Comparison of Activities of Submental, Infrahyoid, and Sternocleidomastoid Muscles During Modified Chin Tuck Against Resistance Exercise and Chin Tuck Against Resistance Exercise

원영식,문종훈 한국지식정보기술학회 2021 한국지식정보기술학회 논문지 Vol.16 No.2

The chin tuck against resistance exercise (CTARE) is a treatment technique that strengthens the submental muscles and improves swallowing function. In addition, previous studies were reported that the jaw opening exercise also improved swallowing function. Accordingly, the authors devised a new exercise technique that combines the two previous exercises. This study aimed to compare the activities of the submental, the infrahyoid, and the sternocleidomastoid muscles between the chin tuck against resistance exercise (CTARE) and the modified CTARE. Twenty healthy adults participated and performed both exercises five times randomly for 10 seconds each and an isometric exercise at 1-minute intervals. There was a 5-minute break between each exercise. The mean and peak values were analyzed. The surface electromyography was used to measure the activities of the submental, the infrahyoid, and the sternocleidomastoid muscles during the two exercises. Results showed that the modified CTARE induced higher the mean and peak activity of the submental muscles than the CTARE (p<0.05), while there was no significant difference in activities of the infrahyoid and the sternocleidomastoid muscles (p>0.05). These findings suggest that modified CTARE may be effective for improving the submental muscles strengthening. A patient study is needed to closely verify the effectiveness of the modified CTARE.

PNF 구강안면 운동 프로그램이 마비말장애가 있는 아급성 뇌졸중 환자의 교대운동속도와 연속운동속도에 미치는 효과

원영식,이순현,김계호,문종훈 대한고유수용성신경근촉진법학회 2018 PNF and Movement Vol.16 No.3

Purpose: The aim of the present study was to investigate the effect of a PNF orofacial exercise program on diadochokinesis in subacute stroke patients with dysarthria. Methods: Thirteen subacute stroke inpatients with dysarthria were recruited for the study. All participants were randomly assigned to two groups: an experimental group (n=7) and a control group (n=6). The experimental group performed a PNF orofacial exercise program, and the control group carried out an orofacial self-exercise. Both groups received the treatments 30 minutes per day, 5 days per week, for 4 weeks. The outcome measures were assessed before and after the intervention, including an alternating motion rate (AMR) and sequential motion rate for diadochokinesis. Results: After the intervention, both groups showed significant improvement in diadochokinesis (p<0.05). In the change values for both groups, the experimental group showed a more significant improvement than the control group did in /pə/ of AMR (p<0.05). Conclusion: These findings suggest that PNF orofacial exercise programs may have positive effects on the improvement of diadochokinesis in subacute stroke patients with dysarthria.

The Immediate Effect of Olfactory Stimulation Using Black Pepper Oil Combined with Sour-bolus Solution on Suprahyoid Muscle Activation in Stroke Patients with Dysphagia

원영식,문종훈 한국지식정보기술학회 2020 한국지식정보기술학회 논문지 Vol.15 No.2

The aim of this study was to investigate the immediate effect of olfactory stimulation using black pepper oil (BPO) combined with sour bolus solution on suprahyoid muscle activation in stroke patients with dysphagia. Twelve stroke patients with dysphagia participated in this study. For all subjects, the suprahyoid muscle activation was measured using surface electromyography (sEMG) during swallowing of four types. Prior to measurement, one of the following four stimulations were applied: odorless+distilled water (ODW), odorless+sour bolus (OSB), black pepper oil+distilled water (BPODW), black pepper oil+sour bolus (BPOSB). The order of swallowing of four types was random, and the subjects swallowed three times for each sensory stimulation, with a rest period of 5 min after finishing each sensory stimulation. Repeated measure ANOVA was used to calculate the mean and maximum values of suprahyoid muscle activation with four sensory stimulations from sEMG. while OSB and BPOSB had a significant effect on mean and maximum values of suprahyoid muscle activation, ODW and BPODW did not have a significant effect (p<.05). The olfactory stimulation using BPO combined with sour bolus solution or sensory stimulation using sour bolus solution may have a positive effect the improvement of suprahyoid muscle strength in stroke patients with dysphagia.

연하장애를 수반한 뇌졸중 환자의 삼킴 기능에 혀 압력 프로토콜과 구강인두운동의 병행적용이 미치는 효과

원영식 대구대학교 특수교육재활과학연구소 2012 특수교육재활과학연구 Vol.51 No.2

본 연구는 혀 압력 훈련 프로토콜과 구강인두운동의 적용이 뇌졸중으로 인한 연하장애 환자의 구강단계와 인두단계의 삼킴 기능에 미치는 효과를 연구하였다. 연구 대상자는 혀 압력이 40KPa 미만이고, 혀 움직임 저하로 고임이 나타나는 14명을 두 그룹으로 배분하였다: (1) 치료군 1(7명, 혀 압력 훈련 프로토콜만 시행), (2) 치료군 2(7명, 압력 훈련 프로토콜과 구강인두운동의 적용). 치료적 중재는 8주간 적용하였고, 치료 전과 후에 등척성 혀 근력, 기능적 연하장애 척도, 침습과 흡인 발생 유무를 평가하였다. 치료군 1은 중재 후 등척성 혀 근력이 증가하고, 침습과 흡인이 감소하였으며, 구강 단계에서 기능적 연하장애 척도가 향상되었다. 혀 압력 훈련 프로토콜과 구강인두운동을 병행하여 적용할 경우는 등척성 혀근력이 증가하고, 침습과 흡인이 감소하였으며, 구강 단계 뿐 아니라 인두단계까지 기능적 연하장애 척도가 향상 되었다. 또한, 침습과 흡인 감소는 치료군 2가 치료군 1보다 더욱 유의하게 나타났다. 따라서 본 연구는 혀 압력 훈련 프로토콜과 구강인두운동의 병행 적용이 뇌줄중에 의한 연하장애 환자의 구강단계와 인두단계의 삼킴 기능 향상에 더욱 효과적인 방법으로 사용될 수 있을 것으로 사료 된다. This study investigated the effects of oropharyngeal exercise (OE) combined with Tongue pressure training protocol (TPTP) on swallowing function in oral and pharyngeal phases of stoke patients with dysphagia. 14 subjects. Subjects with declined tongue pressure less than 40 kPa and pooling caused by decreased tongue movement were randomly allocated to two groups: (1) the treatment group 1 (n =7, TPTP conducted group), (2) the treatment group 2 (n =7, OE combined with TPTP conducted group). Intervention was given for 8 weeks. Isometric tongue strength, functional dysphagia scale and Penetration Aspiration scale (PAS) were assessed at before and after intervention. In the treatment group 1, isometric tongue strength and the scores of functional dysphagia scale in the oral phase were increased, and PAS scores were decreased. Similarly, the treatment group 2 showed the improved isometric tongue strength and functional dysphagia scale scores in the oral and pharyngeal phases of swallowing, and the decreased PAS scores. Especially, the scores of PAS in the treatment group 2 were more significantly decreased than the treatment group 1. We propose that OE combined with TPTP would be more effective to increase the swallowing function in the oral and pharyngeal phases of swallowing of stoke patients with dysphagia.

The Effects of Multi-Sensory Stimulation on Swallowing Function in Stroke Patients with Dysphagia

원영식,문종훈,박희수 한국지식정보기술학회 2020 한국지식정보기술학회 논문지 Vol.15 No.5

The purpose of this study was to investigate the effect of multi-sensory stimulation on swallowing function in stroke patient with dysphagia. Twenty stroke patients with dysphagia participated in this study. Among 20 stroke patients with dysphagia, the 10 patients who have multi-sensory stimulation at the same time were in a experimental group and the other 10 patients who have traditional dysphagia rehabilitation were in a control group. Both groups were randomly assigned. The experimental group received for 4 weeks, for multi-sensory stimulation, visual-auditory stimulation and BPO olfactory stimulation were supplied with traditional dysphagia rehabilitation. For the control group, only traditional dysphagia rehabilitation received. Before and after invention, Videofluoroscopic Swallowing (VFS) was conducted. After that, the data on the test of Functional Dysphagia Scale (FDS), penetration-aspiration scale (PAS), American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS), Olfactory Identification Test was collected. There were significant differences between the data of FDS, PAS, ASHA NOMS before and after invention in the experimental group (p<.05). For the control group, there were significant differences in FDS (p<.05). For change score comparisons between groups, there was greater significant differences in FDS of the experimental group than control group (p<.05). It is confirmed that multi-sensory stimulation has an positive effect on swallowing function in stroke patients with dysphagia.

성별, 연령, 혀 길이에 따른 국내 건강한 성인의 구강안면근의 차이 : 구강안면근력의 예비 표준화 연구

원영식,곽유림,김도희,차은영,문종훈 한국지식정보기술학회 2020 한국지식정보기술학회 논문지 Vol.15 No.6

The aim of this study was to investigate the difference in the orofacial muscles according to the sex, the age, and the length of the tongue in Korean healthy adults. The present study was enrolled in Three hundred healthy adults in Korea. All subjects measured the length of the tongue first, and then measured the strength, the endurance, the accuracy and the timing of the orofacial muscles using the Tongue Pressure Strength-100 (TPS-100). In order to select the subjects, a Korean version of mini mental state examination was performed to check the cognitive function and to measure the strength, the endurance, the accuracy, and the timing of the orofacial muscles. The result showed that there was no significant difference of gender except for anterior tongue elevation and cheek compression (p>.05), and there was a high negative correlation between the orofacial muscles and the age (p<.01). And there was a significant negative correlation between the tongue length and the tongue strength, the endurance, the accuracy, and the timing (p<.01). The current study provides to the literature on normal orofacial muscles strength, the endurance, the accuracy, the timing and indicates that the improvement on swallowing ability in persons with dysphagia by comparing patients with criteria.

CHAID 분석 방법을 이용한 온도촉각자극의 사용실태와 인식에 관한 비판적 관점에서의 연구

원영식,문종훈 한국지식정보기술학회 2020 한국지식정보기술학회 논문지 Vol.15 No.2

The purpose of this study was to investigate the perception and usage of thermal-tactile stimulation using ice stick used in dysphagia rehabilitation. This study surveyed occupational therapists and stroke patients with dysphagia through a convenience sample. The collected questionnaires were 79 occupational therapists and 88 stroke patients. The data were used for statistical analysis. As a result, the equipment used by occupational therapists for thermal-tactile stimulation treatment was ice stick with the highest proportion of 88.6%. Thermal-tactile stimulation using ice sticks was positively recognized by occupational therapists in 67.1% and 48.1% of the effects and satisfaction of stroke patients with dysphagia. Stroke patients with dysphagia such as discomfort of dysphagia, long meal time, and aspiration symptom knew significantly more about the reasons for dysphagia rehabilitation using ice sticks than stroke patients without severe swallowing problems. Occupational therapists, who perceived thermal-tactile stimulation using ice sticks as 'be of help', responded that thermal-tactile stimulation using ice sticks was 'need'. Stroke patients receiving thermal-tactile stimulation using ice sticks for more than 5 to 20 minutes indicated that therapy using ice sticks were 'be of help'. The results of our study can be used as a basis for further intervention and further studies on thermal-tactile stimulation using ice sticks.

비디오 촬영을 통한 건강한 성인 남성의 정상삼킴과 노력삼킴의 시간적 변수 비교

원영식,문종훈 한국지식정보기술학회 2020 한국지식정보기술학회 논문지 Vol.15 No.3

This study aimed to compare the temporal variables during normal swallow and effortful swallow of healthy adult men through smartphone video recording. Ten healthy adult men participated in this study. The participants swallowed 5ml of water in a sitting position, and the video image was shot using a smartphone digital camera during swallowing. All participants performed the normal swallow and the effortful swallow, and The order of normal swallow and the effortful swallow was counterbalanced. The images of all swallowing were analyzed by trained assessors at 30 frames per second. The temporal variables were swallowing onset timing (SOT), laryngeal elevation time (LET), laryngeal elevation stay duration (LESD), and swallowing duration (SD). The collected data were analyzed by using the Paired t test to compare the temporal variables for the two swallowing. In the SOT, the effortful swallow was significantly longer than the normal swallow. The LET was not different between the two swallowing methods. The effortful swallow in the LESD was significantly longer than normal swallow. In the SD, The effortful swallow was significantly longer than the normal swallow. The results of this study suggest that temporal analysis using video images is a convenient method to measure the effortful swallow and the normal swallow.

Effect of Olfactory Stimulation Mixed Carbonated Water Swallow on Suprahyoid Muscle Activity in Healthy Subjects

원영식,문종훈,박희수 한국지식정보기술학회 2020 한국지식정보기술학회 논문지 Vol.15 No.1

The aim of this study was to examine the effect of olfactory stimulation mixed carbonated water swallow on activation of the suprahyoid muscle in healthy adults. Twenty healthy adults measured the activation of the suprahyoid muscle using surface electromyography (sEMG) when swallowing. There are the four swallowing tasks for the subjects: (1) odorless olfactory stimulation with distilled water, (2) odorless olfactory stimulation with carbonated water, (3) Black Pepper Oil (BPO) olfactory stimulation with distilled water, (4) BPO olfactory stimulation with carbonated water swallowing. Counterbalancing was done to exclude order effect. Six times for each task, total 24 times swallowing was done. 5 minute break time was given between each task, one researcher proceeded the experiment for consistency. Fix the reference voluntary contraction as 5 ml water swallowing to standardize the size of sEMG signal. Standardized data were used in statistical analysis, and statistical analyst was blind to the experiment. Among the four tasks, tasks 2 and 4 showed significantly stronger the suprahyoid muscle activity than tasks 1 and 3 in the maximum value (p<.05). In conclusion, Carbonated water, as immediate effect, could promote the maximum activation of the suprahyoid muscle, the immediate effect could not be found with BPO olfactory stimulation.

건강관리 애플리케이션을 통한 타바타 운동이 뇌졸중 환자의 균형, 보행 및 일상생활 활동에 미치는 영향

원영식,문종훈,노정석 한국전자통신학회 2018 한국전자통신학회 논문지 Vol.13 No.6

The purpose of this study was examined the effect of Tabata exercise using health care application on balance, gait and activities of daily living in patients with stroke. Twenty patients with stroke were participated patients with stroke in this study. Nineteen participants were randomly allocated to ten in experimental and nine in control groups. The both groups received the rehabilitation therapy during for 4 weeks. The experimental group performed Tabata exercise based on health care application, supervised under caregivers, during 30 min/day. The control group performed self-exercise supervised under caregivers, during 30 min/day. Both groups exercised for 4 weeks, 3 times a week, 30 min/day. Tabata exercise was trained by an physical and occupational therapists. The outcome measures were the BBS(: Berg Balance Scale), TUG(: Timed Up and Go, K-MBI(: Korean Modified Barthel Index). In results, the experimental groups showed a significant improvements after intervention in all assessments(p<.05), The control groups showed a significant improvements after intervention in BBS(p<.05) The experimental group showed a greater significant improvements than control group in TUG, BBS, K-MBI(p<.05). We suggest that Tabata exercise using health care application can have a effects of the improvements of balance, gait and activities of daily living than only self-exercise in patients with stroke. 본 연구의 목적은 건강관리 애플리케이션을 사용한 타바타 운동이 뇌졸중 환자의 균형, 보행 및 일상생활 활동에 미치는 영향을 알기 위함이다. 뇌졸중 환자 20명이 본 연구를 위해 모집되었다. 총 19명의 참가자는 실험군 10명과 대조군 9명으로 무작위 배정되었다. 두 군은 4주 간의 재활치료를 동일하게 제공 받았다. 실험군은 건강관리 애플리케이션을 통한 타바타 운동을 30분 더 수행하였다. 대조군은 보호자 감독 하에 자가 타바타 운동을 30분 수행하였다. 두 군은 4주 간, 주 3회, 하루 30분 운동을 시행하였다. 타바타 운동은 재활치료사가 교육하였다. 결과측정은 중재 전과 후에 측정하였으며, 버그 균형 검사는 동적 균형을 알아보기 위하여, 보행 능력 검사는 보행을 알아보기 위해서, 수정된 바델 지수는 일상생활 활동을 알아보기 위하여 측정하였다. 연구 결과, 실험군은 중재 전과 후로 균형, 보행, 일상생활 활동에서 유의한 향상이 있었다(p<.05), 대조군은 균형에서 유의한 향상이 있었다(p<.05). 두 군 간 변화량 비교에서 실험군은 대조군보다 균형, 보행, 일상생활 활동에서 유의한 향상이 있었다(p<.05). 본 연구의 결과는 건강관리 애플리케이션을 사용한 타바타 운동이 자가 운동보다 뇌졸중 환자의 균형, 보행, 일상생활 활동에 더 큰 효과를 나타낼 수 있음을 지지한다.