2014, Vol.22, No.3

Korean Journal of Occupational Therapy 2023 KCI Impact Factor : 0.81

pISSN : 1226-0134 / eISSN : 2671-4450
https://journal.kci.go.kr/kjot

Objective : The aim of this study was to develop a Home-based Activities (AHA) assesment that can determine the performance of daily at-home activities of the elderly in three areas: Independence, difficulty, and safety. Methods : Certain steps were followed: Collection and selection of the activities, finalizing the activities, and determination of the scale level and scoring method. A total of 38 daily activities were collected, which were narrowed down to 26 through the three rounds of selection. In the selection rounds, 10 experts and 145 elderly people participated in a survey or panel meeting on the conformance and/or importance of the activities. The degree of independence was determined on a 3-point scale, whereas the difficulty and safety levels were determined on a 4-point scale. The scoring method was determined using a Likert method for the rating summation. Results : The AHA is composed of 3 measurement areas and 26 activities for each area. The activities include 14 BADL, 11 IADL, and 1 leisure activities. Conclusion : The AHA is the first instrument in Korea for assessing elderly people’s performance of daily at-home activities, and is expected to be useful in the planning and implementation of interventions in the field of rehabilitation through occupational therapy.

Objective : This study aims to investigate the effect of an 8-weak tongue pressure resistance training protocol onthe 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 experimentalgroup and a control group from August 2013 to February 2014. Both groups received traditional dysphagiarehabilitation therapy and the experimental group received an additional tongue pressure resistance exercise usingthe Iowa Oral Performance Instrument (IOPI). IOPI was used for a change in muscle strength of the tongue, andVDS & 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 cleardifference in tongue strength, swallowing function, and dietary stage effect compared to the control group. Theresults were as follows. 1) There were significant differences between the experimental and control groups in themuscle strength change at the anterior and posterior of the tongue (p<.05). 2) There were also significantdifferences between both group sin terms of change sin their swallowing function and dietary stage (p<.05). 3) Inaddition, 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 musclestrength of tongue, swallowing function, or dietary stage of chronic stroke patients with dysphagia when comparedwith the results of the control group. Future studies should verify the effect using a protocol with a modificationin the intervention period and amount of training.

Objective : The purpose of this study was to verify the predictive validity of the aspiration capability in strokepatients with dysphagia based on a Swallowing Function Test (SFT). Methods : The subjects of this study included 90 stroke patients with problems of dysphagia. The data collectedusing Videofluoroscopy Swallowing Studies (VFSS), Swallowing Function Test (SFT), Penetration-AspirationScale (PAS), and American Speech-Language-Hearing Association National Outcome Measurement System(ASHA NOMS) for the 90 stroke patients were analyzed based on a Receiver Operating Characteristic curve (ROCcurve) to determine the cutoff score of the aspiration Area Under the Curve (AUC), and the sensitivity andspecificity of the SFT. In addition, the data were analysed based on the positive and negative predictive values fora prediction of the aspiration capability. The items used for the validity of the SFT were analyzed based on theAUC value. In addition, The SFT was analyzed using a Pearson’s correlation analysis with ASHA NOMS andPAS. Results : The cutoff score of the SFT was 36 points, and that of the AUC was .94. In addition, the sensitivity andspecificity of the SFT were 94.3% and 90.9%, respectively. The five best items of the SFT for predicting theaspiration capability were ‘voluntary cough,’ ‘laryngeal elevation,’ ‘swallowing before/during/after coughing,’ ‘voicechanges,’ and ‘the appearance of throat clearing.’ In addition, ASHA NOMS and PAS were significantly correlatedusing the SFT. Conclusion : The SFT for stroke patients with dysphagia has been proven to be a useful test. It is expected thatthe SFT will be used as a predictive tool of aspiration capability and will offer intervention guidelines fordysphagia rehabilitation.