[논문]Effect of Kinesiology Taping on Hyolaryngeal Complex Movement in Stroke Patient with Dysphagia

Hong, Junyong; Oh, Donghwan; Park, Jisu; Jung, Youngjin

doi:10.20540/jiaptr.2020.11.2.2052

Effect of Kinesiology Taping on Hyolaryngeal Complex Movement in Stroke Patient with Dysphagia 원문보기

Journal of international academy of physical therapy research, v.11 no.2, 2020년, pp.2052 - 2059

Hong, Junyong (Department of Multidisciplinary Radiological Science, Dongseo University) , Oh, Donghwan (Department of Occuptional Therapy, Kyungdong University) , Park, Jisu (Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University) , Jung, Youngjin (Department of Radiological Science, Dongseo University)

Abstract ▼ AI-Helper

Background: Kinesiology taping (KT) is a method that helps immediately increase muscle activation, strength and joint stability by being attached to various skeletal muscles and structures of the body. Objectives: To investigate the effect of KT applied below the hyolaryngeal complex on the movement of the hyolaryngeal complex during swallowing in patients with dysphagia after stroke. Design: One-group, pre-post design. Methods: Twenty individuals with dysphagia after stroke participated in this study. KT was applied to the sternum and both clavicles from the hyolaryngeal complex. We analyzed the motion of the hyolaryngeal complex during swallowing with and placebo KT and KT using the Image-J software with videofluoroscopic swallowing study. In addition, a 0-to-10 numerical rating self-report scale was used to check the required effort and resistance felt during swallowing. Results: KT condition showed that the anterior and superior movement of the hyoid bone during swallowing was significantly lower than placebo KT (P<.05, all). Also, KT condition showed that the anterior and superior movement of the larynx during swallowing was significantly lower than placebo KT (P<.05, all). In result of statistical comparison between KT group and placebo KT group, the KT group showed significantly higher self-report scale score than the placebo KT group in terms of two category; the required effort and resistance felt (P<.05, all). Conclusion: This study demonstrated that KT applied below the hyolaryngeal complex inhibits the anterior and superior movement of hyoid bone and larynx during swallowing of patients with dysphagia after stroke.

주제어

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문제 정의

In this study, we investigated the effect of KT as a method to suppress the movement of the hyolaryngeal complex during swallowing in patients with dysphagia following stroke.
This study demonstrated that KT applied below the hyoid bone inhibited the movement of the hyolaryngeal complex during swallowing. Therefore, overcoming the upward movement of the hyolaryngeal complex through KT, and repeatedly applying effortful swallowing, can have potential therapeutic effects as a resistance training method.
This study investigated the effect of KT on the movement of the hyolaryngeal complex in patients with dysphagia after stroke. In this study, we observed that the attachment of KT to the downward direction from the hyolaryngeal complex restricted the anterior-superior movement of the hyolaryngeal complex during swallowing.

제안 방법

Additionally, this study evaluated the resistance feeling and required effort during swallowing in KT and placebo-KT conditions using NRSS. As a result, the resistance feeling and required effort with KT were significantly higher than with placebo KT, which is presumed to be because of the efforts and difficulties to overcome and swallow with KT that acts as a resistance.
The coordinates of the anchor point of the pre-swallow image were Ox1 and Oy1, and those of the excursion image were Ox2 and Oy2. All evaluations were performed as blinding assessment by an occupational therapist and a rehabilitation.
This study was conducted using a one-group design, with participants examined with KT and with a placebo KT. All subjects underwent a VFSS in the KT and placebo-KT conditions, and the order was randomly selected using an opaque envelope by the researcher, who has no conflict of interest with the present study (Figure 1). The evaluation was performed by a blinded rehabilitation physician and an occupational therapist.
In this study, KT was applied downward from the hyoid bone to the sternum and clavicles, and the applied area was composed of muscles that pulled down the hyolaryngeal complex, such as the sternothyroid muscle and the omohyoid muscle. Increased activation of these muscles during swallowing contributes to the downward movement of the hyolaryngeal complex, which may play a role in limiting further upward movement.
First, KT has properties of expansibility and contractile forces, and it can be used to suppress the movement of hyolaryngeal complex by physical external force. In this study, KT was attached using two designs (I- and reverse V-shaped KT) to suppress the movement of the hyolaryngeal complex during swallowing. First, the KT was pulled downward from the thyroid cartilage with about 50- 60% stretch and was attached to the sternum, producing a potential contractile force of about 50-60% for returning to its original length, which acts as an external force pulling the hyolaryngeal complex downward.
First, the KT was pulled downward from the thyroid cartilage with about 50- 60% stretch and was attached to the sternum, producing a potential contractile force of about 50-60% for returning to its original length, which acts as an external force pulling the hyolaryngeal complex downward. This study also applied a reverse Vshaped KT to both clavicles from the hyoid bone. As a result, the KT contractile force is generated, and the hyoid bone is exposed to external force by being pulled downward.
This study is of clinical significance in suggesting the possibility of using resistance training methods by suppressing the movement of hyolaryngeal complex during swallowing in dysphagia patients with the help of KT applied under the hyoid bone. However, there are some factors to consider when applying this method.
This study was conducted using a one-group design, with participants examined with KT and with a placebo KT. All subjects underwent a VFSS in the KT and placebo-KT conditions, and the order was randomly selected using an opaque envelope by the researcher, who has no conflict of interest with the present study (Figure 1).

대상 데이터

The exclusion criteria were as follows: tape allergy on the anterior neck, presence of nasogastric tube, or a tracheotomy. Finally, 23 patients who met the inclusion and exclusion criteria were included in the study.
All subjects underwent a VFSS in the KT and placebo-KT conditions, and the order was randomly selected using an opaque envelope by the researcher, who has no conflict of interest with the present study (Figure 1). The evaluation was performed by a blinded rehabilitation physician and an occupational therapist.
However, three of these dropped out because they were unable to swallow voluntarily in the KT condition. Therefore, data of 20 subjects were analyzed. The general characteristics of the subjects are shown in Table 1.
This study enrolled 20 patients diagnosed with dysphagia after stroke. The inclusion criteria were as follows: Major problems in the pharyngeal phase, within 3 months of onset of stroke, ability to communicate properly, no cognitive problems with Mini Mental State Examination-Korean version 24 score or above, ability to voluntarily swallow, consumption of an oral diet, and decreased hyoid bone movement during swallowing in videofluoroscopic swallowing study (VFSS).
This study was performed on 23 patients with dysphagia after stroke. However, three of these dropped out because they were unable to swallow voluntarily in the KT condition.

데이터처리

The Shapiro Wilk test was used to check the normality of the outcome variables. This study compared differences in the mean values of the KT and nonKT conditions in participants using a Wilcoxon signed-rank test on SPSS software (ver. 18.0 for Windows; SPSS, Chicago, IL, USA). Statistical significance was set at P<.

이론/모형

The Shapiro Wilk test was used to check the normality of the outcome variables. This study compared differences in the mean values of the KT and nonKT conditions in participants using a Wilcoxon signed-rank test on SPSS software (ver.

성능/효과

Second, this study cannot confirm the changes in movement of the hyolaryngeal complex with a greater or lesser stretch because the KT was applied only with a 50% stretch. Third, this study cannot guarantee the therapeutic effects because KT presents only the possibility of resistance training method by confirming instantaneous change of hyolaryngeal complex movement during swallowing. Lastly, since the stretch of KT was determined by experiential evidence of practitioner, there may be the presence of the human error for.

후속연구

Park et al. 15 applied it to healthy adults with about 80% stretch of KT, but this study applied it to about 50% by lowering the intensity of resistance because it is a patient with dysphagia after stroke Therefore, it is recommended that future studies should be performed by considering various variables such as the patient's swallowing function and severity of dysphagia.

참고문헌 (19)

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상세보기
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원문보기 상세보기
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