• Title/Summary/Keyword: 삼킴장애 중재

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Intervention of Swallowing Disorder in Dementia Patient: A Systematic Review (치매환자의 삼킴장애 중재에 관한 체계적 고찰)

  • Park, Chi-Soo;Ham, Min-Joo;Hong, Deok-Gi;Yoo, Doo-Han
    • Therapeutic Science for Rehabilitation
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    • v.11 no.1
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    • pp.21-33
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    • 2022
  • Purpose : The purpose of this study was to establish scientific evidence though a systematic review, of the existing interventional methods and their respective effects, for swallowing disorders among dementia patients. The interventional methods were based on patient characteristics. Methods : An electronic literature search was performed using five electronic databases from 2010 to 2020. The keywords were 'Dementia', 'Alzheimer disease', 'Deglutition disorder', 'Swallowing disorder', 'Dysphagia'. Five articles met the inclusion criteria. Results : One study with moderate-to-severe and four studies with severe dementia patients were included. The interventions consisted of one remedial intervention, three compensatory interventions, and one comprehensive intervention. Compensatory intervention, including behavioral and psychological management, were used in moderate-to-severe patients. For the severe patients, remedial, compensatory, and comprehensive intervention were used to address the feeding tube problem. The interventions used in each study had a positive effect on the outcome variables associated with swallowing ability. Conclusion : The purpose of the intervention and the intervention factors changed depending on the patient's dementia stage. The intervention was effective when considering the progressive stage of the patient. These results may serve as a guide in designing effective interventions for swallowing disorders in dementia patients.

The Effect of Self Swallowing Exercise Program with Neuromuscular Electrical Stimulation(NMES) on Swallowing Function of Dysphagia (신경근 전기자극치료와 함께 적용된 자가 삼킴 운동 프로그램이 삼킴 장애 환자의 삼킴 기능 향상에 미치는 효과)

  • Yoon, In-Jin;Kim, Du-Ri;Cho, Young-Moon
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.1
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    • pp.23-34
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    • 2015
  • Objective : The purpose of this study is to investigate the effect of self swallowing exercise program with neuromuscular electrical stimulation(NMES) on swallowing function. Methods : Subjects who were diagnosed in dysphagia were randomly divided into the control group or experimental group. Both group were received NMES during 60 minutes with traditional swallowing therapy during 30 minutes. Additionally the experimental group was received self swallowing exercise during 30 minutes. We invested subject's characteristics through medical chart. We used VDS(Videofluoroscopic Dysphagia Scale) and PAS(Penetration Aspiration Scale) for assessing the swallowing function. Results : There were not significantly different in both group's pre swallowing function. The control group was significantly improved on pyriform sinus residue, aspiration, and VDS total score(p<.05). The experimental group was significantly improved on vallecular residue, pyriform sinus residue, and VDS total score(p<.05). Both group's difference of pre and post swallowing function were not significantly different. Conclusion : Self swallowing exercise and traditional swallowing therapy with NMES and traditional swallowing therapy with NMES are positive effect on swallowing function. The self swallowing exercise is not effective factor.

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Effect of Direct Feeding Intervention on Swallowing Function and Life Quality of Stroke Patients (직접 삼킴 치료가 뇌졸중 환자의 삼킴 기능과 삶의 질에 미치는 영향)

  • Park, Jin Ju;Oh, Myung Hwa;Chung, Hyun Ae;Chung, Sang Mi;Chong, Bok Hee;Kim, Seung Il
    • 재활복지
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    • v.20 no.4
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    • pp.283-299
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    • 2016
  • The purpose of this study was to investigate the effect of dysphagia intervention function and life quality of stroke patients. each 5 patients were randomly assigned in two groups, control group performing indirect feeding and experimental group performing direct feeding. Evaluation of the swallowing function was performed before intervention, after 4weeks and 8 weeks using CDS, PAS with VFSS and quality of life was performed twice, before and after intervention. Two groups showed the improved swallowing function, control group showed the significant difference only in CDS(p<.05). but experimental group showed the significant differenc in CDS and PAS(p<.01). both groups showed the significant improvement in quality of life(p<.05). but in comparison between group, no significant statistical difference were found(p>.05). Therefore, this study showed that both the swallowing function and quality of life were improved as time passed, but swallowing function was much more improved in experimental group.

Effects of Swallowing Training with Biofeedback on Swallowing Function and Satisfaction in Acute Stroke Patients with Dysphagia (생체되먹임을 통한 삼킴훈련이 삼킴장애가 있는 급성기 뇌졸중 환자의 삼킴기능과 만족감에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Gyu-Yong;Won, Young-Sik
    • The Journal of the Korea Contents Association
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    • v.17 no.4
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    • pp.63-71
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    • 2017
  • The purpose of current investigation was identified to the effects of swallowing training with surface electromyography biofeedback on swallowing function and dietary level, satisfaction in acute stroke patients with dysphagia. Sixteen acute stroke patients with dysphagia was participated in our study. All stroke paitents were allocated in randomly to experiemental group(n=8) and control group(n=8). Both group received traditional dysphagia therapy during 30min/day, five per week, for four weeks. experimental group was perfomed swallowing training with surface electromyography biofeedback, additionally 30 min/day, and control group received only swallowing training, additionally 30 min/day. Assessments evaluated Functional Dysphagia Scale(FDS) and Penetration-Aspiration Scale(PAS) for measure of swallowing function, and Functional Oral Intake Scale(FOIS) assessed for measure of dietary level. satisfaction assessed by using Visual Analog Satisfaction Scale(VASS). In results, after intervention both group improved significant on swallowing function, and dietary level, compared to before intervention(p<0.05). After intervention, satisfaction of both group was not significant difference(p>0.05). In comparison of change score between two group, experimental group improved significantly than control group in dietary level(p<0.05). Swallowing training with surface electromyography biofeedback may be a effective dysphagia therapy to improve on dietary level in acute stroke patients with dysphagia.

Voice Change Associated with Swallowing Disorder Caused by a Stroke After Neuromuscular Electrical Stimulation (뇌졸중으로 인한 삼킴장애 환자의 경부근육전기자극치료에 따른 음성 변화)

  • Byeon, Hae-Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.4
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    • pp.1665-1671
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    • 2012
  • The purpose of this study was to look into changes in voice using acoustic analysis during the process of neuromuscular electrical stimulation targeting dysphagia treatment. Fifteen man with dysphagia caused by stroke was treated neuromuscular electrical stimulation for two months and intensity of voice, $F_0$, Jitter, Shimmer, NNE were measured. The results of this study that improvement in functions of dysphagia and Jitter, Shimmer were stabilized. But there was not significantly changes of $F_0$. NNE was improved after the intervention, but still showed abnormal levels. This result suggests a possibility of effects that Neuromuscular electrical stimulation has on stabilization of Jitter, Shimmer and intensity of voice.

Effects of swallowing training of high viscosity bolus on swallow function based on videofluoroscopic swallowing examination in stroke patients with dysphagia (비디오 투시조영 검사를 통한 높은 점도의 음식 삼킴 훈련이 삼킴 장애가 있는 뇌졸중 환자의 삼킴 기능에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Hee-Jin;Seo, Jin-Young;Hong, Deok-Gi
    • The Journal of the Korea institute of electronic communication sciences
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    • v.11 no.9
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    • pp.909-916
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    • 2016
  • The purpose of this study is to investigate the effect of swallowing training of high viscosity bolus for swallow function of stroke patients with dysphagia. This study subjects, acute stroke 18 patients, which were recruited to receive treatment in inpatient at general hospital, located in Kyunggido. Subjects were randomly allocated in experimental group and control group. Experimental group performed swallowing training of high viscosity bolus, while control group conducted Traditional dysphagia therapy. Both groups received treatment 30 minutes a day five times a week for four weeks. The assessment was conducted FDS(: Functional Dysphagia Scale), PAS(: Penetration Aspiration Scale), ASHA NOMS(: American Speech-language-hearing Association National Outcomes Measurements System Swallowing Scale) to compare swallow function for both group. Both groups showed significant improvements after intervention in all measures(p<.05). Change score between the two groups showed a significant improvement on experimental group than control group in FDS(p<.05). Swallowing training of high viscosity bolus could have a positive impact on swallow function for acute stroke patients with dysphagia.

The Effects of Orofacial Exercises Program using Smart Phone on Swallowing Function and Tongue Strength in Acute Stroke Patients with Dysphagia (스마트폰을 사용한 구강안면 운동 프로그램이 삼킴장애가 있는 급성 뇌졸중 환자의 삼킴기능과 혀 근력에 미치는 효과)

  • Moon, Jong-Hoon;Won, Young-Sik
    • The Journal of the Korea institute of electronic communication sciences
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    • v.11 no.10
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    • pp.995-1002
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    • 2016
  • The aim of this study was investigated the effect of orofacial exercise program using smart phone on swallowing function and tongue strength in acute stroke patients with dysphagia. This study participated in sixteen acute stroke patients with dysphagia. All subjects allocated that randomized each eight patients in experimental and control groups. Subjects of both group received to conventional dysphagia therapy during 30 min/day, 5 times per week, for 4 weeks. Experimental group performed additionally that orofacial exercise program using smart phone, supervised under caregivers, during 30 min/day. The outcome measures were the IOPI(: Iowa Oral Performance Instrument), VR(: Vellecula Residue), PSR(: Pyriform Sinuses Residue), MIP(: Maximum Isometric Pressures). In results of study. Both group showed significant improvements after intervention in all assessments(p<.05). In comparison of change score between two groups, experimental group showed significant improvements than control group in PSR and MIP(p<.05). Orofacial exercise program using smart phone suggested that expected to positive effects the reduction of residue in pharynx and improvements of tongue strength in acute stroke patients with dysphagia.

Effects of Tongue Strength and Accuracy Training on Tongue Strength, Swallowing Function, and Quality of Life in Chronic Stroke Patients with Dysphagia (혀 근력 및 정확도 훈련이 삼킴장애가 있는 만성 뇌졸중 환자의 혀 근력, 삼킴기능, 삶의 질에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Hee-Jin;Kang, Min-Kyu;Won, Young-Sik
    • The Journal of the Korea Contents Association
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    • v.16 no.11
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    • pp.605-613
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    • 2016
  • This study was investigated to effect of tongue strength and accuracy training (TSAT) on tongue strength, swallowing function, quality of life in chronic stroke patients with dysphagia. Eighteen chronic stroke patients with dysphagia participated in this study, and were allocated randomly to experimental(n=9) and control group(n=9). both group conducted to traditional dysphagia therapy, and experimental group was carried out additionally TSAT. TSAT performed using Iowa Oral Performance Instrument(IOPI), and was set up to 50%, 75%, 100% of maximum isometric tongue strength. Two groups received the treatment for five per weeks, eight weeks. Outcome measurements performed that Maximum Isometric Strength(MIS) was assessed by using IOPI for measure the tongue strength, and Swallowing Function Test(SFT) was used to assess the swallowing function. Swallowing-Quality of Life(SWAL-QOL) was used to evaluate quality of life related to swallow. In results of study, experimental group in comparison of change score between two group significantly improve than control group in anterior and posterior MIS, and SFT. SWAL-QOL was not significantly difference in both group. Based on thin study results, TSAT may be a effective intervention to improve on tongue strength, and swallowing function in chronic stroke patients with dysphagia.

Characteristics of the Oropharyngeal Swallowing Impairment in Stroke Patient using the Modified Barium Swallowing Impairment Profile (MBSImP에 따른 뇌졸중 환자의 삼킴 장애 양상 분석)

  • Im, Ikjae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.36-44
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    • 2019
  • Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.

Comparison of Chin Tuck Against Resistance and Shaker Exercise on Suprahyoid and Sternocleidomastoid Muscle Activity in Stroke Older Patients with Dysphagia (삼킴 장애가 있는 뇌졸중 노인 환자에서 저항성 고개 숙이기 운동과 Shaker 운동의 목뿔위 및 목빗근 활성 비교)

  • Kim, Bon Yi;Lee, Seul;Moon, Jong Hoon;Won, Young Sik
    • 재활복지
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    • v.20 no.3
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    • pp.179-193
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    • 2016
  • Chin Tuck Against Resistance Exercise(CTARE) and Shaker exercise is used to common for strengthening of suprahyoid muscle. No previous studies was compare of two exercises for patients with dyaphagia. This study investigated the effects of CTARE and Shaker exercise on suprahyoid, sternocleidomastoid muscle activity in stroke older patients with dysphagia. Ten stroke patients with dyaphagia voluntarily participated in this study. All subjects was performed in the order in the CTARE (isometric, isokinetic), Shaker (isometric, isokinetic), and repeated each ten trials. After CTARE was performed, subjects took a 5 min wash out period to minimize muscle fatigue. Activity of suprahyoid and sternocleidomastoid muscle during two training was analyzed using surface electromyography(sEMG). Wilcoxon signed rank test was used to assess differecences for muscles activity between the effects of the CTAR and Shaker exercise within group. CTARE and Shaker exercise showed no significant difference activity in suprahyoid muscle(p > .05). CTARE showed significantly lower muscle activity in sternocleidomastoid muscle than Shaker exercise(p < .05). CTARE in stroke older patients with dysphagia may be a effective intervention to improve swallowing function than Shaker exercise.