• Title/Summary/Keyword: Swallowing rehabilitation

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전기적 자극방식 삼킴 보조 치료기의 장비관리/안전진단 매뉴얼 개발 (Development of Device Management and Safety Diagnosis Manual for Electrical Stimulating Swallowing-Assist Equipments)

  • 허서윤;최봉근;이근민
    • 재활복지공학회논문지
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    • 제8권2호
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    • pp.79-88
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    • 2014
  • 국내에서 전기적 자극방식 삼킴 보조 치료기는 높은 보급률과 사용빈도를 가진 전문 의료기기임에도 불구하고 기기에 대한 관리체계가 전무하여 유지 보수의 측면에 있어서도 매우 큰 취약성을 노출해 왔다. 이에 본 연구는 전기적 자극방식 삼킴 보조 치료기의 장비관리 및 안전진단 매뉴얼 개발에 목적을 두고 프로그램을 개발하였다. 이를 위하여 국제전기기술위원회(International Electrotechnical Commission, IEC)등의 기관에서 공시한 표준화된 프로그램 수집과 문헌고찰을 통해 매뉴얼 개발의 근거를 마련하고, 프로토콜을 개발하여 제시하였다. 완성된 알고리즘과 프로토콜, 지표 등의 자료를 전문가 및 현장 실무자의 자문을 통하여 수정 및 보완하고 유지보수 워크시트(Maintenance Worksheet)의 5지표 18항목, 삼킴 보조 전자 의료기기 장비관리/안전진단 절차 매뉴얼(Equipment Procedure Manual)에서 4개 지표 32항목으로 구성된 점검 매뉴얼을 최종적으로 완성하였다. 완성된 지표는 장비의 고장률을 줄이고 의료기록 문서화의 체계성 제고에 도움을 줄 것이며, 의료서비스의 효율성, 적절성을 유지하는데 기여할 수 있을 것이라 생각된다.

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자발적 혀 저항 운동이 뇌졸중 환자의 삼킴기능에 미치는 효과: 사례연구 (Effects of a Tongue Self-Resistance Exercise on the Swallowing Function of Patients With Stroke: Case Report)

  • 남경완
    • 재활치료과학
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    • 제7권4호
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    • pp.43-55
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    • 2018
  • 목적: 본 연구는 뇌졸중 환자를 대상으로 자발적 혀 저항 운동을 적용하여 삼킴기능에 미치는 효과를 알아보았다. 연구방법: 본 연구는 2012년 9월 3주간, 2014년 2월 3주간 각각 2명의 환자를 대상으로 하는 사례연구였다. VFSS검사 이후 환자의 동의를 받고 매일 1회기씩 주 5회로, 3주 동안 진행하였다. 자발적 혀 저항운동은 혀 내밀기, 혀 옆으로 밀기, 혀로 입천장 밀기로 구성하였다. 중재는 한 회기 당 각각 운동별로 10회를 1세트로 총 3세트를 진행하였다. 결과: 자발적 혀 저항 운동 프로그램은 삼킴 장애 정도에서 VFS점수가 하강한 것으로 보아 삼킴 기능이 향상되었다. 둘째 자발적 혀 저항 운동 프로그램은 FOIS점수가 향상된 것을 바탕으로 구강섭취능력이 향상되었다. 결론: 삼킴 장애가 있는 뇌졸중 환자에게 환자 스스로 저항을 적용하는 자발적 혀 저항운동을 제공하였을 때 이들의 삼킴 기능 향상에 긍정적인 영향을 미칠 수 있다.

Effect of Neuromuscular Electrical Stimulation Combined with Traditional Dysphagia Rehabilitation on Masseter Muscle Thickness and Bite Force in Stroke with Dysphagia Patient

  • Lee, Myunglyeol;Lee, Kuija;Kim, Jinuk
    • 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.

일본 연하장애 어린이의 치과적 접근 (DENTAL APPROACHES OF CHILDREN WITH DYSPHAGIA IN JAPAN)

  • 양연미
    • 대한장애인치과학회지
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    • 제9권1호
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    • pp.56-65
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    • 2013
  • I participated in Academic Exchange Program(Action plan II) between KADH(Korean Association for Disability and Oral Health) and JSDH(Japanses Society for Disability and Oral Health) for 2 months from 3rd July 2012 to 2nd september 2012 in the Department of Hygiene and Oral Health, School of Dentistry, Showa University at Tokyo, Japan. I have observed their operation process and learned what dysphagia is and how it is consulted and taken care of as a therapy for patients with eating and swallowing disorders for two months in The department of special needs dentistry at Showa University Dental Hospital, Jonan Branch of Tokyo Metropolitan Kita Medical Rehabilitation Center for the Disabled, Smile Nakano Center, Tokyo metropolitan center for persons with disabilities in Lidabashi for one week, Eating and swallowing functional therapy workshop for disabled children, Tokyo metropolitan Tobu medical center for Persons with Developmental/Multiple Disabilities located in Minamisunamitchi for one week and on The 17-18th JSDR(Japanese Society of Dysphagia rehabilitation) in Sapporo. Through Action Plan II program, I learned how precious eating, drinking and swallowing with ease are and observed how they do and what they do as a dentist or a dental hygienist in Japan for dysphagia patients. Therefore, I want to present the dental approaches of children with dysphagia in Japan, based on my experience for two months.

The Effect of Kinesiology Taping on Suprahyoid Muscles Activity in Community-Dwelling Elderly People

  • Kim, Heejeong;Choi, Heesu;Kown, Yonghwa
    • 국제물리치료학회지
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    • 제12권2호
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    • pp.2338-2344
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    • 2021
  • Background: The therapeutic exercise method using kinesiology taping (KT) has been reported to be effective in activating the suprahyoid muscle in healthy adults. However, its applicability and effectiveness are not known to the physically vulnerable elderly. Objectives: To investigate the effects of kinesiology taping on the activity of suprahyoid muscles in community-dwelling elderly people. Design: Repeated measure design. Methods: We enrolled 23 healthy elderly adults (age range 60-75 years) with no history of neurologic disease. Participants performed five consecutive spontaneous swallowing actions at 5-second intervals under three conditions (KT with 80% stretch, placebo-KT, and non-KT. Activation of the suprahyoid muscles during swallowing in the three conditions was measured using surface electromyography (sEMG). In addition, a 0-10 numerical rating self-report scale was used to evaluate the required effort and the resistance felt during swallowing. Results: KT with 80% stretch were significantly higher in sEMG mean value, peak value, required effort, and resistance felt during swallowing compared to other two conditions (P<.05, all). KT with 80% stretch required the most effort during swallowing and, consequently, has a positive effect on increasing suprahyoid muscle activation. Conclusion: Our results could be taken into consideration in therapeutic exercise method for suprahyoid muscle in dysphagia rehabilitation.

비디오투시연하검사 스크리닝을 위한 근적외선 기술 조사 (Investigation of Near Infrared Radiation Based Screening for Video-Fluoroscopy Swallowing Studies)

  • 박지수;정영진
    • 대한방사선기술학회지:방사선기술과학
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    • 제44권1호
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    • pp.9-14
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    • 2021
  • With the recent advances in radiological science, there was radiographic techniques development and several researches to diagnosing dysphagia. We proposed the new Imaging technology based on Near Infrared radiation (NIR) for video fluoroscopic swallowing study (VFSS). To reduce the risk of the VFSS examination for swallowing rehabilitation, multi-NIR camera system comprised. Based on the multi-NIR camera imaging system, Computational simulation was conducted to identify the potential of the multi-NIR camera imaging system as a clinical tool (screening system). As a result of the simulation applied in this study, the proposed system has a potential to be a clinical solution although there is a few of limitations. we believe that it will be a good tool to support the VFSS as a screening technology in clinical fields.

섭식훈련이 연하치료를 받는 뇌졸중 환자의 삼킴기능에 미치는 영향 (The Effects of Eating Training on Patients with Swallowing Disorder Caused by Stroke to Their Swallowing Functions)

  • 안태규;이동훈;김보라
    • 대한통합의학회지
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    • 제1권4호
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    • pp.1-8
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    • 2013
  • Purpose : This study was conducted for the purpose of finding out of effects Eating training on patients with swallowing disorder caused by stroke to their swallowing functions. Method : 29 subjects were selected and the divided into two groups. Group 1 is consist of 14 patients under eating training group and Group 2 is consist of 15 patients each group has five times per week. 30 minuted per time covering 12-week period. Selected patients can swallow them selves without aspiration and basically eating trainings involve Thermal Tactile Stimulation(TTS), Shaker exercise, tongue movements, laryngeal mobilization exercise. MASA(The Mann Assessment of Swallowing Ability)and VFSS(Videofluoroscopic Swallowing Study) was carried out to find out effects of training. And We use FDS(Functional Dysphagia Scale) for VFSS to more objective score. Result : Through the results of this study was increase in Eating performance skill actual eating training group than the practiceless group. Therefore, the actual eating training is to improve the swallowing function and It will be useful in clinical intervention for stroke patients. Conclusion : Through the results of this study was increase in Eating performance skill actual eating training group than the practice less group. Therefore, the actual eating training is to improve the swallowing function and It will be useful in clinical intervention for stroke patients.

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

  • 공광식;나수영
    • 대한임상전기생리학회지
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    • 제11권1호
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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.

Clinical Importance of Peak Cough Flow in Dysphagia Evaluation of Patients Diagnosed With Ischemic Stroke

  • Min, Sang Won;Oh, Se Hyun;Kim, Ghi Chan;Sim, Young Joo;Kim, Dong Kyu;Jeong, Ho Joong
    • Annals of Rehabilitation Medicine
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    • 제42권6호
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    • pp.798-803
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    • 2018
  • Objective To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke. Methods This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups. Results The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups. Conclusion Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.