2015, Vol.23, No.1

Korean Journal of Occupational Therapy 2023 KCI Impact Factor : 0.81

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

Objective : This study aims to provide clinical occupational therapists with proper evidence of the appliablestandard of Intermittent Oroesophageal tube (IOE tube) feeding, and an increased recognition of the IOE tube. Methods : The subjects were 57 patients who were asked to apply IOE tube feeding. The characteristics of thesubjects were investigated by reading their medical records, and their cognitive function was evaluated usingKorean Version of Mini Mental State Examination (K-MMSE). The study divided the subjects into successful andfailed groups in IOE tube training and compared the characteristics of both groups. Results : IOE tube feeding was successfully applied to 45 of the 57 subjects (78.9%), but failed in 12 of them(21.1%). The causes of failure were poor cognitive functions (4 subjects), gag reflex (3 subjects), refusal oftraining method (3 subjects), and pneumonia (2 subjects). The successful group showed significantly higherscores compared to the failed group in K-MMSE. However, there were no significant differences in terms of theaverage age or training period variation. Conclusion : IOE tube feeding is appliable only if the patients and their care givers fully understand the treatmentmanner and agree with its implementation. In addition, IOE tube feeding can be considered not only a transitionalnutrition supply, but also a treatment method for patients who have the proper cognitive function without a severegag reflex. However, IOE tube feeding needs to be restricted to those patients who have pneumonia or a backwardflow. For safe and long-term application of IOE tube feeding, close management for patients and their care giversis required.

Objective : The purpose of this study was to investigate the effects of action observation training on theswallowing function of stroke patients with dysphagia. Methods : Sixteen stroke patients with dysphagia were randomly allocated into an Action Observation (AO) groupor Control (CTL) group. The AO group had watched a movie clip containing a normal person eating a meal, andimitated the movements of this person for five minutes. In contrast, the CTL group observed a video with onlyscenery for an equal period of time. Each group was offered the same therapeutic program with the exception ofthe video intervention. The Functional Dysphagia Scale (FDS), Clinical Dysphagia Scale (CDS), and Oral TransitTime (OTT) based on a Videofluoroscopic Swallowing Study (VFSS) were performed to verify the effect of theintervention. Results : The results of FDS, CDS, and OTT were significantly improved for puree, solid, and liquid types of dietafter intervention in the two groups (p<.05). However, the AO group showed a significant improvement in theswallowing function for all types of diets measured by the FDS, as compared with the CTL group (p<.05). Conclusion : These results show that action observation training is effective for an improvement in the swallowingfunction of stroke patients with dysphagia.

Objective : The purpose of this study was to investigate the effect of treatment according to the neuromuscularelectrical stimulation intensities in dysphagic patients. Methods : Fifty-six patients suffering from a subacute stroke were randomly assigned to either a motor stimulationgroup or a sensory stimulation group. Both groups underwent conventional dysphagia treatment, and differentintensities of the electrical stimulation was applied for 30 minutes, five days a week for six weeks. Theirswallowing function was evaluated using the VDS (Videofluoroscopic Dysphasia Scale) and PAS (Penetration-Aspiration Scale), and the L-tube removal rate was confirmed. Results : Both groups showed a statistically significant difference in the pharyngeal stage and PAS (p<.05), and theresult of the comparison of the two groups also showed a significant difference in the pharyngeal stage and PASafter the intervention (p<.05). Before and after intervention, the result of the change showed that the motorstimulation group was 12.58±8.15, the sensory stimulation group was 4.00±5.07 in the pharyngeal stage, andthere were significant differences between the two groups (p<.05). The L-tube removal rate was 52% in themotor stimulation group, and 29% in the sensory stimulation group. Conclusion : This study showed that both motor and sensory stimulation are effective interventions for thepharyngeal stage in the swallowing function of dysphagic patients, and that motor stimulation is more effectivethan sensory stimulation.