• Journal of The Korean Society of Integrative Medicine
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• v.7 no.1
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• pp.27-36
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• 2019

Purpose : The purpose of this study figures out how the biofeedback exercise combined with a Shaker exercise and a jaw-opening exercise affects the suprahyoid muscle activation of stroke with a swallowing disorder. Methods : The study period was from June, 2018 to September, 2018, to 45 patients who were suitable for selection criteria. Participants were divided into three groups: a visuoauditory biofeedback group (VABG), and a visual biofeedback group (VBG), and a self-exercise group (SG). The three groups were divided into the Shaker exercise and the jaw-opening exercise, and the biofeedback training by themselves. Three groups performed an intervention three times a day, five times a week, and four weeks long. Also, suprahyoid muscle activity was measured with a pre-test, a post-test and a follow-up test. Results : To know the suprahyoid muscle activity after the intervention, there were statistically significant differences between the pre-test and the post-intervention (p< .01). All three groups showed the improvement with the mean comparing followed by VABG, VBG and SG. Comparing between the post- test and the follow-up test, all three groups showed the reduction of suprahyoid muscle activity with the mean comparing, followed VABG, VBG and SG. Conclusion : It found that it was more effective when providing a double-sensory biofeedback than when training with a single-sensory biofeedback. Therefore, it is necessary to provide a multi-sensory input when applying the biofeedback in rehabilitation of the swallowing disorder.

• The Journal of the Korean dental association
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• v.56 no.8
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• pp.437-442
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• 2018

Patients with a wide range of cerebrovascular disease may have difficulty in opening their mouths, resulting in failing to swallow foods and maintain their oral hygiene. K-point was introduced as an effective trigger point to stimulate the jaw opening reflex for those patients. K-point stimulation may be useful as one of methods of helping open the jaw for dental examinations, or for placing foods onto the dorsum of the tongue and swallowing them effectively. Although this method cannot always guarantee the success of the jaw opening for every patient, it may still be considered to be an effective one to apply to patients having difficulty in jaw opening and swallowing disorder.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.437-446
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• 2008

Electroglottography (EGG) is a simple and non-invasive technique for analyzing the vibratory patterns of the vocal folds by detecting impedance changes across the larynx. An abnormal electroglottogram is shown in patients who have a dysphagia associated with neuromuscular disorder. Electroglottography offers reliable informations for diagnosis of swallowing disorder and gives quantitative datas. The purpose of this study is to provide the normal value of electroglottography in normal adults. We took electroglottograms of 80 adults who have no problem in swallowing and utterance. EGG data were analyzed to find out the value of Pitch, Jitter and Closed quotient with a commercially available software. There were significant differences between a usual voice and loud voice in 3 measures on the EGG signalmean pitch, Avg. jitter, mean quotient. To get a proper electroglottography, phonation of a usual voice was better than a loud voice. Four measurements- S.D pitch, Avg. Jitter, Mean closed quotient, S.D closed quotient- were independent of sex for adult. Three measurements- Mean pitch, S.D pitch, Mean closed quotient - were independent of age for adult aged twenties to fifties. The Avg. Jitter of twenties appeared to be lower than those of forties and fifties. The S.D closed quotient of twenties appeared to be lower than those of thirties, forties and fifties.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.sup1
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• pp.77-84
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• 2009

Pediatric dysphagia comes from disturbances in swallowing process, which has 'preparatory phase', 'oral phase', 'pharyngeal phase', and 'esophageal phase', and mainly the causes are neuro-muscular discoor-dination. It is necessary to recognize clinical manifestation if they have accompanied organic disorder and diagnose accurately. Videofluoroscopic study evaluation is a valuable method to find out abnormal swallowing mechanism at each phases. Treatment should be diagnosis specific, and multidisciplinary team approach is desirable. We can use various behavioral techniques to facilitate normal swallowing mechanism including conditioning of oral and pharyngeal structures, bolus manipulation, postural compensation, and adaptive feeding utensils. Important point is that the diagnosis and treatment for pediatric dysphagia should not be delayed because children are under development.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.19-25
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• 2018

PURPOSE: This study was conducted to investigate the correlation between the activity of suprahyoid muscles, infrahyoid muscles and swallowing ability in stroke patients with dysphagia. METHODS: The subjects of this study were 120 patients who were diagnosed with CT or MRI stroke and had swallowing disorder at Daegu Metropolitan General Hospital from August 2014 to February 2017. The suprahyoid and infrahyoid muscle activity was measured in patients with dysphagia and the new videofluoroscopy swallowing studies scale (new VFSS scale) was used for evaluation of swallowing function. Correlation analysis was conducted using the measured data. RESULTS: The activities of suprahyoid muscles were 325.8 (%RVC) on average, while the average infrahyoid muscle activity was 302.65 (%RVC) and the average value of the new VFSS scale was 31.52. The total for oral organs was 3.62 on average and that for pharynx organs was 28.30 on average. The activity of the suprahyoid muscles showed a significant positive correlation with the activity of the infrahyoid muscles, but a significant negative correlation with the total oral phase, total pharyngeal phase and total new VFSS scale (p<.01). The activity of the infrahyoid muscles showed a significant negative correlation with the total oral phase, total pharyngeal phase, and total new VFSS (p<.01). CONCLUSION: Based on the results of this study, it is necessary for researchers to consider the infrahyoid and suprahyoid muscles when conducting swallowing rehabilitation.

• 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.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.8 no.2
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• pp.79-88
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• 2014

In Republic of Korea, there are considerable vulnerability in electrical stimulating swallowing-assist equipments even though they are professional medical equipments and have high penetration rate with heavy frequency of use. Therefore, in this article, we developed Device Management and Safety Diagnosis Manual for Electrical Stimulating Swallowing-Assist Equipments system. For achieving this, we collected and analysed international standard data from international organizations like International Electrotechnical Commission(IEC). After literature reviews, we build maintenance worksheet and equipment procedure manual for electrical stimulating swallowing-assist equipments according to evidences we collected. These manual and protocol would be used as standard process and contribute to sustain accuracy, effectiveness of the devices, also decrease failure rate and assist to save medical documents.

• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.302-306
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• 1997

Persistent pharygoesophageal spasm has been demonstrated to be responsible for poor speech rehabilitation after laryngectomy Management of these patients has included bougienage and pharyngeal neurectomy. Achalasia is a disorder of swallowing in which the lower esophageal sphincter fails to relax. Botulinum toxin injection of the upper esophageal sphincter or lower esophageal sphincter has been successfully used diagnostically and therapeutically for esophageal speech failure or achalasia. So, we report the use of botulinum toxin, a paralytic agent, for the treatment of these conditions.