Effect of Dysphagia Rehabilitation Using Kinesiology Taping on Oropharyngeal Muscle Hypertrophy in Post-Stroke Patients: A Double Blind Randomized Placebo-Controlled Trial.

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.

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.

Immediate effects of kinesiology tape on the pain and gait function in older adults with knee osteoarthritis.

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.

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.

Toxicity of antioxidative extract collected from Styela clava tunics in ICR mice.

Some polymers and bioactive compounds derived from Styela clava tunic (SCT) have been reported as traditional medicine for the treatment of inflammation, oxidative stress and surgical wounds although there is little scientific evidence of their liver and kidney toxicity. To investigate the toxicity of ethanol extracts of SCT (EtSCT) in the liver and kidney of ICR mice, alterations in related markers including body weight, organ weight, urine composition, liver pathology and kidney pathology were analyzed following oral administration of 50 and 100 mg/kg body weight/day of EtSCT for 14 days. EtSCT showed a high level of free radical scavenging activity for DPPH (93.1%) and NO (16.2%) as well as the presence of 14.8 mg/mL of flavonoids and 36.2 mg/mL of phenolics, while EtSCT treated groups did not show any significant alterations in the body and organ weight, clinical phenotypes, urine parameters or mice mortality when compared with the vehicle treated group. In addition, constant levels of serum biochemical markers including alanine phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and serum creatinine (CRE) were maintained. Moreover, no specific histopathological features induced by most toxic compounds were observed in liver and kidney sections stained with hematoxilin and eosin. Therefore, the present results indicate that EtSCT with strong antioxidant activity cannot induce any specific toxicity in liver and kidney organs of ICR at doses of 100 mg/kg body weight/day.

Thalamic Reorganization in Chronic Patients With Intracerebral Hemorrhage: A Retrospective Cross-Sectional Study.

The aim of this study was to investigate changes of synaptic area of the spinothalamic tract and its thalamocortical pathway (STT) in the thalamus in chronic patients with putaminal hemorrhage.Twenty four patients with a lesion in the ventral posterior lateral nucleus (VPL) of the thalamus following putaminal hemorrhage were recruited for this study. The subscale for tactile sensation of the Nottingham Sensory Assessment (NSA) was used for the determination of somatosensory function. Diffusion tensor tractography of the STT was reconstructed using the Functional Magnetic Resonance Imaging of the Brain Software Library. We classified patients according to 2 groups: the VPL group, patients whose STTs were synapsed in the VPL; and the non-VPL group, patients whose STTs were synapsed in other thalamic areas, except for the VPL.Thirteen patients belonged to the VPL group, and 8 patients belonged to the non-VPL group. Three patients were excluded from grouping due to interrupted integrity of the STTs. The tactile sensation score of the NSA in the non-VPL group (10.50 ±â€Š0.93) was significantly decreased compared with that of the VPL group (19.45 ±â€Š1.33) (P < 0.05).We found that 2 types of patient had recovered via the VPL area or other areas of the STT. It appears that patients who showed shifting of the thalamic synaptic area of the STT might have recovered by the process of thalamic reorganization following thalamic injury. In addition, thalamic reorganization appears to be related to poorer somatosensory outcome.

Causal influence of epileptic network during spike-and-wave discharge in juvenile myoclonic epilepsy.

Electroencephalographic (EEG) characteristic of juvenile myoclonic epilepsy (JME) is spike-and-wave discharge (SWD), which is dominant in the frontal region. However, activity in the parietal area, including the precuneus, has also been documented for several seconds before and during SWD. The aim of this study was to identify the role of the parietal region, especially the precuneus, and to clarify the causal dynamics among cortical regions during SWD. EEGs were obtained from seven patients with JME. Each SWD was divided into six distinct temporal phases: spike onset, spike peak, slow-wave onset, slow-wave ascending, slow-wave peak, and slow-wave descending phases. Based on the cortical current source distribution and the results of a previous study, we selected the medial frontal, orbitofrontal, anterior cingulate, and mesial temporal cortices and the precuneus as regions of interest (ROIs). To assess epileptic networks and the causal relationships among ROIs during SWD, the directed transfer function (DTF), a measure of multivariate causality, was calculated for each phase of SWD. During spike onset, the maximal outdegree region in all patients was the precuneus. The spike-peak and slow-wave onset phases did not show a consistently dominant outflow region. Outflow from the anterior cingulate cortex was dominant in four patients during the slow-wave ascending phase, and the precuneus showed the maximal outdegree in six patients during the slow-wave peak. In the slow-wave descending phase, four patients showed maximal outflow from the temporal cortex. Our findings suggest that the precuneus is likely a key region for SWD despite the small amount of neural activity observed. The precuneus was the region with the maximal outdegree during both the spike onset and slow-wave peak phases, indicating that SWD in JME is initiated and sustained by a network involving the frontal cortex, precuneus, and thalamus.

An image-guided transcranial direct current stimulation system: a pilot phantom study.

In this study, an image-guided transcranial direct current stimulation (IG-tDCS) system that can deliver an increased stimulation current to a target brain area without the need to adjust the location of an active electrode was implemented. This IG-tDCS system was based on the array-type tDCS concept, which was validated through computer simulations in a previous study. Unlike a previous study, the present IG-tDCS system adopts a single reference electrode and an active electrode array consisting of 16 (4 × 4) sub-electrodes. The proposed IG-tDCS system is capable of shaping current flow inside the human head by controlling the input currents of the arrayed electrodes. Once a target brain area has been selected, the optimal injection current of each arrayed sub-electrode is evaluated automatically using a genetic algorithm in order to deliver the maximum available current to the target area. The operation of our pilot system was confirmed through a simple phantom experiment.

Neurotization from two medial pectoral nerves to musculocutaneous nerve in a pediatric brachial plexus injury.

Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

An EEG-based real-time cortical functional connectivity imaging system.

In the present study, we introduce an EEG-based, real-time, cortical functional connectivity imaging system capable of monitoring and tracing dynamic changes in cortical functional connectivity between different regions of interest (ROIs) on the brain cortical surface. The proposed system is based on an EEG-based dynamic neuroimaging system, which is capable of monitoring spatiotemporal changes of cortical rhythmic activity at a specific frequency band by conducting real-time cortical source imaging. To verify the implemented system, we performed three test experiments in which we monitored temporal changes in cortical functional connectivity patterns in various frequency bands during structural face processing, finger movements, and working memory task. We also traced the changes in the number of connections between all possible pairs of ROIs whose correlations exceeded a predetermined threshold. The quantitative analysis results were consistent with those of previous off-line studies, thereby demonstrating the possibility of imaging cortical functional connectivity in real-time. We expect our system to be applicable to various potential applications, including real-time diagnosis of psychiatric diseases and EEG neurofeedback.