• 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.

• The Journal of the Korean dental association
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• v.53 no.11
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• pp.789-794
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• 2015

Swallowing disorders or dysphagia, which are difficulties with the act of swallowing, can occur at different phases such as oral, pharyngeal, and esophageal phase in the swallowing process. These disorders can be caused by structural, functional abnormalities or psychological problems. Dentists can actively provide patients suffering from dysphagia with comprehensive professional care, especially from the cognitive stage of food to the pharyngeal stage of the swallow. Many cases of dysphagia can be improved with careful managements based on dental professionals' knowledge, including meticulous evaluation of masticatory and swallowing functions, training on eating and swallowing, and fabrication of palatal or lingual augmentation prosthesis. The important thing is that prevention of these disorders through the oral health care instruction and planned follow-up dental visit at periodic intervals in order to manage the problems caused by anatomical, functional, and psychological reason.

• Nutrition Research and Practice
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• v.16 no.3
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• pp.354-365
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• 2022

BACKGROUND/OBJECTIVES: Understanding the mechanism of chewing and swallowing food is important when creating a proper diet for older adults. This study investigated whether texture-modified model foods can reduce the difference in chewing and swallowing parameters between healthy community-living young and older adults. SUBJECTS/METHODS: In total, 35 older and 20 young adults (mean age: 75 and 25 years, respectively), matched for sex and number of teeth, were recruited and their unstimulated salivation and tongue pressure were measured. Simultaneous assessment of chewing and swallowing characteristics was conducted using surface electromyography and a videofluoroscopic swallowing study while the participants ingested 8 g of model food with one to four levels of hardness. RESULTS: The average tongue pressure and salivation among older adults were 61% and 49.7%, respectively, of the corresponding values observed in young adults. The older adult group used significantly (P < 0.05) increased muscle force with more chewing cycles (P < 0.05) than the young adult group, which was maintained even when consuming foods with the lowest hardness, although without chewing. However, the age effect on oral processing time existed only for the hardest foods. Swallowing difficulties among older adults were demonstrated by the significant increase in vallecula aggregation time. The total food intake duration was significantly (P < 0.05) longer in older adults than in young adults, regardless of food hardness. CONCLUSIONS: There were measurable differences in the process of chewing and swallowing food between young and older adults, which can be improved with food hardness control. Adjusting food hardness may help food intake in healthy older adults.

• Journal of Yeungnam Medical Science
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• v.40 no.1
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• pp.91-95
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• 2023

Psychogenic dysphagia is a deglutition disorder characterized by a fear of swallowing, with no structural or functional causes. This report presents the case of a young male patient who had severe malnutrition due to psychogenic dysphagia and was provided visual biofeedback using fiberoptic endoscopic evaluation of swallowing (FEES). A healthy 25-year-old man presented to our clinic with a complaint of throat discomfort when swallowing that had started 6 months prior. As the symptoms worsened, he became fearful of food spreading to his lungs after swallowing and the development of respiratory difficulties. His food intake gradually decreased, resulting in a weight loss of 20 kg within 2 months. Evaluation of organic and other functional causes of dysphagia was performed, but no abnormalities were detected. The sensation of a lump in his throat, fear of swallowing, and anxiety were transformed into somatic symptoms. The patient was diagnosed with psychogenic dysphagia. After visual biofeedback by a physician who performed FEES, the patient resumed eating normally and increased his food intake. If routine tests do not reveal structural or functional causes of dysphagia, assessment of a psychogenic swallowing disorder should be considered. FEES can help in the diagnosis and management of psychogenic dysphagia.

• 재활복지
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• v.22 no.4
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• pp.43-58
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• 2018

Swallowing disorders that can affect nutrient intakes and quality of life are commonly shown among the elderly as well as patients with neurogenic disorder. This study verifies the reliability and validity of the Swallowing Disturbance Questionnaire (SDQ), a subjective swallowing disability assessment tool, modified for Koreans' eating habit and cultural sentiment, against 105 stroke patients, in order to help identify early swallowing problems of the elderly. Reliability of internal consistency in the Korean version of SDQ is .601, test-retest reliability is .97, and concurrent validity is .956. Based on 8 points of cut-off score, 46.8% of sensitivity and 81.6% of specificity. Comparing the results of video fluoroscopic study (VFSS), an objective swallowing disorder test with those of Korean version of SDQ, negative predictive value (NPV) and positive predictive value (PPV) was shown as 81% and 53%. The Korean version of SDQ is expected to be a useful testing tool to discriminate swallowing disorders in stroke patients. It has great clinical significance in that swallowing difficulties shown by subjects can be sorted out to request a diagnostic assessment before clinical evaluation by a rehabilitation therapist or ruling out unnecessary exposure to additional tests by accurately identifying stroke patients without swallowing problems.

• The Korean Journal of Food And Nutrition
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• v.28 no.2
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• pp.189-195
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• 2015

Failure of the functions involved in ingestion leads to, not only loss of enjoyment of eating, but also protein-energy malnutrition. Dysmasesis and difficulty of swallowing occurs in various diseases, but aging is a major cause. In the aging society, the proportion of elderly people with dysmasesis and difficulty of swallowing is expected to increase rapidly. Developing foods for the elderly that are easy to chew and swallow is thus required. This study was conducted to develop easily chewable and swallowable foods for the elderly who can crush foods and ingest with their own tongues, but occasionally have difficulty in drinking fluids such as water and tea. Various foods for the elderly with chewing and swallowing difficulties were used for sensory assessment. The sensory panel consisted of 10 dietitians (10 women) in nursing care facilities. The sensory optimal composite recipes were determined by central composite design (CCD). The sensory measurements were significantly different in saltiness (p<0.05), sweetness (p<0.05), and overall quality (p<0.05). The optimum formulation of stir fried anchovy calculated by numerical and graphical methods was 3.74 g of soy sauces and 30.17 g of oligo-saccharides. Stir fried anchovy had a moisture content, hardness and adhesiveness of 76.52%, 2.10, and -1.57, respectively.

• 재활복지
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• v.21 no.2
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• pp.217-231
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• 2017

We have to consider two parts of the evaluation and treatment for the patients with head and neck burns. The primary consideration is swallowing function for nutrition supply for them and the next is speech function for efficient communication and aesthetic impression of them. The purpose of this study is to summarize the preliminary questions of Communication Screening Protocols which can help understand comprehensively on swallowing disorder, motor speech disorder and voice disorder of patients with head and neck burns. We divided the evaluation into 4 evaluation areas including 'oral mechanism', 'respiration/voice', 'articulation', and 'swallowing' by referring to overseas studies dealing with various communication disorders caused by burns, and prepared the final questionnaires by conducting the content validity verification by five expert (speech & language pathologist). The range of Content Validity Index was shown relatively appropriate with .50~.84. There was a conflict of opinions in experts whether the items in the areas of respiration/voice and swallowing may be appropriate, whereas there was no different view of the oral mechanism and articulation area. Through the different characteristics of communication difficulties of patients with head and neck burns, we expect it will be modified appropriately according to the patients through evaluation of burn patients by type and severity.

• The Korean Journal of Food And Nutrition
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• v.27 no.6
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• pp.1175-1181
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• 2014

This study was conducted to develop for the elderly food that is safe, well-shaped, and easy to chew and swallow, using gelification. Gelatin, which has low adhesiveness, thereby lowering the possibility of being swallowed wrongly into the respiratory track, was used as a viscosity agent for the gelification. Water and gelatin amounts were adjusted to facilitate breaking the food with the tongue. Various foods for the elderly with chewing and swallowing difficulties were used for sensory assessment. Sensory panel consisted of 10 dietitians (10 women) in nursing care facilities. The sensory optimal composite recipes were determined by central composite design (CCD). The sensory measurements were significantly different in appearance (p<0.05), saltiness (p<0.05), sweetness (p<0.01), and overall quality (p<0.05). The optimum formulation of the Korean barbecue beef calculated by numerical and graphical method was 3.71 g of sugar and 19.53 g of soy sauce. Moisture content, hardness and adhesiveness of the Korean barbecue beef were 78.85%, 2.40, -1.87, respectively. The result shows that food for the elderly, which is easy to chew and swallow, using gelification will have sufficient competitiveness in terms of safety, taste, and preference. The development of food for the elderly that take into account the difficulties in chewing and swallowing among the elderly, reflects their preference, and has sufficient nutrients, is important to enable the elderly to enjoy their meals. Also, as the Korean society is getting older, it remains one of the biggest social challenges.

• The Korean Journal of Food And Nutrition
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• v.29 no.4
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• pp.480-485
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• 2016

This study was conducted to develop food for the elderly, which is easier to chew and swallow, using gelification. Various foods for the elderly with chewing and swallowing difficulties were used for sensory assessment. The sensory panel consisted of 10 dieticians (10 women) working in nursing care facilities. The sensory optimal composite recipes were determined by the central composite design (CCD). The optimum formulation of hot pepper paste stir fried pork calculated by the numerical and graphical method was 1.48 g of sugar and 18.97 g of hot pepper paste. The optimum formulation of seasoned spinach was 8.0 g of sesame oil and 5.41 g of soy sauce. Moisture content, hardness, and adhesiveness of hot pepper paste stir fried pork was 76.49%, 2.50, and -1.20, respectively. Moisture content, hardness, and adhesiveness of seasoned spinach was 83.48%, 2.27, and -1.17, respectively. This study provides the basic materials for the development of easily chewable and swallowable foods for the elderly, which can reduce the risk of food going down the wrong pipe, and the preference can be improved by eating solid food instead of porridge or liquid food. The development of food for the elderly, which takes the difficulties in chewing and swallowing among the elderly into consideration and reflects their preference and has sufficient amount of nutrients, is important to enable the elderly to enjoy their meals and it is one of the biggest challenges in Korea, as Korean society is aging rapidly.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.136-138
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• 2019

Recently, negative pressure wound therapy (NPWT) has been reported to be effective for the treatment of cervical infections including retropharyngeal abscess. The 71-year-old woman with retropharyngeal abscess presented in this case showed improvement of infection through long-term NPWT. She continued to complain of swallowing difficulties after recovery. In this case, we performed the transcutaneous injection of botulinum toxin at the cricopharyngeus muscle for the patient who developed dysphagia after treatment for retropharyngeal abscess and observed improvement in swallowing.