성별, 연령에 따른 구강안면근력의 변화 : 국내 건강한 성인을 대상으로

국문 초록 (Abstract)

목적 : 본 연구는 국내 건강한 성인을 대상으로 구강안면근력을 측정하여 표준치를 제시하고 성별, 연령에 따른 근력 변화에 대해 알아보고자 하였다. 연구방법 : 2012년 5월부터 2013년 1월까지 20~89세의 건강한 성인 341명을 대상으로 아이오와 구강 수행도구 (Iowa Oral Performance Instrument; IOPI)를 사용하여 구강안면근력을 측정하였다. 측정부위는 구강안면근 으로 혀의 전·후방 거상, 좌·우측 볼근, 입술로 각각 3회 측정 후 그 평균값을 측정하였다. 결과 : 1) 성별에 따른 건강한 성인 구강안면근력의 차이는 남성이 여성에 비해 강한 근력을 보였다(p<.01). 2) 연령이 증가할수록 구강안면근력은 유의하게 저하된 것을 알 수 있었다(p<.01). 결론 : 본 연구를 통해 구강안면근력의 표준치를 알아보았으며 성별, 연령에 따른 근력 변화는 삼킴을 치료하는데 있어 기본적 지침으로 환자의 현재 상태를 파악하는 것은 물론 나아가 치료방향을 고려하는데 있어 도움을 줄 수 있을 것이다.

다국어 초록 (Multilingual Abstract)

Objective : This study measured the orofacial muscular strength of healthy adults residing in a domestic area in Korea. By investigating the differences in orofacial muscular strength in relation to gender and age, this study attempted to look at factors influencing their swallowing skills. Methods : Using an Iowa Oral Performance Instrument (IOPI), the orofacial muscular strength was measured for 341 healthy adults with ages ranging from 20 to 89 from May 5, 2012. to Jan. 1, 2013. Specifically, the strength of the forward and back elevations of their tongue, their buccinator muscle strength, and their lip strength were each measured three times, and the average score of each was then calculated. Results : The findings show that 1) the orofacial muscular strength of healthy Korea men is stronger than that of Korean women (p<.01), and 2) the older the participants are, the weaker their orofacial strength, regardless of their gender (p<.01). Conclusion : The IOPI scores of the participants showed that their orofacial muscular strength is affected by their age and gender, which may help guide future swallowing treatments.

목차 (Table of Contents)

• 국문초록
• Ⅰ. 서론
• Ⅱ. 연구 방법
• 1. 연구 대상
• 2. 연구 도구
• 3. 연구절차 및 과정
• 4. 분석 방법
• Ⅲ. 연구 결과
• 1. 건강한 성인의 혀 전방 거상 압력(anterior tongue pressure) 표준치
• 2. 건강한 성인의 혀 후방 거상 압력(posterior tongue pressure)표준치
• 3. 건강한 성인의 우측 볼근 압력(buccodental pressure)
• 4. 건강한 성인의 좌측 볼근 압력(buccodental pressure)
• 5. 건강한 성인의 입술 압력(Lip pressure)
• 6. 성별에 따른 구강안면근력의 비교
• 7. 연령과 구강안면근력의 상관관계
• Ⅳ. 고찰
• Ⅴ. 결론
• 참고문헌
• Abstract

참고문헌 (Reference)

1 이옥희, "연령 증가에 따른 성인 여성의 근력과 체격, 단백질 영양 및 운동습관과의 관계" 한국운동영양학회 7 (7): 197-207, 2003

2 구광수, "신체활동과 노화" 대한미디어 2006

3 송영진, "삼킴장애" 계축문화사 2007

4 박진홍, "삼킴시 순차별 혀의 압력 및 후두거상 반응시간" 대한재활의학회 34 (34): 134-140, 2010

5 김명국, "머리 및 목해부학" 의치학사 2011

6 Trawitzki, L. V., "Tongue strength of healthy young adults" 38 (38): 482-486, 2011

7 Crow, H. C., "Tongue strength and endurance in different aged individuals" 51 (51): 247-250, 1996

8 Mortimore, I. L., "Tongue protrusion force and fatiguability in male and female subjects" 14 (14): 191-195, 1999

9 Hori, K., "Tongue pressure against hard plate during swallowing in post-stroke patients" 22 (22): 227-233, 2005

10 Stierwalt, J. A., "Tongue measures in individuals with normal and impaired swallowing" 16 (16): 148-156, 2007

11 Lenius, K., "The relationship between lingual-palatal pressures and submental surface electromyographic signals" 36 (36): 118-123, 2009

12 Robbins, J., "The effects of lingual exercise on swallowing in older adults" 53 : 1483-1489, 2005

13 Robbins, J., "The effects of lingual exercise in stroke patients with dysphagia" 88 (88): 150-158, 2007

14 Hardy, F., "Swallowng disorders treatment manual" Pro-Ed 2004

15 Hewitt, A., "Standardized instrument for lingual pressure measurement" 23 (23): 16-25, 2008

16 Noyce, A. J., "Severe dysphagia as a presentation of Parkinson’s disease" 27 : 457-458, 2012

17 Rosenberg, I. H., "Sarcopenia : Origins and clinical relevance" 127 : 990-991, 1997

18 Clark, H. M., "Relationships among subjective and objective measures of tongue strength and oral phase swallowing impairments" 12 (12): 40-50, 2003

19 Smith, S. K., "Rehabilitation or compensation : Time for a fresh perspective on speech and language therapy for dysphagia and Parkinson’s disease? International Journal of Language & Communication Disorders, 47(4), 351-364. doi : 10. 1111/ j. 1460-6984. 2011. 00093" 47 (47): 351-364, 2012

20 Lindgren, S., "Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population" 6 (6): 187-192, 1991

21 Shaker, R., "Pressure-flow dynamics of the oral phase of swallowing" 3 (3): 79-84, 1988

22 Tracy, J. F., "Preliminary observations on the effects of age on oropharyngeal deglutition" 4 (4): 90-94, 1989

23 Robbins, J., "Oropharyngeal swallowing in normal adults of different ages" 103 : 823-829, 1992

24 Youmans, S. R., "Measures of tongue function related to normal swallowing" 21 (21): 102-111, 2006

25 Morris, T. J., "Maximum shortening velocity and myosin heavy-chain isoform expression in human masseter muscle fibers" 80 : 1845-1848, 2001

26 Potter, N. L., "Maximal tongue strength in typically developing children an adolescents" 24 (24): 391-397, 2009

27 Prosiegel, M., "Management of dysphagic patients with acute stroke" 83 : 1590-1599, 2012

28 Chigira, A., "Lip closing pressure indisabled children : A comparison with normal children" 9 : 193-198, 1994

29 Korfage, J. A., "Intermuscular and intramuscular differences in myosin heavy chain composition of the human masticatory muscles" 178 (178): 95-106, 2000

30 Morgan, A. T., "Incidence and clinical presentation of dysarthria and dysphagia in the acute setting following paediatric traumatic brain injury" 36 (36): 44-53, 2010

31 Tomonaga, M., "Histochemical and ultrastructural changes in senile human skeletal muscle" 25 (25): 125-131, 1977

32 Bonder, B. R., "Functional performance in older adults" F. A. Davis 2009

33 Stål, P., "Fibre composition of human intrinsic tongue muscles" 173 (173): 147-161, 2003

34 One, T., "Evaluation of tongue motor biomechanics during swallowing : Form oral feeding models to quantitative sensing methods" 45 (45): 65-74, 2009

35 Lazarus, C., "Effects of two types of tongue strengthening exercises in young normals" 55 (55): 199-205, 2003

36 Shaker, R., "Effect of aging on the deglutitive oral, pharyngeal and esophageal motor functon" 9 (9): 221-228, 1994

37 Kronenberger, M. B., "Dysphagia following head and neck cancer surgery" 9 (9): 236-244, 1994

38 Youmans, S. R., "Differences in tongue strength across age and gender: Is there a diminished strength reserve?" 24 (24): 57-65, 2009

39 Yano, J., "Differences in biomechanical features of tongue pressure production between articulation and swallow" 39 (39): 118-125, 2012

40 Cohn, S. H., "Compartmental body composition based on total-body nitrogen, potassium, and calcium" 239 : 524-530, 1980

41 Ball, S., "Comparison of two methods for measuring tongue pressure during swallowing in people with head and neck cancer" 21 (21): 28-37, 2006

42 Yoshikawa, M., "Comparison of three types of tongue pressure measurement devices" 26 (26): 232-237, 2011

43 Yoshida, M., "Comparison of surface Electromyographic(sEMG)activity of submental muscles between the head lift and tongue press exercises as a therapeutic exercise for pharyngeal dysphagia" 24 (24): 111-116, 2007

44 Solomon, N. P., "Assessment of orafacial strength in patient with dysarthria" 16 (16): 251-258, 2008

45 Kahane, J. C., "Anatomic and physiologic changes in the aging peripheral speech mechanism, In Aging: Communication processes and disorders" Grune & Stratton 21-45, 1981

46 Timiras, P. S., "Aging of the skeleton, joints, and muscles, In Physiological basis of aging and geriatrics" CRC Press 259-272, 1994

47 Vandervoort, A. A., "Aging of the human neuromuscular system" 25 (25): 17-25, 2002

48 Nicosia, M, A., "Age effects on the temporal evolution of isometric and swallowing pressure" 55 (55): 634-640, 2000

49 Clark, H. M., "Age and sex differences in orofacial strength" 27 (27): 2-9, 2012