• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.75-83
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• 2022

PURPOSE: This study was conducted to find out the effects of neurocognitive rehabilitation therapy on the swallowing function and quality of life of stroke patients. METHODS: Thirty patients were selected and randomly allocated into an experimental and a control group. Patients in the experimental group received 15 minutes of neurocognitive rehabilitation treatment combined with 15 minutes of traditional treatment. For the control group, patients received 30 minutes of traditional dysphasia treatment. The experiments were conducted for 30 minutes a day, five times a week, for four weeks. New VFSS and SWAL-QOL were administrated to evaluate the outcomes. RESULTS: Swallowing functions were significantly improved in the experimental group and the control group (p < .05), but there was no statistically significant difference in pre- and post-interventional swallowing between the groups (p > .05). The quality of life was also significantly improved (p < .05) for both groups, but there was a statistically significant difference between the two groups (p > .05). Third, a correlational analysis between swallowing function and quality of life revealed a moderate correlation between New VFSS and SWAL-QOL (p < .05). CONCLUSION: The results of this study suggest that swallowing therapy through neurocognitive rehabilitation treatment program could be helpful for improving swallowing function and quality of life in stroke patients. Although there was no statistically significant changes from traditional rehabilitation therapy, training in recognizing the senses in the oral cavity and external environment through neurocognitive rehabilitation therapy can be applied as one of the treatment options.

• Journal of Korean Public Health Nursing
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• v.28 no.3
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• pp.605-618
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• 2014

Purpose: The purpose of this study was to examine the effect of a swallowing rehabilitation program for elderly on the stage of dysphagia, nutritional status, and swallowing-quality of life. Methods: The research design was Pretest-Posttest Nonequivalent Groups Design. The subjects of this study consisted of 85 elderly patients hospitalized at geriatric hospitals between August 23rd and October 25th in 2012. Eighty five research subjects were assigned to experimental (42 patients) and control (43 patients) groups. The rehabilitation program was provided to the experimental group 5 days per week for 8 weeks. The effects were evaluated by measurement of Mid-upper Arm Muscle Circumference (MAMC), Total Lymphocyte Counts, albumin, Total Cholesterol, and Swallowing Quality of Life (SWAL-QOL). The collected data were analyzed with x2-test and independent t-test using PASW WIN 18.0. Results: Changes in the stage of dysphagia were not significant (p>.05). In nutrition status, the degree of MAMC points in the experimental group was significantly increased compared with that in the control group (t=2.36, p=.021). In swallowing quality of life, the score of SWAL-QOL in the experimental group was significantly increased, particularly burden (t=3.34, p=.002), frequency (t=2.68, p=.011), fear (t=2.44, p=.019), mental health (t=2.47, p=.018), and sleep (t=2.08, p=.044). Conclusion: Based on the results, this swallowing rehabilitation program for elderly would be helpful in promoting their nutritional status and swallowing-QOL in geriatric hospitals.

• 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.

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.42-49
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• 2002

Backgroud and Objectives : Supracricoid partial laryngectomy(SCPL) has showed good functional and oncological results since it was introduced by Laccourreye in 1990. But loss of laryngeal functions, especially glottic sphincteric one, due to a wide resection of laryngeal structures is a major problem and needs a active and effective rehabilitation postperatively. Modified barium swallow(MBS) is a videofluoroscopy designed to define the etiology of the aspiration or dysphagia and simultaneously provide the therapeutic and rehabilitative method eliminating etiology of the aspiration. And we examined the effectiveness of the MBS in swallowing rehabilitation of the SCPL Patients. Materials and Methods : We reviewed the medical records of the 52 Patients who received SCPL for laryngeal squamous cell carcinoma according to the description of Laccourreye in our clinic from 1993 to 2001. Among them 21 patients were performed MBS(MBS(+) group) postoperatively and remaining 31 were not(MBS(-) group). During MBS, we selected 12 patients who showed aspiration and trained them with a swallowing rehabilitation maneuver which was identified as the most effective one eliminating the aspiration and remaining nine without aspiration were able to feed orally immediately after MBS without rehabilitation. In MBS(-) Uoup, they were received the traditional rehabilitation training with a supraglottic swallow. Results : The mean postoperative day(POD) of decannulation was earlier in MBS(+) group ($12.6{\pm}4.7$ POD) than in MBS(-) group ($19.5{\pm}11.0$ POD) (p =0.012), especially in patients showing aspiration (MBS(+) ; $12.9{\pm}5.2$ POD, MBS(-) : $22.3{\pm}9.9$ POD (p =0.008)). No significant difference was found in the mean POD of oral feeding between MBS(+) and (-) group, but in patients showing aspiration the time of oral feeding was earlier in MBS(+) group than in MBS(-) by average 10 days though it was not statistically significant. The incidence of aspiration pneumonia was lower in MBS(+) group (1/12cases) than in MBS(-) (7/12cases). Conclusions : In SCPL Patients, the Swallowing rehabilitation introduced to eliminate the aspiration during MBS after SCPL is very helpful for some patients to resume the safe oral intake more rapidly.

• Journal of Korean Physical Therapy Science
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• v.26 no.2
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• pp.13-23
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• 2019

Background: The purpose of this study was to provide the basis for the treatment intervention by identifying the treatment effect when rehabilitation intervention is applied to patients with dysphagia due to stroke and by comparing the results of the treatment mediation according to the differences of the treatment methods and frequency. Design: Randomized Controlled Trial. Methods: 30 people diagnosed with dysphagia due to stroke were divided in accordance with the differences in treatment mediation techniques and treatment frequency- traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group and only neuromuscular electrical stimulation group/ 5 times per week group and 2 times per week group, and ten weeks of treatment intervention was performed. Paired t test was employed to show the efficacy of treatment intervention, Independent sample t test was used to compare the results according to difference and number of treatment intervention techniques. Results: There was a significant positive effect of treatment on traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group, only neuromuscular electrical stimulation group, 5 times per week group and 2 times per week group (p<0.05). There was no statistically significant difference in treatment effect between traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group and only neuromuscular electrical stimulation group (p<0.05). There was no statistically significant difference in treatment effect between 5 times per week group and 2 times per week group (p<0.05). Conclusion: There was no significant difference according to the technique or number of treatments of swallowing rehabilitation treatment interventions, but it was confirmed that rehabilitation intervention for dysphagia showed positive treatment effect.

• 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 The Korean Society of Integrative Medicine
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• v.5 no.4
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• pp.31-39
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• 2017

Purpose : The purpose of this study was to examine the effects of short neck flexor strengthening in proprioceptive neuromuscular facilitation and neuromuscular electrical stimulation on swallowing function in patients with chronic stroke and to provide basic data for swallowing rehabilitation in stroke patients. Method : The study involved 30 chronic stroke patients who visited ${\bigcirc}{\bigcirc}$ General Hospital in Daegu Metropolitan City between March and July, 2017. The subjects were randomly assigned to either an experimental group (n=15) or a control group (n=15). Both groups underwent traditional swallowing rehabilitation therapy for 30 minutes five times a week over a six-week period. The experimental group performed short neck flexor exercises, which are part of the proprioceptive neuromuscular facilitation, for 30 minutes three times a week over a six-week period. The control group performed neuromuscular electrical stimulation for 30 minutes three times a week over a six-week period. Based on its results, changes in the patients' swallowing function and degree of food intake were analyzed. Result : In terms of the ASHA NOMS scale and new VFSS scale, the experimental group and the control group showed statistically significant changes in ten sub-items and six sub-items, respectively. Statistically significant differences in one sub-item were found between the groups. Conclusion : PNF-based short neck flexion exercise appear to be effective at improving swallowing function of stroke patients with dysphagia.

• Journal of Biomedical Engineering Research
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• v.30 no.1
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• pp.41-48
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• 2009

In this paper, we present the diagnosis system for swallowing disorder. There are some types of diagnosis device for swallowing disorder, for example, the video fluoroscopy, the nuclear medicine inspection, the endoscopy, EMG and motion analysis. But these systems need heavy devices or have dangerous nuclear exposure, so are uncomfortable for handicapped person. Our system has advantages of simplicity, accuracy and quantitative analysis. In addition to the diagnosis aspect, this system can be used to biofeedback treatment.

• 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 Korean Medicine Rehabilitation
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• v.18 no.1
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• pp.111-123
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• 2008

Objectives : The objective of this study was to investigate the outcomes of functional electrical stimulation (FES) which was applied twice a day in patients with dysphagia after stroke. Methods : Eleven patients with dysphagia after stroke were participated. The electrical stimulator with two channels was employed for forty minutes daily or forty minutes twice a day for fifteen days. Participants were divided into two groups by random method; The FES was performed twice a day for Twice-FES group (n=6), and once a day for Standard-FES group (n=5). For evaluation of dysphagia, the functional dysphagia scale by videofluoroscopic swallowing study, and swallow function scoring system by six clinical swallowing stage were assessed at pre- and post-treatment. Results : In both groups, there was a significant decrease of total functional dysphagia scales after FES treatment (p<0.05) and the results mainly affected the pharyngeal phase of deglutition. There was no significant difference between the two groups in total functional dysphagia scales, but the Twice-FES group had a decreased residue in oral cavity compared to the standard FES group. In both groups, there were significant improvements in swallow function scoring system (p<0.05). The twice-FES group had more high clinical swallowing stages. Conclusions : The results demonstrated that FES is a clinically effective intervention in treatment of stroke patients with dysphagia. Moreover, the treatment applied twice a day had relatively positive effects on the reduction of oral cavity residue and the improvement of clinical swallowing stage.