• 제목/요약/키워드: swallowing disorder

검색결과 69건 처리시간 0.024초

바이오피드백 훈련이 삼킴장애가 있는 뇌졸중환자의 설골상근 근활성도에 미치는 영향 (Effects of Biofeedback Training on the Suprahyoid Muscle Activity of Stroke with Swallowing Disorder)

  • 신윤아;권혁철;이선민
    • 대한통합의학회지
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    • 제7권1호
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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.

뇌병변장애 환자의 개구 및 연하 촉진을 위한 K-point 자극법 (K-point stimulation: triggering the jaw opening reflex for brain-damaged patients)

  • 현홍근
    • 대한치과의사협회지
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    • 제56권8호
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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.

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Diagnosis and successful visual biofeedback therapy using fiberoptic endoscopic evaluation of swallowing in a young adult patient with psychogenic dysphagia: a case report

  • Youngmo Kim;Sang Hun Han;Yong Beom Shin;Jin A Yoon;Sang Hun Kim
    • 영남대 의대 학술지(영문지)
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    • 제40권1호
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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.

한국판 삼킴 곤란 척도(K-SDQ)의 번안본 검증 (The Verification of Korean Version Swallowing Disturbance Questionnaire (K-SDQ))

  • 정소운;김정완
    • 재활복지
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    • 제22권4호
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    • pp.43-58
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    • 2018
  • 영양 섭취와 일상생활 삶의 질에 영향을 미치는 삼킴장애는 신경장애 환자뿐만 아니라 정상 노년층에게서도 적지 않게 나타난다. 본 연구에서는 노인의 삼킴 문제를 조기 선별하여 진단 검사로 연결될 수 있도록 도움을 주기 위한 기초연구로서, 주관적 삼킴장애 평가도구인 삼킴곤란척도(Swallowing Disturbance Questionnaire, SDQ)를 한국인의 정서와 문화에 맞게 번안하여 신뢰도와 타당도를 검증하고, 뇌졸중 환자 105명을 대상으로 하여 그 유용성을 검증하였다. 연구 결과, 한국판 SDQ의 문항내적 일관성 신뢰도는 .601, 검사-재검사 신뢰도는 .97, 공인타당도는 .956이었고, 절단점 8점을 기준으로 민감도가 46.8%, 특이도가 81.6%인 것으로 나타났다. 객관적 삼킴장애 검사인 비디오투시조영검사와 한국판 SDQ 검사 상 관찰된 삼킴곤란 유무와의 비교 결과, 음성예측도(negative predictive value, NPV)는 81%, 양성예측도(positive predictive value, PPV)는 53%로 나타났다. 한국판 SDQ는 뇌졸중 환자들의 삼킴장애 유무를 변별하는데 유용한 검사도구로 활용될 수 있을 것으로 기대되며, 재활전문가에 의한 임상평가가 이루어지기 전에 대상자가 보이는 삼킴곤란을 미리 선별하여 진단검사를 의뢰하거나, 삼킴문제가 없는 뇌졸중 환자를 정확하게 선별하여 잉여적인 추가 검사 노출을 배제하는 차원에서 그 임상적 의의가 크다고 볼 수 있다.

정상 성인에서의 전기성문파형 검사 ; 연하장애 환자의 전기성문파형 검사를 위한 예비연구 (ELECTOROGLOTTOGRAPH IN NORMAL ADULT ; PRELIMINARY STUDY FOR ELECTROGLOTTOGRAPHIC STUDY OF SWALLOING DISORDER)

  • 김영빈;이주경;임대호;백진아;고승오;임익재;김현기;신효근
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권5호
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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.

기질적 섭식장애 (Pediatric Dysphagia)

  • 김민영
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제12권sup1호
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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.

Analysis of the Correlation between Activity of the Suprahyoid Muscles, Infrahyoid Muscles and the New VFSS Scale in Stroke Patients with Dysphagia

  • Lee, Hyun-Jin;Kim, Kyoung-Don
    • 대한물리의학회지
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    • 제13권4호
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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.

섭식연하장애와 치과적 관리 (Dental management of the patient difficulty in swallowing)

  • 현홍근
    • 대한치과의사협회지
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    • 제53권11호
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    • pp.789-794
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    • 2015
  • 섭식 연하장애는 수술이나 치료로 인한 기질적 원인, 뇌혈관장애나 뇌성마비, 근육이나 신경장애 등으로 인한 기능적 원인, 그리고 거식증이나 폭식증과 같은 심리적 원인에 의해 발생할 수 있다. 치과의원급에서는 주로 음식물의 인식장애 단계부터 인두로의 전달장애 단계까지의 환자에게 적극적으로 도움을 줄 수 있으며, 그 방법으로는 치의학적 전문지식을 바탕으로 환자의 섭식, 저작과정을 주의 깊게 관찰하여 문제점을 파악하여 각 단계에 적절한 기초 훈련과 섭식 훈련을 실시하는 것이며, 또한 필요시 혀 접촉 보조장치와 같은 장치를 제작하여 환자에게 장착시키고 섭식, 연하 훈련을 시행하여 환자의 연하능력을 개선시켜줄 수 있다. 하지만 무엇보다 가장 중요한 것은 환자가 식전과 식후에 엄격한 구강관리를 시행할 수 있도록 잘 지도하고, 치과의 정기적 방문과 전문적 관리를 통해 구강내 저작기관의 해부학적, 기능적 문제점을 해결해 주도록 하며, 이 때 마다 심리적으로도 환자가 섭식, 연하에 문제가 없도록 세심하게 설명하고 상담해 주는 것으로, 이는 모두 치과의사의 책무라고 할 수 있다.

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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보툴리눔독소를 이용한 후두전적출술후 식도발성장애 및 식도이완불능증의 치료 (Botulinum Toxin Injection for Postlaryngectomy esophageal speech failure and Achalasia)

  • 최홍식;문형진;한재욱;서진원;김광문
    • 대한기관식도과학회지
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    • 제3권2호
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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.

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