Korean Journal of Occupational Therapy (대한작업치료학회지)

Korean Society of Occupational Therapy (대한작업치료학회)
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Effect of Tongue Pressure Resistance Training on Tongue Strength, Swallowing Function and Dietary Stage of Chronic Stroke Patients With Dysphagia

혀의 저항 운동이 연하장애를 동반한 만성 뇌졸중 환자의 혀 근력, 연하기능, 식이단계에 미치는 영향

  • Park, Ji-Su (Dept. of Occupational Therapy, Inje University Busan Paik Hospital) ;
  • Jeong, Cheol-Hoon (Dept. of Occupational Therapy, Konkuk University Medical Center) ;
  • Oh, Dong-Hwan (Dept. of Occupational Therapy, Kyunghee University Medical Center)
  • 박지수 (인제대학교 부산백병원 재활의학과 작업치료실) ;
  • 정철훈 (건국대학교병원 재활의학과 작업치료실) ;
  • 오동환 (경희대학교병원 재활의학과 작업치료실)
  • Received : 2014.04.30
  • Accepted : 2014.09.15
  • Published : 2014.09.30
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Abstract

Objective : This study aims to investigate the effect of an 8-weak tongue pressure resistance training protocol on the tongue strength, overall swallowing function, and dietary stage in chronic stroke patients with dysphagia. Methods : The subjects of this study were seventy-five dysphagia patients who were divided into an experimental group and a control group from August 2013 to February 2014. Both groups received traditional dysphagia rehabilitation therapy and the experimental group received an additional tongue pressure resistance exercise using the Iowa Oral Performance Instrument (IOPI). IOPI was used for a change in muscle strength of the tongue, and VDS & ASHA NOMS based on VFSS were used for changes in the overall swallowing function and dietary stage. Results : The experimental group, which underwent tongue pressure resistance training, did not have a clear difference in tongue strength, swallowing function, and dietary stage effect compared to the control group. The results were as follows. 1) There were significant differences between the experimental and control groups in the muscle strength change at the anterior and posterior of the tongue (p<.05). 2) There were also significant differences between both group sin terms of change sin their swallowing function and dietary stage (p<.05). 3) In addition, variations before and after intervention showed no statistically significant difference for either group. Conclusion : This study was unable to verify the effect of tongue pressure resistance training on the muscle strength of tongue, swallowing function, or dietary stage of chronic stroke patients with dysphagia when compared with the results of the control group. Future studies should verify the effect using a protocol with a modification in the intervention period and amount of training.

목적 : 본 연구는 연하장애를 동반한 만성 뇌졸중 환자를 대상으로 8주간 실시된 혀의 저항 운동 프로토콜이 혀의 근력과 전반적인 연하 기능에 미치는 영향을 알아보고자 하였다. 연구방법 : 본 연구는 2013년 8월부터 2014년 2월까지 75명의 연하장애 환자를 대상으로 실험군과 대조군으로 나누어 실시하였다. 두 군 모두 전통적 연하재활치료를 시행 받았으며 실험군은 아이오아 구강 수행도구를 이용하여 혀의 저항 운동을 추가적으로 시행 받았다. 혀의 근력 변화는 아이오아 구강 수행척도(Iowa Oral Performance Instrument; IOPI)를 사용하였으며 전반적인 연하기능과 식이단계의 변화는 비디오 투시 조영검사(Video Fluroscopic Swallowing Study; VFSS)를 기반으로 비디오 투시 연하장애척도(Videofluoroscopic Dysphagia Scale; VDS)와 미국언어청각협회 연하척도(American Speech-Language-Hearing Association National Outcome Measurement System; ASHA NOMS)를 사용하였다. 결과 : 본 연구 결과 혀의 저항운동을 실시한 실험군에서 대조군에 비해 혀의 근력, 연하의 기능과 식이단계에 있어 효과에 대한 명확한 차이를 확인 할 수 없었으며 결과는 다음과 같다. 1) 혀의 전방과 후방의 근력 변화는 실험군, 대조군 모두 유의한 차이를 보였다(p<.05). 2) 연하기능의 변화와 식이단계 변화 역시 두 군 모두에서 유의한 차이를 보였다(p<.05). 3) 두 그룹 모두 중재 전과 후의 변화량 역시 통계학적 유의한 차이가 없었다. 결론 : 본 연구는 연하장애를 동반한 만성 뇌졸중 환자를 대상으로 혀의 저항운동이 혀의 근력 향상, 연하 기능과 식이단계의 변화에 있어 대조군과 비교한 결과 그 효과에 대한 차이가 없었다. 추후 연구에서는 중재 기간과 횟수가 수정된 프로토콜을 이용한 효과 검증이 필요할 것이다.

Keywords

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