Objective: To determine the relationship between electrode position and hyoid movement for effective surface electrical stimulation in the treatment of dysphagia. Methods: Surface electrode pairs targeted on the suprahyoid muscle group were placed in mesial, distal, or pervasive placement patterns on the skin anterior to the suprahyoid muscle group of five healthy subjects, and the vertical and horizontal movements of the hyoid induced by electrical stimulation in the three pattern groups were measured and compared. Results: The mesial electrode-pair pattern induced significant anterior movement of the hyoid. The distal pattern showed a tendency to induce upward hyoid movement. The distance of hyoid movement induced by the electrical stimulation was about half of that found for actual water swallowing. No significant difference in electrical stimulus intensity was found among the electrode patterns. Conclusion: Surface electrical stimulation with mesial electrode-pair placement anterior to the hyoid presumably induces contraction of the digastric muscle anterior belly and the geniohyoid muscle, and was found to pull the hyoid forward. This information and further elucidation of the relationship between surface electrode position and hyoid movement is expected to increase the range of clinical applications.
Objective: Ultrasonography can be used to assess both the morphology and movement of the muscles of deglutition. This study investigated the intratester, intertester, and retest reliability of ultrasonic assessments of the suprahyoid muscle group. Methods: Three testers performed ultrasonographic measurements of the length and area of the geniohyoid muscle in 10 healthy adults, and the contraction ratio during swallowing. Results were compared using intraclass correlation coefficients (ICCs) to determine intratester, retest, and intertester reliabilities. Results: Intratester and retest reliabilities were very good, with ICCs ≥0.8 for all assessment parameters. In intertester reliability, ICCs were ≥0.8 for geniohyoid muscle length and area during swallowing and ≥0.6 for geniohyoid muscle length at rest and contraction ratio. Discussion: These results indicate high reliability of this assessment method for assessments made by the same individual, with reliability of the method remaining high for assessments performed at intervals.
Metani H, Tsubahara A, Hiraoka T, Seki S, Hasegawa T. Risk factors for patients who develop pneumonia either before or after hip fracture surgery. Jpn J Compr Rehabil Sci 2015; 6: 43-49. Objective: The objectives of this study were to examine the risk factors for patients who develop pneumonia either before or after hip fracture surgery and to investigate the utility of dysphagia rehabilitation and oral care. Methods: The medical histories of 145 patients who were hospitalized for a new hip fracture and underwent surgical treatment were retrospectively investigated, and the rate of and risk factors for pneumonia were evaluated. Results:The rate of pneumonia with hip fracture was 14.5%. Psychiatric disorders, history of stroke, time between admission and surgery, blood hemoglobin concentration, serum total protein level, and serum albumin level were risk factors associated with pneumonia. In particular, the serum albumin level and psychiatric disorders were independent risk factors. Conclusion:The majority of pneumonias that develop either after admission or after hip fracture surgery are considered to be aspiration pneumonias, and their frequency was greater than expected. Since patients with malnutrition or psychiatric disorders are more susceptible to pneumonia, ascertaining the patient's activities of daily living prior to injury and conducting thorough oral care are considered essential for preventing aspiration pneumonia.
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