1007/s00455-010-9315-z
  27. Shaker R, Easterling C, Kern M, et al. Rehabilitation of swallowing by exercise in tubefed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology. 2002;122(5):1314-21. https://doi.org/10.1053/gast.2002.32999
  28. Smitard DG, O'Neill PA, England RE, et al.The natural history of dysphagia following a stroke.Dysphagia. 1997; 12(4):188-93. https://doi.org/10.1007/PL00009535
  29. Smithard DG, O'Neill PA, Parks C, et al. Complications and outcome after acute stroke. Does dysphagia matter? Stroke. 1996;27(7):1200-4. https://doi.org/10.1161/01.STR.27.7.1200
  30. Tan C, Liu Y, Li W, et al. Transcutaneous neuromuscular electrical stimulation can improve swallowing function in patients with dysphagia caused by non-stroke diseases: a meta-analysis. J Oral Rehabil. 2013;40(6):472-80. https://doi.org/10.1111/joor.12057
  31. White KR, Easterling C, Roberts N, et al. Fatigue analysis before and after shaker exercise: Physiologic tool for exercise design. Dysphagia. 2008;23(4):385-91. https://doi.org/10.1007/s00455-008-9155-2
  32. Woo HS, Chang KY, Oh JC. The effects of eight-week tongue-holding maneuver program on activation of swallowing-related muscle. J Korean Soc Occup Ther. 2014;22(1):53-63. https://doi.org/10.14519/jksot.2014.22.1.05