[논문]Effects of Dysphagia Treatment Applied to Infants with Pierre Robin Syndrome - Single Subject Research Design

Kim, Mikyung; Kim, Deokju

doi:10.17703/ijact.2020.8.1.1

Effects of Dysphagia Treatment Applied to Infants with Pierre Robin Syndrome - Single Subject Research Design 원문보기

The International journal of advanced culture technology, v.8 no.1, 2020년, pp.1 - 12

Kim, Mikyung (Sanggye-paik Hospital) , Kim, Deokju (Dept. of Occupational Therapy, Cheongju Univeristy)

Abstract ▼ AI-Helper

Pierre Robin syndrome is characterized by micrognathia, glossoptosis, and cleft palate. Infants with Pierre Robin syndrome causes feeding difficulty, upper airway obstruction, and other symptoms. This study aims to examine the effects of applying dysphagia treatment to infants with Pierre Robin syndrome. The study participant was an infant who was born four weeks premature and referred for dysphagia treatment approximately 100 days after birth. At the initial assessment, the infant showed oral sensory sensitivity, a high level of facial and masticatory muscle tension, and a low stability of the chin and cheeks with almost no normal "sucking-swallowing-breathing" pattern. We set the baseline period and intervention period using the AB design. During the baseline period, non-nutritive sucking training using a rubber nipple was conducted without implementing an oral stimulation intervention. During the intervention period, non-nutritive sucking training and an oral stimulation intervention were performed. After the intervention period, the infant's daily oral intake and oral intake per time significantly increased compared to that during the baseline period. We observed that the oral intake time of the infant decreased during the intervention period compared to that in the baseline period, which indicated an improvement in control over the chin, tongue, and lip movements, a change in muscular tension, and stabilization of the "sucking-swallowing-breathing" pattern. We provided dysphagia treatment before breastfeeding, it was positive effects such as normal development of the infant, transition from tube feeding to bottle feeding, and enhancement of overall oral motor function.

주제어

표/그림 (10)

그림 Figure 1. Oral structure of an infant with cleft palate
그림 Figure 2. Ordinary nipple of feeding bottle
그림 Figure 3. Special nipple of feeding bottle
표 Table 1. Oral stimulation program
그림 Figure 4. Change of average oral feeding volume per time by session
그림 Figure 5. Change of oral feeding volume per Time compared by intervention method.
그림 Figure 6. Change of total daily oral feeding volume per session
그림 Figure 7. Change of total daily oral feeding volume compared by intervention method
그림 Figure 8. Feeding time required to feed 1 cc per session
그림 Figure 9. Feeding time required to feed 1 cc compared by intervention method

AI 본문요약
AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

문제 정의

Most infants with dysphagia experience malnutrition and growth retardation due to their swallowing problems; therefore, it is very important to treat dysphagia. In this study, a paediatric occupational therapist carried out oral stimulation intervention in an infant with Pierre Robin syndrome to treat their dysphagia, and this study aims to examine the results and how intervention therapy helped the infant.
In this study, an occupational therapist implemented a dysphagia treatment for Pierre Robin syndrome using an oral stimulation program, and this study aimed to present the effects and results of this dysphagia treatment. We set the baseline period and the intervention period using the AB design.

제안 방법

During the baseline period, only non-nutritive sucking training was offered without an oral stimulation program. During the intervention period, non-nutritive sucking training and a 30-minute oral stimulation program were conducted.
Oral stimulation intervention usually refers to a massage performed 15 minutes before feeding that includes activities to stimulate the cheeks, upper lip, lower lip, upper gum, lower gum, inner cheeks, lateral border of the tongue, and middle blade of the tongue by pressing those parts with fingers. In this study, a manual oral stimulation program was implemented on the infant with Pierre Robin Syndrome for three weeks. The study was structured with a single-subject research design using the AB design.
In this study, the dysphagia treatment was conducted in the infant’s incubator at the neonatal intensive care unit (NICU) of S hospital.
0. The feeding volume was checked every day during both the baseline period and the intervention period, and the frequency analysis was conducted using the daily check results. The measurements obtained during the baseline period and the intervention period were compared and analysed using visual graphs and descriptive statistics.
The feeding volume was checked every day during both the baseline period and the intervention period, and the frequency analysis was conducted using the daily check results. The measurements obtained during the baseline period and the intervention period were compared and analysed using visual graphs and descriptive statistics.
The dysphagia treatment program was customized for the infant in this study by referring to the “Oralstimulation program” of Sandra [13], which implemented treatment for preterm infants receiving tube feeding Effects of Dysphagia Treatment Applied to Infants with Pierre Robin Syndrome– Single Subject Research Design 5to help them transition to oral feeding (Table 1). The program consisted of methods to stimulate the neck, chin,cheeks, upper lip, lower lip, upper gum, lower gum, internal cheeks, and tongue-surrounding parts for 30minutes at a time. After conducting the treatment program, feeding was offered by using the Medela special feeding bottle at the scheduled time.
In this study, a manual oral stimulation program was implemented on the infant with Pierre Robin Syndrome for three weeks. The study was structured with a single-subject research design using the AB design. During the baseline period, only non-nutritive sucking training was offered without an oral stimulation program.
Therefore, an emergency caesarean operation was conducted, and she gave birth to a baby at 35 + 5 weeks’ gestation (Bwt. 2140 g).
Treatment was provided by an occupational therapist with more than 10 years’ experience in paediatric dysphagia treatment and education, and the difficulty level of activities was adjusted depending on the condition of the infant.

대상 데이터

The infant in this study was a girl born on March 3, 2017. The mother of the infant was hospitalized twice Effects of Dysphagia Treatment Applied to Infants with Pierre Robin Syndrome– Single Subject Research Design 3in the M obstetrics and gynaecology clinic in January owing to preterm labor, and she was treated with antibiotics from February 27 to March 2 because of amniotic fluid leakage.
The research period was from March 15 to April 7, 2017, and measurements were conducted for a total of 25 sessions.

이론/모형

This study is a single-subject research design using the AB design. The research period was from March 15 to April 7, 2017, and measurements were conducted for a total of 25 sessions.

후속연구

In addition, the results of this study could be confirmed with supplemental case studies that explore the effectiveness of dysphagia treatment using oral therapy intervention that can stabilize the juxtaoral muscles and improve an infant’s oral feeding capability.

참고문헌 (23)

B. Benjamin and P. Walker, "Management of Airway Obstruction in the Pierre Robin Sequence," International Journal of Pediatric Otorhinolaryngology, Vol. 22, pp. 29-37, 1981.
H. G. Marvin and H. E. Roger, "The Treatment of the Pierre Robin Syndrome," Pediatrics, Vol. 30, pp. 450-458, 1962.

상세보기
J. Y. Ryu, T. J. Shin, H. G. Hyun, Y. J. Kim, J. W. Kim, K. T. Jang, J. C. Kim and S. H. Lee, “Dental Treatment in a Patient with Pierre Robin Syndrome under General Anesthesia: A Case Report,” Journal of Korean Association for Disability and Oral Health, Vol. 12, No. 2, pp. 87-91, 2016. DOI: http://dx.doi.org/10.12655/KADH.2016.12.2.87

원문보기 상세보기
F. Cozzi, G. Totonelli, S. Frediani, A. Zani, L. Spaqnol and D. A. Cozzi, “The Effect of Glossopexy on Weight Velocity in Infants with Pierre Robin Syndrome,” Journal of Pediatric Surgery, Vol. 43, No. 2, pp. 296-298, 2008.

상세보기
A. C. Silva, S. R. C. Fabio and R. O. Dantas, “A Scintigraphic Study of Oral, Pharyngeal, and Esophageal Transit in Patients with Stroke,” Dysphagia, Vol. 23, No. 2, pp. 165-171, 2008.

상세보기
E. L. Leonard, L. E. Trykowski and B. V. Kirkpatric, "Nutritive Sucking in High-risk Neonates after Perioral Stimulation," Physical Therapy, Vol. 60, pp. 299-302, 1980.

상세보기
E. H. Her and S. L. Kim, “Early Childhood Teacher’s Professionalism, Teaching Efficacy, and Teacherchild Interaction,” International Journal of Advanced Culture Technology, Vol. 6, No. 4, pp. 39-44, 2018. DOI: https://doi.org/10.17703//IJACT2018.6.4.39

원문보기 상세보기
B. H. Lee and J. G. Kim, “The Effect of Health Promotion Behavior on Emotional Happiness,” International Journal of Advanced Culture Technology, Vol. 7, No. 1, pp. 20-27, 2019. DOI: 10.17703/IJACT.2019.7.1.20

원문보기 상세보기
M. J. Kim, J.H. An, Y.S. Cho, S. M. Ahn and J. W. Kim "Rapid Palatal Expansion in Treatment of Cleft Lip and Palate Patients," Korean Journal of Cleft Lip and Palate Association, Vol. 17, No. 2, pp. 45-53, 2014.
Y. G. Kim and J. S. Seo, "Nutritional Assessment of ICU Inpatients with Tube Feeding," J Kor Diet Assoc, Vol. 21, No.1, pp. 11-24, 2015. DOI: http://dx.doi.org/10.14373/JKDA.2015.21.1.11
L. M. Einarsson Backes, J. Deitz, and R. Price, “The Effect of Oral Support on Sucking Efficiency in Preterm Infants,” Developmental Medicine & Child Neurology, Vol. 48, No. 6, pp. 490-498, 1994.
E. Y. Park, "Clinical Evaluation and Screening Test of Pediatric Dysphagia," Journal of the Korean Dysphagia Society, Vol. 4, pp. 50-55, 2014. DOI: 10.34160/jkds.2014.4.2.001

상세보기
F. Sandra, G. Erika, and L. Chantal, “Oral Stimulation Accelerates the Transition from Tube to Oral Feeding in Preterm Infants,” J Pediatr, Vol. 141, No. 2, pp. 230-236, 2002.

상세보기
P. B. Scott, E. L. Joseph and B. B. Stephen, Reconstruction of craniofacial syndrome. In Mathes JS: Plastic Srugery, 2nd de. Philadelpia: WB Saunders company, 2006.
H. J. Nam, J. H. Lee and Y. H. Kim, “Application of Temporary Tongue-lip Traction During the Initial Period of Mandibular Distraction in Pierre Robin Sequence,” Archives of Plastic Surgery, Vol. 35, No. 3, pp. 349-353, 2008.
S. L. Gardner and M. I. Hagedorn, "Physiologic Sequelae of Prematurity: The Nurse Practitioner's role. Part V. Feeding Difficulties and Growth Failure (pathophysiology, cause, and data collection)," Journal of Pediatric Health Care, Vol. 5, pp. 122-134, 1991.

상세보기
H. W. Choi, H. W. Park and H. Y. Kim, "Feeding Desaturation and Effects of Orocutaneous Stimulation in Extremely Low Birth Weight Infants," Neonatal Medicine, Vol. 17, pp. 193-200, 2010.
S. Frucile, E. Gisel and C. Lau, "Oral Stimulation Accelerates the Transition from Tube to Oral Feeding in Preterm Infants," The Journal of Pediatrics, Vol. 141, pp. 230-236, 2002. DOI: 10.1067-mpd.2002.125731.

상세보기
J. E. Kim, The Effects of Oral Stimulation Program on Oral Feeding of Premature Infants, Ph. D. Thesis, Seoul National University, Seoul, 2007.
M. J. Lee and J. H. Park, “Effects of Oral Stimulation Program for Oral Feeding Performance in Premature Infants: Case Study,” Therapeutic Science for Neurorehabilitation, Vol. 3, No. 2, pp. 49-57, 2014.
A. D. Rocha, M. E. Moreira, H. P. Pimenta, J. R. Ramos and S. L. Lucena, "A Randomized Study of the Efficacy of Sensory-motor-oral Stimulation and Non-nutritive Sucking in Very Low Birth Weight Infant," Early Human Development, Vol. 83, pp. 385-388, 2007. DOI: 10.1016/j.earlhumdev.2006.08.003

상세보기
J. Y. Kim and S. Y. Kim, “Evaluation and Intervention for Children with Dysphagia,” Journal of Korea Academic of Dysphagia Rehabilitation, Vol. 1, No. 1, pp. 61-69, 2009.
S. Reilly, A. Wisbeach and L. Carr, "Assessing and Treatment of Sensory Versus Motor-based Feeding Problem in Very Young Children," Infant and Young Children, No. 6, pp. 67-73, 2000.

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증