Effects of effortful swallowing against kinesiology taping resistance on the swallowing function in patients with poststroke dysphagia: A randomized controlled trial.

BACKGROUND: A dysphagia rehabilitation method using kinesiology taping (KT) was recently introduced, and its potential for clinical efficacy was demonstrated by evaluating muscle activity and thickness. However, its effect on the swallowing function in patients with dysphagia remains unclear. This study aimed to investigate the effects of effortful swallowing against KT resistance on the swallowing function in patients with post stroke dysphagia. METHODS: Thirty patients with poststroke dysphagia were recruited and randomly assigned to the experimental and placebo groups. In the experimental group, the KT was attached to the front of the neck (the hyoid bone between the sternum) with a tension of approximately 70% to 80%, and effortful swallowing was performed against the KT tension. In contrast, the placebo group performed effortful swallowing with KT applied at the same location without tension. The intervention was performed 30 times/day, 5 days/week for 6 weeks. The videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study were used to analyze oropharyngeal swallowing function. RESULTS: The experimental group showed statistically significant improvements in the oral and pharyngeal phases of the VDS (P = .029 and .007, respectively) and PAS (P = .034) compared with the placebo group. Effect sizes were observed for the oral (0.3) and pharyngeal phases (0.5) of the VDS and PAS (1.1). CONCLUSION: This study demonstrated that effortful swallowing against resistance to KT is an effective therapeutic exercise for improving the swallowing function in patients with poststroke dysphagia.

Data Resource Profile: The Cancer Public Library Database in South Korea.

This paper provides a comprehensive overview of the Cancer Public Library Database (CPLD), established under the Korean Clinical Data Utilization for Research Excellence project (K-CURE). The CPLD links data from four major population-based public sources: the Korea National Cancer Incidence Database in the Korea Central Cancer Registry, cause-of-death data in Statistics Korea, the National Health Information Database in the National Health Insurance Service, and the National Health Insurance Research Database in the Health Insurance Review & Assessment Service. These databases are linked using an encrypted resident registration number. The CPLD, established in 2022 and updated annually, comprises 1,983,499 men and women newly diagnosed with cancer between 2012 and 2019. It contains data on cancer registration and death, demographics, medical claims, general health checkups, and national cancer screening. The most common cancers among men in the CPLD were stomach (16.1%), lung (14.0%), colorectal (13.3%), prostate (9.6%), and liver (9.3%) cancers. The most common cancers among women were thyroid (20.4%), breast (16.6%), colorectal (9.0%), stomach (7.8%), and lung (6.2%) cancers. Among them, 571,285 died between 2012 and 2020 owing to cancer (89.2%) or other causes (10.8%). Upon approval, the CPLD is accessible to researchers through the K-CURE portal. The CPLD is a unique resource for diverse cancer research to investigate medical use before a cancer diagnosis, during initial diagnosis and treatment, and long-term follow-up. This offers expanded insight into healthcare delivery across the cancer continuum, from screening to end-of-life care.

Strain versus Tunable Terahertz Nanogap Width: A Simple Formula and a Trench below.

A flexible zerogap metallic structure is periodically formed, healing metal cracks on a flexible substrate. Zerogap is continuously tunable from nearly zero to one hundred nanometers by applying compressive strains on the flexible substrate. However, there have been few studies on how the gap width is related to the strain and periodicity, nor the mechanism of tunability itself. Here, based on atomic force microscopy (AFM) measurements, we found that 200 nm-deep nano-trenches are periodically generated on the polymer substrate below the zerogap owing to the strain singularities extant between the first and the second metallic deposition layers. Terahertz and visible transmission properties are consistent with this picture whereby the outer-bending polyethylene terephthalate (PET) substrate controls the gap size linearly with the inverse of the radius of the curvature.

Observing inhibition of the SARS-CoV-2 helicase at single-nucleotide resolution.

The genome of SARS-CoV-2 encodes for a helicase (nsp13) that is essential for viral replication and highly conserved across related viruses, making it an attractive antiviral target. Here we use nanopore tweezers, a high-resolution single-molecule technique, to gain detailed insight into how nsp13 turns ATP-hydrolysis into directed motion along nucleic acid strands. We measured nsp13 both as it translocates along single-stranded DNA or unwinds double-stranded DNA. Our data reveal nsp13's single-nucleotide steps, translocating at ∼1000 nt/s or unwinding at ∼100 bp/s. Nanopore tweezers' high spatiotemporal resolution enables detailed kinetic analysis of nsp13 motion. As a proof-of-principle for inhibition studies, we observed nsp13's motion in the presence of the ATPase inhibitor ATPγS. We construct a detailed picture of inhibition in which ATPγS has multiple mechanisms of inhibition. The dominant mechanism of inhibition depends on the application of assisting force. This lays the groundwork for future single-molecule inhibition studies with viral helicases.

Assessing Readability of an 8-Letter Expanded Deoxyribonucleic Acid Alphabet with Nanopores.

Chemists have now synthesized new kinds of DNA that add nucleotides to the four standard nucleotides (guanine, adenine, cytosine, and thymine) found in standard Terran DNA. Such "artificially expanded genetic information systems" are today used in molecular diagnostics; to support directed evolution to create medically useful receptors, ligands, and catalysts; and to explore issues related to the early evolution of life. Further applications are limited by the inability to directly sequence DNA containing nonstandard nucleotides. Nanopore sequencing is well-suited for this purpose, as it does not require enzymatic synthesis, amplification, or nucleotide modification. Here, we take the first steps to realize nanopore sequencing of an 8-letter "hachimoji" expanded DNA alphabet by assessing its nanopore signal range using the MspA (Mycobacterium smegmatis porin A) nanopore. We find that hachimoji DNA exhibits a broader signal range in nanopore sequencing than standard DNA alone and that hachimoji single-base substitutions are distinguishable with high confidence. Because nanopore sequencing relies on a molecular motor to control the motion of DNA, we then assessed the compatibility of the Hel308 motor enzyme with nonstandard nucleotides by tracking the translocation of single Hel308 molecules along hachimoji DNA, monitoring the enzyme kinetics and premature enzyme dissociation from the DNA. We find that Hel308 is compatible with hachimoji DNA but dissociates more frequently when walking over C-glycoside nucleosides, compared to N-glycosides. C-glycocide nucleosides passing a particular site within Hel308 induce a higher likelihood of dissociation. This highlights the need to optimize nanopore sequencing motors to handle different glycosidic bonds. It may also inform designs of future alternative DNA systems that can be sequenced with existing motors and pores.

Effects of Assistive Technology Application in Dementia Intervention for People with Mild Cognitive Impairment & Mild Alzheimer Type Dementia and Caregiver.

Background: Dementia, a degenerative disease, requires alternative treatment to maintain function, but previous studies suggest only the therapeutic effect of a temporary program. Primary Study Objective: The current study aimed to examine the effects of assistive technologies on cognitive function, daily living ability, and psychosocial symptoms in elderlies with mild cognitive impairment, elderlies with mild dementia and their caregivers. Design: The research team designed an experimental study that used application as the intervention. Setting: To recruit participants living in the local community, research participation was supported through local public health centers, welfare centers, and social welfare organizations. Evaluation and intervention were conducted by visiting the participant's home. Participant: The study participants were 29 Mild Cognitive Impairment (MCI) and 16 mild Alzheimer type dementia (AD) patients over the age of 75 with a total of 45 patients, 10 MCI caregivers and 11 AD caregivers with a total of 21 caregivers. Intervention: The assistive technologies used for intervention are 3 area (8 daily living assistive devices, 7 safety assistive technologies, and 7 cognitive assistive technologies). Up to 5 assistive technologies were provided to one subject, and they were instructed to use them every day for 8 weeks. Outcome measure: Participants were evaluated at baseline and postintervention using specific scales appropriate to an area: cognitive function, activities of daily living, depression, anxiety, quality of life, satisfaction. Results: Cognitive function showed statistically significant changes in the MCI group. Basic activities of daily living, depression, anxiety, quality of life, satisfaction showed statistically significant positive effects in both MCI and AD groups. Instrumental activities of daily living did not show any statistically significant differences. Conclusion: As an alternative to dementia care in the future, the application and management of assistive technologies for each area should be provided at the government level.

Predicting chemical structure using reinforcement learning with a stack-augmented conditional variational autoencoder.

In this paper, a reinforcement learning model is proposed that can maximize the predicted binding affinity between a generated molecule and target proteins. The model used to generate molecules in the proposed model was the Stacked Conditional Variation AutoEncoder (Stack-CVAE), which acts as an agent in reinforcement learning so that the resulting chemical formulas have the desired chemical properties and show high binding affinity with specific target proteins. We generated 1000 chemical formulas using the chemical properties of sorafenib and the three target kinases of sorafenib. Then, we confirmed that Stack-CVAE generates more of the valid and unique chemical compounds that have the desired chemical properties and predicted binding affinity better than other generative models. More detailed analysis for 100 of the top scoring molecules show that they are novel ones not found in existing chemical databases. Moreover, they reveal significantly higher predicted binding affinity score for Raf kinases than for other kinases. Furthermore, they are highly druggable and synthesizable.

Inhibition of the SARS-CoV-2 helicase at single-nucleotide resolution.

The genome of SARS-CoV-2 encodes for a helicase called nsp13 that is essential for viral replication and highly conserved across related viruses, making it an attractive antiviral target. Here we use nanopore tweezers, a high-resolution single-molecule technique, to gain detailed insight into how nsp13 turns ATP-hydrolysis into directed motion along nucleic acid strands. We measured nsp13 both as it translocates along single-stranded DNA or unwinds short DNA duplexes. Our data confirm that nsp13 uses the inchworm mechanism to move along the DNA in single-nucleotide steps, translocating at ~1000 nt/s or unwinding at ~100 bp/s. Nanopore tweezers' high spatio-temporal resolution enables observation of the fundamental physical steps taken by nsp13 even as it translocates at speeds in excess of 1000 nucleotides per second enabling detailed kinetic analysis of nsp13 motion. As a proof-of-principle for inhibition studies, we observed nsp13's motion in the presence of the ATPase inhibitor ATPγS. Our data reveals that ATPγS interferes with nsp13's action by affecting several different kinetic processes. The dominant mechanism of inhibition differs depending on the application of assisting force. These advances demonstrate that nanopore tweezers are a powerful method for studying viral helicase mechanism and inhibition.

Nanopore tweezers measurements of RecQ conformational changes reveal the energy landscape of helicase motion.

Helicases are essential for nearly all nucleic acid processes across the tree of life, yet detailed understanding of how they couple ATP hydrolysis to translocation and unwinding remains incomplete because their small (∼300 picometer), fast (∼1 ms) steps are difficult to resolve. Here, we use Nanopore Tweezers to observe single Escherichia coli RecQ helicases as they translocate on and unwind DNA at ultrahigh spatiotemporal resolution. Nanopore Tweezers simultaneously resolve individual steps of RecQ along the DNA and conformational changes of the helicase associated with stepping. Our data reveal the mechanochemical coupling between physical domain motions and chemical reactions that together produce directed motion of the helicase along DNA. Nanopore Tweezers measurements are performed under either assisting or opposing force applied directly on RecQ, shedding light on how RecQ responds to such forces in vivo. Determining the rates of translocation and physical conformational changes under a wide range of assisting and opposing forces reveals the underlying dynamic energy landscape that drives RecQ motion. We show that RecQ has a highly asymmetric energy landscape that enables RecQ to maintain velocity when encountering molecular roadblocks such as bound proteins and DNA secondary structures. This energy landscape also provides a mechanistic basis making RecQ an 'active helicase,' capable of unwinding dsDNA as fast as it translocates on ssDNA. Such an energy landscape may be a general strategy for molecular motors to maintain consistent velocity despite opposing loads or roadblocks.

Sequence-dependent mechanochemical coupling of helicase translocation and unwinding at single-nucleotide resolution.

We used single-molecule picometer-resolution nanopore tweezers (SPRNT) to resolve the millisecond single-nucleotide steps of superfamily 1 helicase PcrA as it translocates on, or unwinds, several kilobase-long DNA molecules. We recorded more than two million enzyme steps under various assisting and opposing forces in diverse adenosine tri- and diphosphate conditions to comprehensively explore the mechanochemistry of PcrA motion. Forces applied in SPRNT mimic forces and physical barriers PcrA experiences in vivo, such as when the helicase encounters bound proteins or duplex DNA. We show how PcrA's kinetics change with such stimuli. SPRNT allows for direct association of the underlying DNA sequence with observed enzyme kinetics. Our data reveal that the underlying DNA sequence passing through the helicase strongly influences the kinetics during translocation and unwinding. Surprisingly, unwinding kinetics are not solely dominated by the base pairs being unwound. Instead, the sequence of the single-stranded DNA on which the PcrA walks determines much of the kinetics of unwinding.

Smart Wireless Near-Infrared Light Emitting Contact Lens for the Treatment of Diabetic Retinopathy.

Diabetic retinopathy is currently treated by highly invasive repeated therapeutic injections and surgical interventions without complete vision recovery. Here, a noninvasive smart wireless far red/near-infrared (NIR) light emitting contact lens developed successfully for the repeated treatment of diabetic retinopathy with significantly improved compliance. A far red/NIR light emitting diode (LED) is connected with an application-specific integrated circuit chip, wireless power, and communication systems on a PET film, which is embedded in a silicone elastomer contact lens by thermal crosslinking. After in vitro characterization, it is confirmed that the retinal vascular hyper-permeability induced by diabetic retinopathy in rabbits is reduced to a statistically significant level by simply repeated wearing of smart far red/NIR LED contact lens for 8 weeks with 120 µW light irradiation for 15 min thrice a week. Histological analysis exhibits the safety and feasibility of LED contact lenses for treating diabetic retinopathy. This platform technology for smart LED contact lens would be harnessed for various biomedical photonic applications.

Glucocorticoid Receptor Agonists to Improve the Productivity and Health of Early-Weaned Pigs: What is the Best Method of Delivery?

The purpose of the current study was to determine the best method of delivery for glucocorticoid receptor agonist (GRA) treatment. A total of 167 Pig Improvement Company (PIC) piglets (body weight (BW) 7.35 ± 1.24 kg) were weaned at 25.0 ± 0.81 days of age and randomly assigned to 14 treatment groups based on a 2 × 7 factorial arrangement with sex (gilts vs. barrows), in-feed antibiotic (ANT; 110 mg/kg in-feed tylosin), repeated intramuscular (I.M.) injection of GRA (two injections, 0.2 mg/kg BW dexamethasone (DEX)), low dose in-feed GRA (LF, 2.5 mg/kg diet DEX ), high dose in-feed GRA (HF, 5 mg/kg diet DEX), low dose in-water GRA (LW, 0.8 mg/L DEX ), high dose in-water GRA (HW, 1.6 mg/L DEX ), and no treatment control (CON) as the main factors. Body weight and feed intake were measured daily from days 0 to 7 and weekly from days 7 to 28 post-weaning. The interaction effect for average daily gain (ADG) was significant with gilts performing better in the I.M., ANT, and LF groups (p = 0.05). All treatment groups, with the exception of the HW group, had a higher ADG than the CON group. Gilts in the I.M., LF, and HF groups had the highest ADG compared to other treatment groups (p ≤ 0.05). Sex and the interaction between sex and treatments had no effect on the gain-to-feed ratio (G:F; p ≥ 0.21). All treatment groups had a higher G:F than the CON group (p ≥ 0.04). These results suggest that the low-dose, in-feed GRA treatment is the best GRA delivery method and is a suitable alternative to in-feed sub-therapeutic antibiotics.

Effects of chewing exercises on the occlusal force and masseter muscle thickness in community-dwelling Koreans aged 65 years and older: A randomised assessor-blind trial.

Chewing exercises have been applied in clinical settings to improve the occlusal force and function of the masseter muscle in elderly individuals. However, the clinical relevance and effects of chewing exercises are unclear. This study aimed to investigate the effects of bilateral chewing exercises on the occlusal force and masseter muscle thickness in community-dwelling Koreans aged 65 years. Forty community-dwelling healthy elderly individuals were enrolled in this study. They were assigned to the experimental or the control group. The experimental group performed chewing exercises using medical equipment developed to facilitate such exercises. The chewing exercises were divided into isometric and isotonic types and were performed for 20 min/d, 5 days/wk, for 6 weeks. The control group did not perform any chewing exercises. The outcome measures were occlusal force and masseter muscle thickness, which were evaluated using an occlusometer and ultrasound device, respectively. A paired t test and an independent t test were used to evaluate the training effects. Within-group comparisons showed that occlusal force and masseter muscle thickness improved significantly in the experimental group (P < .001 for both), while the control group showed no significant improvements (P = .098 and .130). Between-group comparisons showed that the experimental group had a greater increase in occlusal force and masseter muscle thickness (P < .05 for both) compared to the control group. These results suggest that chewing exercises are effective in improving occlusal force and masseter muscle thickness in healthy elderly individuals.

The Effects of a Glucocorticoid Receptor Agonist (GRA) on the Immune Function, Nutrient Digestibility, and Wean-to-Finish Growth Performance of Early-Weaned Pigs.

This study assessed the viability of glucocorticoid receptor agonist (GRA) treatment as an alternative to in-feed antibiotics (ANT) in wean-to-finish pigs. A total of 209 piglets were assigned to eight treatments based on a factorial arrangement, with GRA (+ vs. -; dexamethasone, 0.2 mg/kg body weight, BW), ANT (+ vs. -; 110 mg/kg in-feed Tylosin) and sex (gilt vs. barrow) as the main factors. The serial slaughter technique and serial blood collection were performed on 115 pigs during the first week post-weaning to collect blood, tissue and ileal digesta samples. Fecal samples were collected to determine energy digestibility. In comparison to ANT, GRA more effectively improved the measures of systemic inflammation, protein utilization and recovery-associated biomarkers (p ≤ 0.05). Relative to the control group, GRA treatment improved (p ≤ 0.03) dietary nutrient digestibility relative to control pigs, which was comparable to ANT effects. Relative to the control group, all groups had a higher ADG and BW during the starter phase (p < 0.01). Similar to the ANT group, GRA improved the gain-to-feed ratio relative to the control group during the starter phase. Relative to control pigs, overall BW was higher in GRA and ANT pigs during the grow-to-finish phase (p < 0.01). Collectively, these results suggest that GRA injection improves the growth performance of newly weaned pigs by reducing weaning-induced inflammation and improving nutrient digestibility. GRA can be used as an alternative to in-feed ANT to mitigate the effects of weaning stress on pigs.

Nanopore Sequencing of an Expanded Genetic Alphabet Reveals High-Fidelity Replication of a Predominantly Hydrophobic Unnatural Base Pair.

Unnatural base pairs (UBPs) have been developed and used for a variety of in vitro applications as well as for the engineering of semisynthetic organisms (SSOs) that store and retrieve increased information. However, these applications are limited by the availability of methods to rapidly and accurately determine the sequence of unnatural DNA. Here we report the development and application of the MspA nanopore to sequence DNA containing the dTPT3-dNaM UBP. Analysis of two sequence contexts reveals that DNA containing the UBP is replicated with an efficiency and fidelity similar to that of natural DNA and sufficient for use as the basis of an SSO that produces proteins with noncanonical amino acids.

Supramolecular Injectable Hyaluronate Hydrogels for Cartilage Tissue Regeneration.

Mesenchymal stem cells (MSCs) have been widely investigated to repair injured cartilage tissues for the treatment of arthritis. Despite these great efforts, the difficulty in the spatiotemporal control of delivered cells has limited the further clinical development with rapid clearance. Here, we developed injectable hyaluronate (HA) hydrogels to encapsulate MSCs for controlled cartilage tissue regeneration based on the supramolecular chemistry between ß-cyclodextrin-modified HA (HA-CD) and adamantane (Ad)-modified HA (HA-Ad). Supramolecular HA hydrogels exhibited remarkable mechanical characteristics such as shear thinning and self-healing with a high cell viability of encapsulated MSCs. The spatiotemporally controlled delivery of MSCs from the supramolecular HA hydrogels resulted in the statistically significant chondrogenic differentiation and extracellular matrix deposition in vitro and in vivo. We could confirm the notable cartilage tissue regeneration in cartilage defect model rats after treatment with supramolecular HA hydrogels encapsulating MSCs for 28 days. Taken together, supramolecular HA hydrogels would be successfully harnessed as an injectable delivery system of MSCs for cartilage tissue regeneration and other tissue engineering applications.

A Novel Method Using Kinesiology Taping for the Activation of Suprahyoid Muscles in Healthy Adults: A Preliminary Research.

The suprahyoid muscles play a major role in safe swallowing in the pharyngeal phase. Therefore, it is clinically important to design a therapeutic approach for strengthening the suprahyoid muscles for safe and normal swallowing. This study aimed to investigate the activation of suprahyoid muscles by resistance training using kinesiology taping (KT). We enrolled 23 healthy adults. All participants performed saliva swallowing five times at 5 s intervals in three conditions (without KT, 50% stretch with KT, and 80% stretch with KT). KT in the I and reverse V shapes was pulled vertically from the hyolaryngeal complex to the sternum and medially from the superior surface of the clavicle, respectively. Another KT horizontally covered the hyolaryngeal complex to enhance the movement restriction of the hyolaryngeal complex during swallowing. Activation of the suprahyoid muscles during swallowing in the two conditions was measured using surface electromyography. In addition, a 0-10 numerical rating self-report scale was used to evaluate the required effort and the resistance felt during swallowing. Both KT 50% and 80% were significantly higher in surface electromyography (sEMG) mean value, peak value, required effort, and resistance felt during swallowing compared to normal swallowing (p < 0.05). In addition, KT 80% was significantly higher in sEMG value, peak value, required effort, and resistance felt during swallowing than KT 50% (p < 0.05). This study demonstrated that KT applied to the area under the hyolaryngeal complex improves activation of the suprahyoid muscle during swallowing. Therefore, KT applied as resistance during swallowing is considered to have therapeutic potential in dysphagia rehabilitation.

Effect of neuromuscular electrical stimulation combined with effortful swallowing using electromyographic biofeedback on oropharyngeal swallowing function in stroke patients with dysphagia: A pilot study.

BACKGROUND: Electromyographic biofeedback (EMG-BF) is known to be an effective therapy for stroke rehabilitation. However, because few studies have investigated the therapy in patients with dysphagia, its effectiveness is not yet clear. This study aimed to investigate the effect of neuromuscular electrical stimulation (NMES) using EMG-BF on swallowing function in stroke patients with oropharyngeal dysphagia. METHODS: In this study, 10 patients with dysphagia were recruited. The 1-group, pre-post study design was adopted. All subjects received NMES combined with EMG-BF in the suprahyoid area. Electrical stimulation was provided as a reward when the electrical signal generated by effortful swallowing reached a preset threshold. The intervention was provided for 30 minutes a day, 5 times a week for 4 weeks. The videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) based on the videofluoroscopic swallowing study were used to evaluate the swallowing function. RESULTS: Pre-intervention showed no significant differences in all items of VDS (P > .05). However, there was a statistically significant change in VDS from 13.36 ±â€Š5.94 to 9.36 ±â€Š5.14 (P = .015) in the oral phase, and from 38.36 ±â€Š7.42 to 20.71 ±â€Š14.61 (P = .016) in the pharyngeal phase. The PAS scores showed significant change from 5.14 ±â€Š2.27 to 3.00 ±â€Š1.00 (P = .031). CONCLUSION: This study demonstrated that the use of NMES combined with EMG-BF had the potential to improve oropharyngeal swallowing in stroke patients with dysphagia.

Tongue stretching exercises improve tongue motility and oromotor function in patients with dysphagia after stroke: A preliminary randomized controlled trial.

OBJECTIVES: This study investigated the effect of tongue stretching exercises (TSE) on tongue motility and oromotor function in patients with dysphagia after stroke. DESIGN: This study was designed as a 4-week, double-blind, two-group, block randomized controlled trial. A total of 25 patients were randomly allocated into either the experimental (n = 13) or the control group (n = 12). The experimental group received TSE from an occupational therapist. TSE were divided into dynamic and static passive stretching exercises (20 repetitions each). The intervention was performed five times a week for four weeks. Tongue motility was measured before and after the intervention as the distance from the lower lip to the tip of tongue during maximum protrusion of the tongue. Measurements were performed twice each time and the mean value recorded. Oromotor function was assessed using the oral phase events of the videofluoroscopic dysphagia scale (VDS) based on a videofluoroscopic swallowing study. RESULTS: The experimental group showed significant differences in tongue motility, bolus formation, tongue to palate contact, premature bolus loss, and oral transit time in the oral phase of VDS (p < 0.05 for all) before and after the intervention, whereas the control group showed a significant difference only in lip closure (p < 0.05). CONCLUSION: This study demonstrated that TSE have a positive effect on tongue motility and oromotor function in patients with dysphagia after stroke. Therefore, we recommend TSE as an effective treatment for dysphagia.

Efficacy of modified chin tuck against resistance exercise using hand-free device for dysphagia in stroke survivors: A randomised controlled trial.

BACKGROUND: Chin tuck against resistance exercise was recently reported as a novel method for improving the swallowing function of patients with post-stroke dysphagia. However, as this exercise involves holding and fixing the device using the hand, physically weak patients may find it difficult to perform it. OBJECTIVES: This study aimed to investigate the effect of modified chin tuck against resistance (mCTAR) exercise on patients with post-stroke dysphagia. METHODS: In total, 30 patients with dysphagia were recruited in this study. They were randomly assigned to either the experimental or control group. The experimental group performed mCTAR exercise and received traditional dysphagia treatment, whereas the control group received only traditional dysphagia treatment. mCTAR exercise involved isometric and isotonic exercises. Aspiration and oral diet were evaluated using penetration-aspiration scale (PAS) and functional oral intake scale (FOIS), respectively. Moreover, the rate of nasogastric tube removal was analysed. RESULTS: Compared with the control group, the experimental group showed statistically significant improvement in PAS and FOIS (P < 0.001, both). The rates of nasogastric tube removal were 25% and 15% in the experimental and control groups, respectively. CONCLUSION: This study demonstrated that mCTAR exercise can reduce aspiration and improve dietary levels in patients with post-stroke dysphagia. Therefore, mCTAR exercise is expected to be beneficial for physically vulnerable patients with dysphagia who have limited hand strength and range of motion.