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김새현,오병모,한태련,정호중,심영주 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.4
Objective To identify the differences in the movement of the hyoid bone and the vocal cord with and without electrical stimulation in normal subjects.Methods Two-dimensional motion analysis using a videofluoroscopic swallowing study with and without electrical stimulation was performed. Surface electrical stimulation was applied during swallowing using electrodes placed at three different locations on each subject. All subjects were analyzed three times using the following electrode placements: with one pair of electrodes on the suprahyoid muscles and a second pair on the infrahyoid muscles (SI); with placement of the electrode pairs on only the infrahyoid muscles (IO); and with the electrode pairs placed vertically on the suprahyoid and infrahyoid muscles (SIV).Results The main outcomes of this study demonstrated an initial downward displacement as well as different movements of the hyoid bone with the three electrode placements used for electrical stimulation. The initial positions of the hyoid bone with the SI and IO placements resulted in an inferior and anterior displaced position. During swallowing, the hyoid bone moved in a more superior and less anterior direction, resulting in almost the same peak position compared with no electrical stimulation.Conclusion These results demonstrate that electrical stimulation caused an initial depression of the hyoid bone, which had nearly the same peak position during swallowing. Electrical stimulation during swallowing was not dependent on the position of the electrode on the neck, such as on the infrahyoid or on both the suprahyoid and infrahyoid muscles.
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Kinematic Analysis of Hyo-laryngeal Complex in Parkinson’s Disease
김상준,권정이,한태련 대한연하장애학회 2013 대한연하장애학회지 Vol.3 No.2
Objective: To find the swallowing characteristics in patients with Parkinson’s disease through the movement analysis of the hyo-laryngeal structures. Method: Thirteen patients who had been diagnosed as Parkinson’s disease and underwent videofluoroscopic swallowing study (VFSS) from January 2006 to December 2008 were selected in our study. Thirty five normal volunteers without any sign of neurological compromise or swallowing problem were recruited for control group. The functional dysphagia scale and the Dysphagia Outcome and Severity Scales (DOSS) were used for the evaluation of dysphagia severity. Maximal anterior and superior displacements of the hyoid (MADH and MSDH), and those of the larynx (MADL and MSDL) were acquired through the kinematic analysis using the Ariel Performance Analysis System. Result: MADH was 9.3 mm in Parkinson group, which was significantly less than that in the control group (P=0.003). Other parameters, MSDH, MADL, and MSDL were not significantly different from those in the control group. MADH was significantly correlated with disease duration (ρ=0.649, P=0.016). However other kinematic parameters did not show any correlation with disease duration. Current diet status in Parkinson group did not affect the kinematic data in Kruskal-Wallis test (P=0.144 in MADH, P=0.188 in MSDH, P=0.255 in MADS, and P=0.378 in MSDS). Conclusion: We found that anterior displacement of the hyoid decreased in Parkinson’s disease and this had correlation with the disease duration. Effort to increase the anterior displacement of the hyoid can be made to improve the dysphagia in Parkinson’s disease.
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