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Objective@#This study was undertaken to identify the effect of Oral Motor Facilitation Technique (OMFT) on the drooling control ability of children afflicted with Cerebral Palsy (CP). @*Methods@#Totally, 21 CP children with drooling problems participated in the study. OMFT was provided for 16 weeks (30 minutes, 1 session a week, 16 sessions). The drooling control ability was assessed by determining the severity and frequency using the Drooling Severity and Frequency Scale (DSFS) before, at 8 weeks, and 16 weeks after OMFT administration. The effectiveness of OMFT was analyzed at the time intervals using the Friedman test. Post hoc analyses were conducted by the Wilcoxon signed rank test and Kruskal Wallis test. @*Results@#Drooling control ability showed significant improvement after 16 weeks of OMFT. Although the severity of drooling significantly increased after 8 weeks, the frequency was unchanged. Our results indicate that OMFT is a useful oral motor treatment protocol to manage the drooling control ability of children with CP. We recommend at least 8 weeks of OMFT administration. @*Conclusion@#Drooling is an important problem in dysphagia. Clinicians need to show more importance in controlling drooling, and a comprehensive oral motor treatment like OMFT should be considered for children afflicted with CP.
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Objective@#Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. @*Methods@#Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. @*Results@#Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. @*Conclusion@#This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.
ABSTRACT
The definition of drooling is very broad, Drooling is characterized by saliva flowing out of the mouth or moving behind the pharynx unintentionally due to various reasons. Drooling is affected by increased salivation, and oral motor and swallowing functions. The amount depends on the situation, place, mood, and concentration. There is a need for comprehensive evaluation and treatment since drooling could be stimulated by various causes, such as sensory, motor, cognitive, and behavioral. Drooling evaluation is divided into objective and subjective evaluations. The objective evaluation mainly measures the amount of saliva secretion using a towel, a container, and a dental swab, and assessing the frequency of drooling at a fixed time. Subjective evaluation usually evaluates the subject’s severity and frequency of drooling during certain periods. A comprehensive evaluation that identifies the effects of salivation on the subject’s daily life, social interaction, psychology, and self-esteem, and evaluates the degree of drooling according to various postures, situations, and conditions, also needs to be considered. Nevertheless, there are several difficulties in developing standardized drooling assessment tools. The evaluation contents and results may vary depending on the treatment approach, such as botulinum toxin treatment or oral exercise therapy. The current article will help understand and select drooling assessment tools for identifying and measuring outcomes in clinical settings and studies.
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Drooling is defined as the unintentional flow of saliva out of the mouth or to the back of the pharynx due to salivary control problems and swallowing difficulties. Drooling is caused by posture, oral sensori-motor and cognitive problems, and medical symptoms. Treatments of drooling are defined under two criteria: 1) non-invasive treatment, which includes posture and oral motor therapy, and 2) invasive treatment, including botox injection and surgery.Drooling treatment should be initiated non-invasively and in a step-wise manner in all individuals. This mode of treatment is safe, age-free, and is considered the first line of therapy, before subjecting to invasive treatment.Clinical professionals provide non-invasive treatment via manual approaches, through passive sensori-motor stimulation to active oral motor activities. Comprehensive therapy protocols such as oral motor facilitation technique (OMFT) for oral sensory normalization, head and neck postural control, and oral motor function improvements, are required to help control drooling. Clinical professionals therefore need to deeply understand the reason for drooling, and provide qualified non-invasive treatment for intensifying drooling control.
ABSTRACT
Drooling is defined as the unintentional flow of saliva out of the mouth or to the back of the pharynx due to salivary control problems and swallowing difficulties. Drooling is caused by posture, oral sensori-motor and cognitive problems, and medical symptoms. Treatments of drooling are defined under two criteria: 1) non-invasive treatment, which includes posture and oral motor therapy, and 2) invasive treatment, including botox injection and surgery.Drooling treatment should be initiated non-invasively and in a step-wise manner in all individuals. This mode of treatment is safe, age-free, and is considered the first line of therapy, before subjecting to invasive treatment.Clinical professionals provide non-invasive treatment via manual approaches, through passive sensori-motor stimulation to active oral motor activities. Comprehensive therapy protocols such as oral motor facilitation technique (OMFT) for oral sensory normalization, head and neck postural control, and oral motor function improvements, are required to help control drooling. Clinical professionals therefore need to deeply understand the reason for drooling, and provide qualified non-invasive treatment for intensifying drooling control.
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Objective@#The purpose of this study was to identify the current status of dysphagia therapy administered by occupational therapists in Korea as well as to obtain basic data to explore the development direction of dysphagia therapy. @*Methods@#This study surveyed occupational therapists who underwent rehabilitation therapy for swallowing disorders in general hospitals, rehabilitation hospitals, and nursing hospitals from April 2019 to September 2019.Resdults: According to the results of the survey, dysphagia therapy has been actively conducted in rehabilitation hospitals, nursing hospitals, and general hospitals. In the area of dysphagia therapy, increased intervention of pediatric patients and psychiatric patients was confirmed, and various intervention methods such as compensation and restorative methods were applied. The results of this study confirm the importance of a structured environment along with the necessity of a systematic intervention system. Therapists who performed dysphagia therapy recognize the importance of evidence-based practice, but the application of evidence-based practice is proportionally low. @*Conclusion@#It was confirmed that dysphagia rehabilitation growing both quantitatively and qualitatively in the short period of 20 years after supported by insurance. In addition, due to the systematic evaluation and provision of appropriate treatments according to the symptoms, dysphagia rehabilitation is firmly established as the main area of occupational therapy.
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OBJECTIVE: This study examined how changes in the volume, texture, and taste of food affect the variation of tongue pressure during the swallowing of food in healthy adults. METHODS: Fifty-four healthy subjects participated in this study. The tongue pressure was measured using an Iowa Oral. Performance Instrument (IOPI) during swallowing of food in 54 healthy adults. The food bolus with modified volumes (3, 5, 10, and 15 ml), textures (water, puree, and cracker), and tastes (pure water, sour taste, sweet taste, and salty taste) were provided and the variation of the tongue pressure was traced during the swallowing of food. RESULTS: The tongue pressure changed significantly when the volume of food chunks increased. When the texture of food was modified, the tongue pressure was significantly different when swallowing a cracker than when swallowing water and puree. In addition, the tongue pressure was increased more by a sour taste liquid than pure water or sweet taste liquid. CONCLUSION: When swallowing food, the tongue pressure at the appropriate level is essential for safe swallowing. Because modification of the volume, texture, and taste of food can induce the variation of tongue pressure, it can be recommended as an effective therapeutic method that can move food in the mouth.
Subject(s)
Adult , Humans , Deglutition , Healthy Volunteers , Iowa , Methods , Mouth , Tongue , WaterABSTRACT
OBJECTIVE: To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. METHODS: We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. RESULTS: Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 100,000 people (p<0.001), while the proportion of indoor fall accidents decreased from 38.12% to 23.16% (p<0.001). Females had more annual fall accidents than males (p<0.001). The major reason for fall accidents was slippery floors (33.7% in 2011 and 36.3% in 2013). Between 2008 and 2010, variables associated with higher fall accident risk included specific months (August and September), old age, female gender, current drinker, current smoker, diabetes, osteoarthritis, osteoporosis, and depression. A high level of education and living with a partner were negatively associated with fall accident risk. In 2013, people experiencing more than 1 fall accident felt more fear of falling than those having no fall accidents (odds ratio [OR] for 1 fall, 2.12; 95% confidence interval [CI], 2.04–2.12; OR for more than 2 falls, 2.97; 95% CI, 2.83–3.10). CONCLUSION: The occurrence of fall accidents has consistently increased in Korea from 2008 to 2013. Future intervention studies are needed to reduce the increasing incidence rates of fall accidents in community dwelling adults.