• Title/Summary/Keyword: swallowing

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Effects of Proprioceptive Neuromuscular Facilitation Neck Flexion Exercise and the Shaker Exercise on the Activities of the Suprahyoid Muscles in Chronic Stroke Patients with Dysphagia

  • Hwangbo, Gak;Kim, Kyoung-Don
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.43-50
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    • 2018
  • PURPOSE: The purpose of this study is to examine the effect of proprioceptive neuromuscular facilitation (PNF) neck flexion exercise and the Shaker exercises on the activity of the suprahyoid muscles in chronic stroke patients with dysphagia and to show what exercise methods are effective for swallowing rehabilitation. METHODS: This study was conducted at F hospital in Daegu from August 2014 to February 2017 with 60 participants who understood the purpose of the study and desired to participate. The 60 participants were randomly divided into an experimental group (PNF neck flexion exercise) (n=30) and a control group (Shaker exercise) (n=30). PNF neck flexion exercise was performed in the experimental group and the Shaker exercise was performed in the control group for 30 minutes, 5 times a week for 6 weeks. The activity of the suprahyoid muscles was measured before and after treatment. RESULTS: Both the experimental group and the control group showed a statistically significant change in the activity of the suprahyoid muscles before and after the treatment. The changes were also statistically significant when compared by group. CONCLUSION: In conclusion, PNF neck flexion exercise should be used in addition to Shaker exercise when rehabilitating a patient with a swallowing disability.

Occupational Therapy in Hypoxic-Ischemic Brain Injury Patient by Suicidal Attempt: Case Report (자살시도로 인한 저산소성 허혈성 뇌손상 환자의 재활치료 - 인지 재활과 연하 재활을 중심으로: 사례연구)

  • Lee, Eui-Yun;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.7 no.1
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    • pp.11-26
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    • 2018
  • Objective : This case study was to verify effects of cognitive rehabilitation and swallowing rehabilitation on Hypoxic-Ischemic Brain Injury patient by Suicidal Attempt. Methods : The subject was a 32-year old Hypoxic-ischemic brain injury patient by suicidal attempt. He received treatment once a day five times a week, for a half an hour for each session from September 8th to December 16th, 2016. Treatment were cognitive and swallowing rehabilitation. He was assessed based on Mini-Mental State Examination-Korean (MMSE-K), Korean-Modified Barthel Index (K-MBI), Computerized Neurocognitive Function Test (CNT), Videofluoroscopic Dysphagia Scale (VDS), American Speech-Language-Hearing Association National Outcomes Measurements System (ASHA-NOMS). Results : The patient's total MMSE-K score increased from 25 to 27. His K-MBI score increased from 74 to 88. His memory, attention span, and executive function (DST, VST, SWCT, WCST) by CNT scores were improved. VDS score has no changes to 34, 44.5 and 34. ASHA-NOMS score also has no change to 6, 2 and 6. Conclusion : The study showed that the application of the treatment of cognitive and swallowing in hypoxic-ischemic brain injury patient by suicidal attempt results has positive effects on cognitive functions, and swallowing function.

Efficacy of Electroacupuncture with Dysphagia Caused by Stroke - Double-blind, Randomized Controlled Trial - (중풍으로 유발된 연하 장애 환자에 대한 전침 치료의 임상 효과)

  • Kim, Min-Kyung;Lu, Hsu-Yuan;Cho, Seung-Yeon;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Park, Seong-Uk
    • The Journal of Korean Medicine
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    • v.35 no.1
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    • pp.26-40
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    • 2014
  • Objectives: This study investigated the effect of electroacupuncture on swallow function in stroke patients with dysphagia. The purpose was to determine whether electroacupuncture could improve swallow function and quality of life for patients with dysphagia caused by stroke. A pilot double-blind, randomized controlled trial design was used Methods: A total of 17 stroke patients with dysphagia were recruited to this study, 8 assigned to the swallowing electroacupuncture (SE) group and 9 to the control group. Swallowing electroacupuncture was assessed for 5 Hz electrical or sham stimulation for 20 min duration 3 times a week. Outcome measurements were DOSS, 14-item questionnaire from the SWAL-QOL, NIHSS and MBI. Assessment was carried out for baseline, 2 weeks and 4 weeks Results: In the 2 weeks follow up data, the study group showed significant difference in DOSS and SWAL-QOL compared with the baseline. The study group also showed significant difference in DOSS and SWAL-QOL compared with the control group. Similarly in the 4 weeks follow up data, the study group showed improvement tendency in DOSS and SWAL-QOL compared with baseline and also with the control. The NIHSS and MBI scores returned no significant differences. The swallowing electroacupuncture was well tolerated in all cases with no serious adverse effects. Conclusions: The findings from the pilot study indicated that electroacupuncture has significant effects on improvement in swallowing function and quality of life. With both inpatients and outpatients, further larger and longer-term follow-up study is needed to confirm this suggestion.

Analysis of Voice and Swallowing Symptoms after Thyroidectomy in Patients without Recurrent Laryngeal Nerve Injury in Early Postoperative Period (반회후두신경 손상을 동반하지 않은 갑상선 절제술 환자에서 수술 초기의 음성 및 연하 기능의 변화에 대한 분석)

  • Kim, Heejin;Keum, Bo-Ram;Kim, Geun Hee;Jeon, Seung Sik;Kim, Hyejeen;Kim, Sung Kyun;Hong, Seok Jin;Hong, Seok-Min;Kim, Yong-Bok;Park, Il-Seok
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.108-113
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    • 2016
  • Background and Objectives : After thyroidectomy, many patients experience problems report such things as reduced voice range and vocal fatigue, swallowing problems without superior and recurrent laryngeal nerve injury. The purpose of this study was to evaluate voice and swallowing problems before and after thyroid surgery without laryngeal nerve injury. Materials and Methods : Ninety-three patients who underwent thyroidectomy without laryngeal nerve injury and completed the follow-up evaluations were studied between June 2013 and December 2015. Each evaluation was performed preoperatively, as well as 1 week, 1 month postoperatively. Analysis was performed including voice handicap index (VHI), dysphagia handicap index (DHI), and acoustic voice analysis. Results : Patients show significant variation of parameters in the fundamental frequency (F), maximal phonation time (MPT), shimmer, jitter and soft phonation index (SPI) early after operation, and most of them showed recovery of parameters after 1month of operation. Perceptive complaint of voice and swallowing also showed significant decreased after operation (p<0.005). After 1month of operation, MPT, highest frequency and frequency ranges still showed significant decreased parameters. Comparing acoustic and perceptive parameters of total thyroidectomy and lobectomy, there was no significant changes between them except highest frequency (p=0.042). Conclusion : The results from both subjective and objective evaluations show voice and swallowing disturbance after thyroidectomy even in the absence of laryngeal nerve and provide patients information about the recovery process after surgery. Highest frequency parameter showed most significant changes after operation.

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AN ELECTROMYOGRAGHIC STUDY OF MUSCULAR ACTIVITIES OF TONGUE AND LIP MUSCLES IN ANTERIOR OPEN-BITE (개방교합자의 설근과 구륜근 활성도에 관한 연구)

  • Choi, Yeon-Suk;Lee, Ki-Soo;Park, Young-Guk
    • The korean journal of orthodontics
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    • v.24 no.2
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    • pp.233-246
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    • 1994
  • The purpose of the present study was to investigate the difference of muscular activities of the tongue and lip muscles between anterior open-bite and normal occlusion during various function. Thirty eight subjects of 12.1-39.6 years were employed in this study : Eighteen subjects were anterior open-bites and tweenty subjects were normal occlusions. During rest position, maximum effort of lip sealing, command swallow of saliva and sucking & swallowing of juice, the electromyographic datas of the genioglossus, superior longitudinal muscle of tongue, upper and lower orbicularis oris were recorded and integrated with Medelec MS 25 electromyographic machine. Lateral cephalometric radiographs were taken on all subjects for the analysis of tongue posture and size. All data were recored and statistically processed. The findings of this study can be summerized as follows : 1. During the rest position, muscular activity of tongue was higher than that of lip muscle in open-bite, but no difference in normal occlusion group. 2. During the swallowing of juice, the activity of orbicularis oris was higher than that of genioglossus in open-bite. But the normal occusion was showed higher activity of tongue during the swallowing of juice. 3. The open-bite, compared to the normal occlusion, had higher value of tongue muscle activity during the rest position. 4. Compared to normal occlusion group, the open-bite had higher value of lip muscle activity during the sucking and swallowing of juice. 5. During the command swallow of saliva, the normal occlusion was showed harmonious swallowing pattern, but the open-bite showed much variation and disharmony in muscular contraction sequence, tended to absent of lip muscle activity. 6. At the lateral cephalometric radiographs, compared to the normal occlusion, the open-bite was showed lower tongue posture. But no difference was found in intermaxillary space. It is suggested that the open-bite, compared to the normal occlusion, had higher muscular activity of tongue during the rest position and various functions, showed lower tongue posture on the lateral cephalogram. In the development of anterior open-bite malocclusion, these factors may be an etiologic factor.

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The Importance of Video Fluoroscopy Swallowing Study for Nasogastric Tube Removal in Rehabilitation Patients (재활치료환자의 비위관(nasogastric tube)제거에 따른 비디오 투시연하검사(VFSS)의 중요성 평가)

  • Jung, Myoyoung;Choi, Namgil;Han, Jaebok;Song, Jongnam;Kim, Weonjin
    • Journal of the Korean Society of Radiology
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    • v.9 no.1
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    • pp.1-7
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    • 2015
  • Acute phase patients who are unconscious and are suffering from cerebral infarction, cranial nerve disorders, or cerebral apoplexy are susceptible to aspiration pneumonia due to dysphagia. In these cases, a nasogastric tube is inserted to supply nutrients. Although bedside screening tests are administered during recovery after rehabilitation, clinical examinations may not be able to ascertain asymptomatic aspiration. Therefore, a video fluoroscopy swallowing study (VFSS) was performed in 10 patients with dysphagia after rehabilitation therapy; these patients had nasogastric tubes inserted, and a rehabilitation specialist assessed the degree of swallowing based on the patients' diet and posture. If aspiration or swallowing difficulties were observed, dysphagia rehabilitation therapy was administered. The patients were reassessed approximately 30-50 days after administration of therapy, based on the patients' condition. If aspiration is not observed, the nasogastric tube was removed. A functional dysphagia scale was used to analyze the VFSS images, and the scores were statistically calculated. The mean score of patients with nasogastric tubes was $49.79{\pm}9.431$, thereby indicating aspiration risk, whereas the group without nasogastric tubes showed a mean score of $11.20{\pm}1.932$, which indicated low risk of aspiration. These results demonstrated that a significantly low score was associated with nasogastric tube removal. Mann-Whitney's test was performed to assess the significance of both the groups, and the results were statistically significant with a P value <0.001. In conclusion, VFSS can effectively assess the movements and structural abnormalities in the oral cavity, pharynx, and esophagus. It can also be used to determine the aspiration status and ascertain the appropriate diet or swallowing posture for the patient. Therefore, VFSS can potentially be used as a reliable standard test to assess swallowing in order to determine nasogastric tube removal.

Esophageal Pressure Monitoring in Normal Korean Adults (정상 한국성인의 식도내압 측정)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.462-469
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    • 1980
  • Here, I and wer report the results of our studying about; 1. The length of esophagus and sphincters; 2. Resting pressure of upper sphincter, upper esophagus, mid-esophagus, lower esophagus and lower sphincter; 3. Pressure changes in swallowing at these points of esophagus; 4. Resting and swallowing pressure curves in these points in 50 normal Korean adults. In addition to these we wbserved pressure inversion point, slow and fast components of phasic pressure which are originating from respiration and heart beat. And we studied transportation time and speed of peristalsis. The speed of peristalsis is faster in the lower esophagus than in the upper. I can probalby be proud in the results of these study because these will become a standard criteria in the further evaluation of esophageal functional disturbances in such lesions as; Achalasia, Hiatal hernia, Esophageal canceer, Scleroderma, diverticula.

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