Search

As consumer demand for meat analogs continues to grow, various plant proteins are being explored for their production. This study uses isolated mung bean protein (IMBP) to replace isolated soy protein (ISP), investigating the effects of IMBP content (0%, 10%, 20%, 30%, 40%, and 50%) on the physicochemical and textural properties of high-moisture meat analogs (HMMAs) and exploring the potential of IMBP in the development and production of meat analogs. The results show that IMBP can bind water and cause protein denaturation, thus requiring more time and higher temperatures to be formed compared to HMMAs without IMBP. Additionally, increasing the IMBP content improves the gelling ability, thereby increasing the input of specific mechanical energy. As the IMBP content increases, the fibrous structure of the HMMA also increases. When the IMBP content reaches 40-50%, the most meat-like fibrous structure is observed. The water-holding capacity, water absorption capacity, springiness, and cohesiveness are negatively correlated with the IMBP content, while the oil absorption capacity is positively correlated with it. The integrity index and nitrogen solubility index show opposite trends with the increase in the IMBP content. When the IMBP content is 50%, the springiness and chewiness are the lowest, and the cutting strength is also the lowest, but the sample has a rich fibrous content, indicating that the HMMA with 50% IMBP content is soft and juicy. In conclusion, IMBP has the potential to be a substitute for ISP in the production of HMMAs.

There is no comprehensive predischarge occupational therapy assessment tool in South Korea. The objective of this study was to determine Stroke-Predischarge Occupational Therapy Assessment (S-POTA) validity and reliability. Twenty-seven occupational therapists (OTs) assessed 97 patients with stroke. Concurrent validity was evaluated by comparing S-POTA scores with stroke-specific quality of life (SS-QOL). Discriminant validity was evaluated by comparing S-POTA scores between outpatient and readmitted groups, and a receiver operating characteristic analysis was conducted. The test-retest was conducted twice in 20 patients, and the inter-rater test was conducted with two OTs per patient. S-POTA positively correlated with SS-QOL. S-POTA rating differs significantly across outpatients and readmitted groups. All S-POTA areas under curve values ranged from .70 to .85, and cut-off points were derived. Cronbach's α for internal consistency was .953, the intraclass correlation coefficient for test-retest was .990, and .987 for inter-rater reliability. The results suggest S-POTA is a reliable tool for efficient implementation of discharge planning.

Sexuality is a common concern among people with disabilities or chronic conditions, and failure to address sexuality can lead to poorer rehabilitation outcomes. To explore the factors affecting addressing the sexuality of adult clients in clinical practice as perceived by Korean Occupational Therapists (OTs) and the perspective on what needs to be established to address sexuality in occupational therapy practice. This descriptive qualitative study using focus group interviews was conducted with 15 OTs providing rehabilitation services for adult clients in the post-onset maintenance phase or for outpatients in Seoul, South Korea. Data collected through focus groups were analyzed using the constant comparative method. The main factors influencing addressing clients sexuality in clinical practice were identified: "absence of institutional system for addressing sexuality in rehabilitation setting" for environmental factors; "lack of professional competency" for therapist-related factors; and "repressed sexuality" for client-related factors. Moreover, recognizing that "sexual health is one of the goals of rehabilitation" and prioritizing it in rehabilitation settings are essential. OTs must be "experts with knowledge and skills" to access the client's sexuality, and "education and publicity" should be actively conducted to raise awareness of sexual health for clients. To deal with clients sexuality, institutional preparation should be prioritized under the recognition that sexual health is one of the goals of rehabilitation. In addition, it is necessary to prepare a relevant curriculum for OTs and create awareness so that clients can recognize improving sexual activity as a role of OTs., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Digital learning is a rapidly advancing method for teaching and learning in professional health education. Although various digital learning designs have been tried in OT education, studies on digital learning designs are still limited., Methods: We conducted a scoping study that aimed to identify the digital learning designs used in occupational therapy (OT) education and review the effectiveness, learner perceptions, clinical skills integrated, and technology-based learning strategies used to facilitate learning. Four databases were searched using subheadings and terms relating to digital learning, occupational therapy, and education. The included studies were mapped according to the types of digital learning design, subjects, key clinical skills, and outcomes., Results: Twenty-two studies were included in this review, most of which were qualitative, observational, or mixed studies of the two designs. The digital learning designs identified in OT education were flipped, blended, hybrid, and distance learning, including e-learning and massive open online courses (MOOC). Among the components of clinical skills, professional reasoning and procedural knowledge were the most integrated into digital learning, and covered various OT subjects. Digital learning designs were reported to be equivalent to or more effective than the traditional face-to-face (F2F) class in learning outcomes of knowledge and skill acquisition, enhancing learning participation, reflection, and collaboration between learners. Various technologies have been used to promote synchronous or asynchronous active learning, providing learning strategies such as thinking, reflection, discussion, peer learning-group activity, and gamifying online learning., Conclusions: In OT digital learning, appropriate learning subjects, the arrangement of clinical skill components that can be well integrated into digital learning, and the selection of appropriate technologies for effective learning are important. The results should be confirmed within an experimental study design., (© 2022. The Author(s).)

Recently, a therapeutic method to stimulate the suprahyoid muscle using peripheral magnetic stimulation for dysphagia rehabilitation has been reported. However, clinical evidence, application protocol, and intervention method remain unclear. Therefore, a systematic review of the published literature is needed. The objective of this study was to systematically review clinical studies of peripheral magnetic stimulation applied for rehabilitation of dysphagia. Issues to be considered in future studies are also suggested. This systematic review performed a literature search of four databases (Medline, Embase, CINAHL, and Web of Science) to identify relevant studies published on the application of repetitive peripheral magnetic stimulation (rPMS) for swallowing-related muscles between 2010 and 2022. Seven studies were reviewed. Randomized controlled trials and one-group pre-post, case study designs were included. In the included studies, rPMS was applied to strengthen the submental suprahyoid muscles. The intervention regime varied. The rPMS was applied at a frequency of 30 Hz for 2 s. Rest time ranged from 8 s to 27-28 s. The number of intervention sessions ranged from 2-3 to 30. The intensity ranged from pain-inducing minimum intensity (90% of maximum stimulus output) to non-painful intensity (70-80% of maximum intensity). The rPMS on the suprahyoid muscles had positive effects on physiological changes in the swallowing function, such as displacement of the hyoid bone, muscle strength (cervical flexor, jaw-opening force), swallowing safety, swallowing performance, and swallowing-related quality of life. Participants also reported little pain and adverse reactions during rPMS. Although rPMS is a therapeutic option that can help improve the swallowing function as a non-invasive stimulation method in the rehabilitation of dysphagia, clinical evidence is needed for the development of clear stimulation protocols and guidelines.

The convergence and development of information and communication technology (ICT) have brought changes to occupational therapy practices, posing novel challenges for occupational therapists (OTs). This study aimed to investigate current practices of ICT use and factors affecting the clinical use of ICT among Korean OTs. An online survey was conducted among 158 domestic OTs working in hospitals. Participants reported that the therapeutic use of ICT positively affected client outcomes, ICT choice, and continued use. Participants highlighted the necessity to assess the ability of clients to use smart devices and ensure familiarity in the OT process. Of respondents, 31% reported the application of ICT-based interventions or recommendations in clinical practice. The use of ICT was predominantly associated with cognitive function, leisure activities, and information access and communication. A significant difference in barriers to ICT use was observed between familiar users and non-users. Familiar users reported a lack of knowledge and training as major barriers, whereas non-users reported expensive products or technology. Ease of use and usefulness were facilitators of ICT use among familiar users. Information and training opportunities are required to promote ICT use by OTs, and the usefulness of ICT must be realized via client-centered, customized approaches.

Healthcare is a field in which the benefits of virtual reality (VR), such as risk-taking without consequences, direct experience, and service outcome prediction, can be utilized. VR technology has been used to help clients face environmental barriers by implementing a home environment in virtual reality without a home visit by an expert. This scoping review was conducted to identify the areas and implementation methods of the home modification process supported by VR technology. Twelve studies met the research criteria. The following three types of tools supported by VR technology for the home modification process were identified: educational tools for clients or specialists, home environment measurement tools, and intermediaries for decision making and collaboration between clients and specialists. Most of the studies reported positive results regarding the usability and acceptability of the technology, but barriers have also been reported, such as technical problems, inappropriate population groups for technical use, cost-related issues, the need for training, and fear that the technology could replace home visits. Thus, VR technology has potential value in the home modification process. However, for future clinical applications, additional studies to maximize the benefits of these VR technologies and address the identified problems are required.

Background: Chin tuck against resistance (CTAR) exercise has been recently reported to be a new therapeutic exercise method that can help improve swallowing function in patients with dysphagia. However, due to the differences in exercise protocols, methods and the tools used across studies of CTAR exercise, an overall systematic review of these studies is necessary., Objective: The present study investigated the exercise protocols, methods and tools used in various studies of CTAR exercise and summarised their findings., Methods: We searched for studies related to CTAR exercise using electronic databases and selected nine articles for review. The articles were categorised on the basis of four criteria: study design and quality, training protocol, outcome measures and clinical effect., Results: Four articles reported that CTAR exercise not only helped activate the suprahyoid muscle in healthy adults, but also activated the sternocleidomastoid muscle less than Shaker exercise. In addition, five articles reported that CTAR exercise was effective in improving swallowing function and oral diet stage in the pharyngeal phase, including reduction of airway aspiration in patients with dysphagia after stroke., Conclusions: CTAR exercise more selectively activates the suprahyoid muscle and is an effective therapeutic exercise for improving swallowing function in patients with dysphagia. Because it is less strenuous than Shaker exercise, it requires less physical burden and effort, allowing greater compliance., (© 2021 John Wiley & Sons Ltd.)

This study aimed to investigate the effects of semi-immersive virtual reality-based cognitive training (VRCT) combined with locomotor activity on cognitive function, balance, and gait ability in older adults. Eighteen community-dwelling older adults participated in this study. Subjects who met the selection criteria were assigned to an experimental group ( n = 9) and a control group ( n = 9). The experimental group received VRCT combined with locomotor activity for 30 min a day, three times a week, for 6 weeks. The control group received tabletop activity-based cognitive training for the same amount of time. Before and after the training, the Korean Mini-Mental State Examination (K-MMSE), Trail Making Test (TMT; A and B), and Digit Span Test (DST; forward and backward) were used to evaluate cognitive function; and the Timed Up and Go (TUG) test and 10-m Walking Test (10MWT) were used to evaluate the improvement in the balance and gait ability parameters. After the intervention, the experimental group showed a significantly greater improvement in the TMT-A ( p = 0.045) and DST-backward ( p = 0.012) scores compared with the control group. Regarding the gait ability variable, the experimental group showed a significant improvement in the 10MWT test ( p = 0.001). This study confirmed that semi-immersive VRCT combined with locomotor activity is useful for improving cognitive function and gait ability in older adults. Therefore, VRCT combined with locomotor activity can be used as a simultaneous intervention for cognitive rehabilitation and functional capacity improvement in older adults.

Telehealth (TH) intervention is a method to optimize self-management (SM) support in stroke survivors. Objectives of this study included identifying the TH-SM intervention's focus and SM support components, the TH delivery type, and the TH-SM support effects on stroke survivors. Five databases were searched for the years 2005-2020 to identify TH-SM support interventions for stroke survivors. Randomized controlled trials and quasi-experimental, one-group re-post study designs were included. Ten studies were reviewed. TH-SM support focused on post-stroke depression, obesity management, participation, functional mobility, and activities of daily living. The TH delivery type most used in selected studies was messaging. Regarding the SM support components, the education component was used in all studies, and psychological support and lifestyle advice and support were used in 8 out of 10 studies. TH-SM intervention had positive effects in terms of goal achievement for SM behavior, emotional state, and mobility of clinical outcomes, and TH acceptance in stroke survivors. Although the TH-SM-supported intervention effects were not found consistently in all outcomes, this review discovered a positive effect on various SM-related outcomes. In addition, TH delivery types and SM support components showed the possibility of various options to be considered for intervention. Therefore, we suggest that TH-SM supported intervention is a positive alternative for SM support in stroke survivors.

Videofluoroscopic swallowing study (VFSS) is generally used to diagnose dysphagia and oropharyngeal aspiration during swallowing movement. Patients and bolus-feeding operators (such as occupational therapist and speech language pathologist) may undergo multiple VFSS procedure, placing them at risk for more radiation exposure due to increased scan time. The present study investigated the dose-area product, effective dose of various protocols, and summarized dose reports from various studies of VFSS. The PubMed database searched for relevant publications reporting radiation dose in the VFSS procedure. 13 articles were selected to be reviewed. This systematic review involved 13 peer-reviewed articles that reported the specific dose of the VFSS procedure. The articles were categorized into three types: operator radiation dose, adult patient radiation dose, and pediatric radiation dose. The operator dose reports showed that the operators' scattering exposure, equivalent dose (across the whole body, eyes, and hands), and annual effective dose were significantly lower than the annual dose limit of 20 mSv. Both adult and pediatric patient dose reports showed that the effective dose, which was estimated from recorded dose-area product, was significantly lower than the annual background exposure of 2.4 mSv in various protocols. The present literature review suggested that the radiation dose of VFSS by modified barium swallowing is acceptable in both operators and patients. However, various radiation protection strategies should be conducted during the procedure to reduce the risk of stochastic effect.

Background: It has recently been shown that suprahyoid muscle exercise using kinesiology taping (KT) increases the activation of the suprahyoid muscle in healthy adults, suggesting a potential therapeutic clinical exercise for dysphagia rehabilitation. This study investigated the effect of dysphagia rehabilitation using KT in stroke patients with dysphagia., Methods: Thirty subjects in South Korea were enrolled in this prospective placebo-controlled double-blind study. Participants were randomly assigned to the experimental and sham groups. In the experimental group, the tape was attached to the hyolaryngeal complex, pulled downward with approximately 70% tension, and then attached to the sternum and the clavicle bilaterally. In the sham group, the tape was applied similarly but without the tension. Both groups performed voluntary swallowing 50 times (10 times swallowing per set, times 5 sets) a day for 4 weeks with KT applied. Outcome measures were assessed using portable ultrasound equipment. The parameter measured was the change in thickness of the tongue muscle, mylohyoid muscle, and the anterior belly of the digastric muscle., Results: The experimental group showed statistically significant changes in the thickness of the tongue muscle, mylohyoid muscle, and anterior belly of the digastric muscle than the sham group ( p = 0.007, 0.002, and 0.001)., Conclusion: Dysphagia rehabilitation using KT is a technique that may promote oropharyngeal muscle thickness in patients with dysphagia after stroke., Competing Interests: The authors declare no conflict of interest.

(1) Background: Occupational therapy (OT) practice has a unique perspective that addresses the complex needs of cancer survivors. Despite the expanded research and application of OT services using telehealth (TH) to promote clients' health and well-being, studies on OT services using TH for cancer survivors are rare. This study aimed to review the TH approaches in the scope of OT and the outcome of factors affecting occupational engagement in adult cancer survivors. (2) Materials and Methods: This systematic review performed a literature search of five databases (Medline Complete, PubMed, CINAHL, PsycINFO, Web of Science) using a combination of keywords and cross-referencing. Studies were included if they described a TH intervention within the scope of OT practice to improve occupational engagement. (3) Results: Fifteen studies (12 randomized controlled trials, three quasiexperimental studies) were reviewed. Physical activity had a positive effect on physical and cognitive function. Symptom self-management showed positive effects on the relief of symptom burden. Psychosocial interventions, which included cognitive behavioral therapy, problem-solving, cognitive behavioral therapy for insomnia, mind-body training, reduced sleep disturbance, and improved physical activity. Lifestyle behavior change interventions improved participation in moderate-intensity physical activity and diet quality. In addition, these interventions reduced cancer-related symptoms such as pain, depression, fatigue, distress, and improved quality of life. There were no direct outcomes of occupational engagement, excluding sleep, that could be confirmed through this review. (4) Conclusion: This review explored and confirmed the usefulness of TH approaches in the scope of OT practice in adult cancer survivors. It also supports the notion that OT-specific research using TH interventions for cancer survivors will be needed in the future.

Background: Game-based training has been shown to improve behavioural motor learning in various medical fields including rehabilitation., Objectives: This study aimed to investigate the effects of a tablet PC (personal computer) game-based tongue training on tongue strength, thickness and compliance in healthy adults., Methods: This study recruited 30 healthy volunteers. Subjects were randomly assigned to two groups (n = 15/group). Group 1 performed game-based tongue training, and group 2 performed tongue resistance training using the Iowa Oral Performance Instrument. Both groups performed the same tongue exercises as follows: frequency (isotonic = 30 times × 3, isometric = 20 seconds × 3), intensity (70% of 1-repeated maximum contraction) and intervention period (5 days for 6 weeks). The primary outcomes were tongue muscle strength and thickness. Secondary outcomes were assessed using a 0-to-10 numerical rating self-report scale that included motivation, interest/fun, physical effort and muscle fatigue/pain., Results: Both groups showed significant improvement in tongue strength and thickness, but there were no significant differences between the groups after the intervention. The self-report scale numerical rating revealed that group 1 had significantly higher motivation and interest/fun after the exercise than group 2. Group 1 had expended a significantly lower physical effort than group 2. No significant differences were noted between the 2 groups for muscle fatigue/pain., Conclusion: This study showed that both exercises had similar effects on tongue strength and thickness increase in healthy adults, but game-based tongue training was more fun and physically less demanding., (© 2020 John Wiley & Sons Ltd.)

Objective: To examine the effects of neuromuscular electrical stimulation (NMES) on oropharyngeal swallowing function according to 2 types of placement, acting as assistance and as resistance, in stroke patients with dysphagia., Methods: Thirty-eight stroke patients with dysphasia were randomly assigned to the suprahyoid group (SMG), or infrahyoid muscle group (IMG); 26 patients completed the intervention and were included in the analysis. In the SMG, the electrodes were placed on the region between the jaw and the hyoid bone, whereas in the IMG, the electrodes were placed on the region below the hyoid for the targeted infrahyoid muscles. Both groups received NMES for 30 min/d, 5 d/wk, for 4 weeks and conventional dysphagia therapy. Swallowing function was measured using the Videofluoroscopic Dysphagia Scale and Penetration-Aspiration Scale based on videofluoroscopic swallowing study. Oral dietary intake was measured using the Functional Oral Intake Scale., Results: Both groups showed significant improvements in oropharyngeal function and level of functional oral intake, but there was no significant difference between the two groups. However, the SMG showed a more reduced penetration-aspiration, compared with the IMG., Conclusions: Altogether, these data demonstrate that 2 types of NMES placements have a similar effect on improving swallowing function and oral diet intake in patients with dysphagia.

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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Osteoarthritis (OA) is a degenerative disease that not only causes knee pain in older adults, but also has an adverse effect on walking. Therefore, intervention for older patients with OA is important. To investigate the immediate effects of kinesiology taping (KT) on the pain and gait function of the older adults with knee OA., Methods: This study enrolled 10 older adults individuals living in the community who were diagnosed with knee OA. All participants were assessed for knee pain, walking ability, and balance before and after application of knee KT. Knee pain was assessed in resting and walking conditions using the visual analog scale. Walking and balance were assessed using a 10-m walking test and a timed up and go test., Results: In the present study, KT significantly improved gait and balance with reduction in knee pain during walking than non-KT (P < .05)., Conclusions: This study demonstrated that knee KT has a positive effect on pain reduction and walking and balance ability of the older adults with OA. Therefore, this study suggests that KT can be used as an intervention to relieve knee pain and aid walking and balance ability in the older adult.

Background: Lingual strength training (LST) has been reported to positively affect the activation of submental muscles, as well as to increase lingual muscle strength. However, there is little evidence to support its effectiveness., Objectives: This study aimed to investigate the effect of LST on the strength and thickness of oropharyngeal muscles in healthy adults., Methods: The study included 30 subjects who were assigned to the experimental (n = 15) and the control groups (n = 15). The experimental group performed LST based on tongue-to-palate resistance exercise method. LST was categorised as isometric and isotonic exercise. The intervention was performed five times a week for 6 weeks. The control group did not receive any intervention. The lingual strength was measured using the Iowa Oral Performance Instrument. Changes in the thickness of the mylohyoid and the digastric muscles and the lingual were assessed ultrasonographically., Results: After the intervention, the thickness of the mylohyoid and the digastric muscles in the experimental group was significantly greater than that in the control group (P = 0.037 and 0.042)., Conclusion: This study demonstrated that LST increases the thickness and the strength of oropharyngeal muscles. Therefore, LST is a useful option in patients with dysphagia or in elderly patients prone to swallowing dysfunction., (© 2019 John Wiley & Sons Ltd.)

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 ± 5.94 to 9.36 ± 5.14 (P = .015) in the oral phase, and from 38.36 ± 7.42 to 20.71 ± 14.61 (P = .016) in the pharyngeal phase. The PAS scores showed significant change from 5.14 ± 2.27 to 3.00 ± 1.00 (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.

Background: Game-based exercise is effective for improving strength and motor function in stroke patients undergoing rehabilitation, and it creates fun and motivation for exercise., Objective: We investigated the effect of game-based exercise on hand strength, motor function, and compliance in stroke patients., Methods: Fifty stroke patients were randomly divided into experimental and control groups. The experimental group performed a game-based hand resistance exercise. This exercise was divided into isotonic and isometric types and was performed 30 min/day, 5 days/week, for 6 weeks with 70% of the 1-repetition maximum. In contrast, the control group was given a traditional manual exercise by the occupational therapist, and the type of exercise and time involved were the same as those in the experimental group. The primary outcome measure was hand strength test measured using a dynamometer. Secondary outcome measures were manual function tests (MFT) and hand function tests using box and block test (BBT). Subject-based reports of motivation, fun, pain/fatigue evaluated on 0 to 10 numeric rating scales were compared between groups., Results: After training, hand strength, MFT and BBT was improved in the experimental group compared to the control group (P < 0.001, both). Subject-based reports of motivation and fun was significantly greater in the experimental group than the control group (P < 0.001, both), except to pain/fatigue (P = 0.728)., Conclusions: In conclusion, we demonstrated that game-based exercise is more effective than manual exercise in improving muscle strength, motor function, and compliance in stroke patients.

Background: Neuromuscular electrical stimulation has been used to improve swallowing function in neurologic patients with dysphagia, but its effect on patients with dysphagia and Parkinson's disease remains unclear., Objectives: This study aimed to identify the effect of effortful swallowing combined with neuromuscular electrical stimulation as a novel treatment approach in dysphagic patients with Parkinson's disease., Methods: Participants were randomly allocated to an experimental group (n = 9) or a placebo group (n = 9). The experimental group simultaneously received neuromuscular electrical stimulation with effortful swallowing, while the placebo group received sham neuromuscular electrical stimulation with effortful swallowing. All participants received the treatment for 30 min/day at five sessions per week for 4 weeks. Both groups also received the same conventional dysphagia therapy., Results: The experimental group showed significant differences in horizontal movement (p = 0.038) and vertical movement (p = 0.042) compared to the placebo group, but showed no significant differences in the oral (p = 0.648) or pharyngeal phase (p = 0.329) of the Videofluoroscopic Dysphagia Scale compared to the placebo group, except for the Penetration-Aspiration Scale (p = 0.039)., Conclusions: We demonstrated that neuromuscular electrical stimulation applied to the infrahyoid region combined with effortful swallowing effectively increased hyoid bone movement and reduced aspiration in dysphagic patients with Parkinson's disease.

The head lift exercise (HLE) is a head-raising workout performed in a supine position. This exercise facilitates activation of the submental muscles located above the hyoid bone in front of the neck. HLE is a potential method to improve the movement of the hyolaryngeal movement and swallowing functions. The purpose of this study was to investigate the effect of HLE on the hyolaryngeal movement and aspiration in patients with dysphagic stroke. A total of 27 patients with stroke were randomly assigned either into the experimental (n = 13) or the control group (n = 14). The experimental group performed HLE 5 days a week for 4 weeks (a total of 20 sessions). Both groups received the same conventional dysphagia therapy. Two-dimensional analysis of the hyolaryngeal movement was carried out using Image J program based on a videofluoroscopic swallowing study. Penetration-aspiration was assessed using Penetration-Aspiration Scale (PAS). The experimental group showed a significant increase in the only superior movements of the hyoid bone compared with the control group (P = 0·033). Aspiration in liquid also exhibited a significant decrease in the experimental group compared with the control group (P = 0·044). Findings from this study confirmed that HLE is an effective intervention to improve hyoid movement and decrease aspiration., (© 2017 John Wiley & Sons Ltd.)

Background: The world's population is aging faster and the incidence of acute kidney injury (AKI) needing continuous renal replacement therapy (CRRT) is increasing in elderly population. The outcome of AKI needing CRRT in elderly patients is known to be poor. However, the definitions of elderly used in the previous literatures were diverse and, there were few data that compared the long-term mortality rates of these patients with middle aged patients. This study was aimed to evaluate this issue., Methods: This study was a single-center, retrospective cohort study of patients who underwent CRRT from January 2013 to December 2015. The patients were divided into the following four age cohorts: middle-aged (55-64), young-old (65-74), middle-old (75-84), and old-old (≥85). The short- and long-term mortality rates for each age cohort were compared., Results: A total of 562 patients met the inclusion criteria. The short-term mortality rate was 57.3% in the entire cohort. Compared with the middle-aged cohort, the middle-old cohort (HR 1.48 (1.09-2.02), p = 0.012) and the old-old cohort (HR 2.33 (1.30-4.19), p = 0.005) showed an increased short-term mortality rate along with an increased SOFA score, acidemia and a prolonged prothrombin time. When we analyzed the long-term mortality rate of the 238 survived patients, the middle-old cohort (HR 3.76 (1.84-7.68), p<0.001), the old-old cohort (HR 4.40(1.20-16.10), p = 0.025), a lower BMI, the presence of liver cirrhosis, the presence of congestive heart failure and a history of sepsis were independent risk factors for the prediction of long-term mortality., Conclusion: Compared with the middle-aged cohort, the middle-old and the old-old cohort showed an increased short-term and long-term mortality rate. However, in the young-old cohort, neither the short-term nor the long-term mortality rate was increased., Competing Interests: The authors have declared that no competing interests exist.

Neuromuscular electrical stimulation (NMES) has been used as a therapeutic intervention for dysphagia. However, the therapeutic effects of NMES lack supporting evidence. In recent years, NMES combined with traditional swallowing therapy has been used to improve functional recovery in patients with post-stroke dysphagia. This study aimed to investigate the effects of effortful swallowing combined with neuromuscular electrical stimulation on hyoid bone movement and swallowing function in stroke patients. Fifty stroke patients with mild dysphagia who were able to swallow against the resistance applied by using NMES and cooperate actively in training were included. This study was designed as a 6-week single-blind, randomised, controlled study. In the experimental group, two pairs of electrodes were placed horizontally in the infrahyoid region to depress the hyoid bone. The NMES intensity was increased gradually until the participants felt a grabbing sensation in their neck and performed an effortful swallow during the stimulation. In the placebo group, the same procedure was followed except for the intensity, which was increased gradually until the participants felt an electrical sensation. All participants underwent this intervention for 30 min per session, 5 sessions per week, for 6 weeks. Videofluoroscopic swallowing studies (VFSS) were carried out before and after the intervention and kinematics of the hyoid bone and swallowing function were analysed based on the VFSS. The experimental group revealed a significant increase in anterior and superior hyoid bone movement and the pharyngeal phase of the swallowing function. This intervention can be used as a novel remedial approach in dysphagic stroke patients., (© 2016 John Wiley & Sons Ltd.)

Ym1 and Ym2 (Ym1/2) are chitinase-like proteins and we reported previously that IL-4 induced Ym1/2 in mouse bone marrow-derived mast cells. In the present study, ovalbumin-induced asthmatic mice were used to investigate the effect of glucocorticoids on Ym1/2 expression. Ym1/2 were highly induced in bronchoalveolar lavage fluid (BALF) and the lung. Ym1/2 expression was completely inhibited by dexamethasone (Dex) in BALF and weakly inhibited in the lung. Primary cultured macrophages were used to investigate the inhibition of Ym1/2 expression at the cellular level. Although Dex pretreatment inhibited the Ym1/2 expression level in an animal model, it did not reduce IL-4 induction of Ym1/2 expression in vitro. Next, we tested whether Dex blocks IL-4 induced STAT6 signaling and found that it had no inhibitory effect on the phosphorylation level of STAT6 in macrophages. The luciferase reporter assay also revealed that Dex did not inhibit IL-4 induction of Ym1/2 promoter activity. These results indicate that the inhibitory effect of Dex on Ym1/2 protein expression in the murine model of asthma does not involve the STAT6 signaling pathway.

Meso-dihydroguaiaretic acid (MDGA) is a medicinal herbal product isolated from the aerial parts of Saururus chinensis that inhibits the cyclooxygenase-2 (COX-2)-dependent phase of prostaglandin D(2) (PGD(2)) generation in bone marrow-derived mast cells (BMMC) (IC(50) 9.8 microM). However, this compound did not inhibit COX-2 protein expression in BMMC at concentrations up to 30 microM, indicating that MDGA directly inhibits COX-2 activity. In addition, this compound consistently inhibited the production of leukotriene C(4) (IC(50) 1.3 microM). These results demonstrate that MDGA inhibits both COX-2 and 5-lipoxygenase. Furthermore, this compound strongly inhibited the degranulation reaction in BMMC (IC(50) 11.4 microM). Therefore, this compound might provide a basis for novel anti-inflammatory drug development.

In our ongoing search for anti-inflammatory agents originating from Korean medicinal plants, we found that the hexane and BuOH fractions of the MeOH extract from the whole plants of Melandrium firmum Rohrbach inhibited 5-lipoxygenase (5-LOX) activity. By activity-guided fractionation, eleven compounds, alpha-spinaterol (1), ursolic acid (2), ergosterol peroxide (3), alpha-spinaterol glucoside (4), 2-methoxy-9-beta-D-ribofuranosyl purine (5), aristeromycin (6), ecdysteron (7), polypodoaurein (8), (-)-bornesitol (9), mannitol (10) and cytisoside (11) were isolated from the hexane and BuOH fractions using column chromatography. Compounds 2, 5, 6, 8, 9, 10 and 11 were isolated for the first time from this plant. Compounds 1, 3, 4 and 7 inhibited 5-LOX activity with IC50 values of 21.04 microM, 42.30 microM, 32.82 microM, and 17.18 microM, respectively.