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.

The effect of modified cervical exercise on smartphone users with forward head posture.

[Purpose] The purpose of this study was to evaluate the effect of modified cervical exercise and determine whether such exercise improves the range of motion of the cervical movement in smartphone users with forward head posture. [Subjects and Methods] Some 32 subjects with forward head posture participated in this study. They were randomly allocated to three groups, and the modified cervical exercises were performed either once, twice, or three times per day. The exercise program was followed for four weeks and then the joint range of motion of the participants was measured. [Results] A significantly increased range of motion was seen in all three groups that performed the modified cervical exercises. The analysis of the effects among the three groups indicated that the greatest effect was seen in Group C, members of which performed the modified exercises three times per day. In addition, a significant difference was found between Group A and Group C in terms of the inter-group results. [Conclusion] According to the results of this study, although the modified cervical exercises were performed for only a relatively short duration (four weeks), the exercises brought about an improvement in the forward head posture that was induced by using a smartphone.

The effects of plantar flexor static stretching and dynamic stretching using an aero-step on foot pressure during gait in healthy adults: a preliminary study.

[Purpose] The aim of this study was to examine whether plantar flexor static stretching and dynamic stretching using an Aero-Step results in changes in foot pressure during gait in healthy adults. [Subjects] Eighteen normal adults were randomly allocated to either a dynamic stretching using an Aero-Step group (DSUAS) group (n = 8) or a static stretching (SS) group (n = 10). [Methods] The DSUAS and SS participants took part in an exercise program for 15 minutes. Outcome measures were foot plantar pressure, which was measured during the subject's gait stance phase; the asymmetric ratio of foot pressure for both feet; and the visual analogue scale (VAS) measured during the interventions. [Results] There were significant differences in the asymmetric ratio of foot pressure for both feet and VAS between the two groups after intervention. However, there were no significant differences in foot plantar pressure during the gait stance phase within both groups. [Conclusion] DSUSAS is an effective stretching method, as pain during it is lower than that with SS, which can minimize the asymmetric ratio of foot pressure for both feet during gait due to asymmetric postural alignment.

The effects of wet heat and dry heat on the gait and feet of healthy adults.

[Purpose] The purpose of this study was to examine the degree of changes in gait and feet after wet heat and dry heat exposure for 20 minutes. [Subjects] The participants of this study were 17 young adult males. The subjects were divided into a wet heat group of 9 subjects and dry heat group of 8 subjects. [Methods] Dry heat was applied for 20 min. To facilitate temperature adjustment of an electrical hot pack, to which a temperature controller was attached to the hot compress, the outer cover of the electrical pad was wrapped in a cotton towel and then rolled around the femur and the leg. As a hot compress, a constant-temperature water tank with double-boiling functionality was used for the hot pack unit. Its surface was covered with a towel twice or three times, as needed. We measured gait and feet. [Results] Left and right step time and the step width significantly increased in the wet heat group. Left foot flat to heel off significantly increased in the dry heat group. Right heel contact to foot flat significantly increased in the wet heat group. Left rearfoot pressure significantly increased in the dry heat group. [Conclusion] Wet heat affects physical functions like gait more than dry heat. However, there is no great difference between wet heat and dry heat with respect to the distribution of foot pressure.

Effects of Abdominal Stimulation during Inspiratory Muscle Training on Respiratory Function of Chronic Stroke Patients.

[Purpose] The purpose of the present study was to verify a new method for improving respiratory functions by applying both abdominal stimulation and inspiratory muscle training (IMT) to train the inspiratory muscle and the expiratory muscle simultaneously, to improve the efficiency of IMT of chronic stroke patients. [Subjects] Eighteen stroke patients were randomly assigned to an experimental group (n = 9) and a control group (n = 9). [Methods] The experimental group was administered IMT with abdominal stimulation, and the control group was administered only IMT. During the intervention period, the experimental group and control group received training 20 min/day, 3 times/wk, for 4 weeks. To examine the lung functions of the subjects, FVC, FEV1, PEF, and FEF25-75 were measured using an electronic spirometer. The diaphragm thickness ratio was calculated from measurements made with a 7.5-MHz linear probe ultrasonic imaging system. [Result] The experimental group and the control group showed significant increases in diaphragm thickness ratio on the paretic side, but not on the non-paretic side. With regard to lung function, the experimental group showed significant increases in FEV1, PEF, and FEF25-75. The changes between before and after the intervention in the two groups were compared with each other, and the results showed significant differences in FEV1 and PEF. [Conclusion] The present study identified that IMT accompanied by abdominal stimulation improved the pulmonary function of chronic stroke patients.

Comparison of the Effects of Walking with and without Nordic Pole on Upper Extremity and Lower Extremity Muscle Activation.

[Purpose] The aim of this study was to assess the effect of Nordic pole walking on the electromyographic activities of upper extremity and lower extremity muscles. [Subjects and Methods] The subjects were randomly divided into two groups as follows: without Nordic pole walking group (n=13) and with Nordic pole walking group (n=13). The EMG data were collected by measurement while the subjects walking on a treadmill for 30 minutes by measuring from one heel strike to the next. [Results] Both the average values and maximum values of the muscle activity of the upper extremity increased in both the group that used Nordic poles and the group that did not use Nordic poles, and the values showed statistically significant differences. There was an increase in the average value for muscle activity of the latissimus dorsi, but the difference was not statistically significant, although there was a statistically significant increase in its maximum value. The average and maximum values for muscle activity of the lower extremity did not show large differences in either group, and the values did not show any statistically significant differences. [Conclusion] The use of Nordic poles by increased muscle activity of the upper extremity compared with regular walking but did not affect the lower extremity.