Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. However, during exercise, excessive activation of the posterior deltoid compared to the infraspinatus causes the humeral head to move anteriorly in an abnormal position. Many researchers have emphasized selective activation of the infraspinatus during shoulder external rotation exercise. Objects: This study aims to delineate the optimal exercise method for selective activation of infraspinatus by investigating the muscle activities of the infraspinatus and posterior deltoid according to the four shoulder exercise methods and two forearm positions. Methods: Thirty healthy individuals participated in this study. The participants were instructed to perform shoulder external rotation exercises following four exercise methods: sitting external rotation (SIER); standing external rotation at 90° abduction (STER); prone external rotation at 90° abduction (PRER); side-lying external rotation (SLER), and two forearm positions (neutral, supinated). The electromyography (EMG) signal amplitude was measured during each exercise. Surface EMG signals were recorded from the posterior deltoid, infraspinatus, and biceps brachii. Results: EMG results of the infraspinatus and posterior deltoid in PRER, were significantly higher than that of the other exercises (p < 0.01). The EMG ratio (infraspinatus/posterior deltoid) in SIER was significantly higher than that of the other exercises. EMG activation of the posterior deltoid in SIER, PRER, and SLER was significantly higher in neutral than in supinated (p < 0.01). Furthermore, the EMG of the infraspinatus in SIER was significantly higher in neutral than in supinated (p < 0.01). The EMG ratio (infraspinatus/ posterior deltoid) in SIER was significantly higher in neutral than in supinated (p < 0.05.) Contrarily EMG ratios in PRER and SLER were significantly higher in supinated than in neutral (p < 0.05). Conclusion: The results show that clinicians should consider these exercise methods and forearm positions when planning shoulder external rotation exercises for optimal shoulder rehabilitation.

Background: Gluteus medius muscle is important for the stability of hip joint. The sufficient core stability can be contributed to the performance of gluteus medius muscle in standing position. In addition, the external support may affect core stability in standing position. Objects: The purpose of this study was to investigated the effectiveness of the external support on the strength and muscle activity of hip abductor muscle during hip abduction in standing position in subjects without core stability. Methods: Fifteen subjects participated in this study. The subjects were evaluated by using the double-leg lowering with bent knees to measure the core stability. The strength and muscle activity of hip abductors was measured in standing position with the condition with and without external support using the tensiometer sensor and the surface electromyography. The paired t-test was used to investigate the difference between hip abductor strength and activity according to external support. The level of statistical significance was set at α = 0.05. Results: The hip abductor strength and muscle activity of gluteus medius muscle with external support were significantly greater than those without external support during hip abduction in standing position (p < 0.05). Conclusion: During hip abduction in standing position, the external support may be contributed to the improvement of the hip abductor strength and muscle activity of gluteus medius especially in the subjects without core stability.

Background: Muscle activities of gluteus maximus (GM) and hamstring (HAM) have important roles in the stability and mobility of the hip joint during various functional activities including bridge and prone hip extension exercises. Objects: The purpose of this study is to investigate muscle activities of GM, multifidus (MF) and HAM during three different bridge exercises in healthy individuals. Methods: Twenty healthy subjects were participated. Electromyography device was used to measure muscle activities of GM, MF and HAM. Each subject was asked to perform three different bridge exercises with hip abduction (0°, 15°, 30°) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Statistical significance was set at α = 0.01. Results: The muscle activity of GM was significantly different among three conditions (hip abduction 0°, 15°, 30°) (adjusted p-value [Padj] < 0.01). The muscle activity of GM was significantly greater during bridge exercise with hip abduction 30° compared to 0° and 15° (Padj < 0.01). There was no significant difference in the muscle activity of MF and HAM muscle (Padj > 0.01). The ratio of muscle activity (ratio = GM/HAM) during bridge exercise with hip abduction 30° was significant greater compared to the hip abduction angles 0° and 15° (Padj < 0.01). Conclusion: Bridge exercise with hip abduction 30° can be recommended to selectively facilitate the muscle activity of GM and improve the ratio of muscle activity between GM and HAM.

Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.

Background: Studies suggest that induced emotional changes can affect the sensory-motor system involved in the practice of muscle activity and movement in physical aspects. Previous studies have shown focused on effects just feedback on muscle activity associated with emotions but rarely have focused induced emotional change on gross motor function such as muscle activity. Objects: The purpose of this study was to compare biceps activity and emotion that before and after viewing a video was induced positive or negative emotion. Methods: The study enrolled 34 healthy male and female who scored at normal points on the Center for Epidermiological Studies-Depression Scale. The study measured over two weeks, showing subjects pleasant and sad videos one by one in a week. We performed to measure the biceps brachii activity which is maximal voluntary isometric contraction (MVIC) and the visual analog mood scale (VAMS) scores before and after one week. The significance level was set to α = 0.05. Results: There was no significant difference in muscle activity of the biceps brachii before and after each video was viewed (p > 0.05). However, the visual analogue mood scale showed an increase in VAMS after viewing each video (p < 0.05). Conclusion: We figured out induced emotional changes are cause actual emotional changes but there are no differences in muscle activity. In this research, watching the video with a short time looks like insufficient to change muscle activity. Nevertheless, there might be different when we check various muscles with sufficient time for viewing the video. Further study is needed to measure a variety of muscles with more time for viewing the video.

Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal conditions of the upper extremity with pain and wrist extension disability. The tendon which is most affected is the extensor carpi radialis brevis (ECRB). Previous study evaluated the effect of taping technique on patient with LE, but no study investigated the changes of electromyography (EMG) on ECRB when using dynamic taping (DT) technique. Objects: The aim of this study was to investigate the effect of DT technique using dynamic tape on muscle activity of ECRB during wrist isometric extension, isotonic extension and flexion. Methods: Twenty-one healthy subjects volunteered to participate in this study. Subjects were instructed to perform wrist isometric extension, isotonic extension and flexion without and with DT on origin area of ECRB. Wrist isometric extension was performed at 75%, 50% and 25% (%maximal voluntary contraction force), respectively, based on maximum contraction force. Isotonic extension and flexion test used dumbbell. EMG data was collected from ECRB. Results: EMG of ECRB were statistically significant decrease in wrist isotonic extension after DT (p < 0.05). Significant increase in wrist isometric extension during 25% and 50% force task (p < 0.05). Conclusion: This study applied DT technique to suppress the wrist extensor muscles in 21 healthy adults in their twenties. Change in muscle activity was compared in the ECRB muscle during wrist isometric extension, isotonic extension and flexion task. Based on the results of this study, the DT technique applied to the wrist and forearm area can reduce the load on the wrist extensors when the wrist performs various movements during daily life movements or repetitive tasks, and by using these effects, excessive stress is applied to tennis elbow patients.

목적 : 본 연구는 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련이 뇌졸중 환자의 상지기능, 상지의 근 활성도, 일상생활 활동과 삶의 질에 미치는 효과를 분석하고자 한다. 연구방법 : 선착순 무작위 대조 실험연구 방식으로 연구를 진행하였다. 의료연구협의회 지표(medical research council scale), 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination; MMSE-K)로 대상자를 선별하여 뇌졸중 환자 31명을 무작위로 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련군과 일반적 작업치료군으로 나눈 뒤, 주 5회 하루 30분씩 총 25회기 동안 실험을 진행하였다. 중재 전ᆞ후 비교 분석을 하기 위해서 뇌졸중 상지 기능평가(Manual Function Test; MFT), 표면 근전도 검사(Surface Electromyography; EMG), 한국판 수정된 바델지수(Korean version of Modified Barthel Index; K-MBI), 뇌졸중 영향 척도 3.0(Stroke Impact Scale 3.0; SIS)을 사용하였다. 결과 : 첫째, 실험군과 대조군에서 상지의 기능향상(MFT)이 있었고, 실험군에서 위팔노근의 근 활성도에 유 의한 향상이 있었다. 둘째, 일상생활활동에서는 실험군과 대조군에서 유의한 향상을 보였다. 셋째, 삶의 질 에서는 실험군에서 유의한 향상이 있었다. 결론 : 스마트 글러브를 이용한 가상현실 기반 상지재활훈련은 뇌졸중 환자의 상지기능, 근 활성도, 일상생활 활동과 삶의 질을 향상하는 효과적인 작업치료 방법이다.

Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal pain condition of the upper extremities. LE is often related to forceful grip activities that require isometric contraction of the wrist extensors. A previous study evaluated the effect of the diamond taping technique on grip strength and pain; however, there has been no report on the change in the electromyography (EMG) findings of wrist extensors. Objects: The aim of this study was to investigate the effect of diamond taping technique, using a rigid tape, on the EMG activities of the extensor carpi radialis (ECR) during grip activities. Methods: Twenty-four healthy subjects (mean age = 21.50 ± 2.76 years) volunteered to participate in this study. The subjects were instructed to perform forceful grip activities with and without diamond-type taping on the origin area of the ECR. Grip strength tests were performed at 100%, 75%, 50%, and 25% for maximal isometric contraction force. EMG data were collected from the ECR. Repeated measure analysis of variance was used to analyze the effect of grip force and taping (with and without). Statistical significance levels were set at α = 0.05. Comparison of the results with and without taping at different grip force were analyzed using independent t-test. Statistical significance levels were set at α = 0.01. Results: Statistically significant association was observed between the taping application and forceful grip activity as revealed by the EMG data of the ECR (p < 0.05). EMG of the ECR significantly reduced for all muscle strength levels (p < 0.01) after taping. Conclusion: This study shows an impressive effect of the diamond taping technique, using rigid tape, on wrist extensors during grip activities. Decreasing muscle activity via this taping approach could be utilized to enhance pain-free grip force and reduce pain in patients with LE. Our study suggested that this taping technique could be considered as an effective management strategy of LE.

Background: For performing various movements well, cooperation between the muscles around the scapula and shoulder has been emphasized. Taping has been widely used clinically as a helpful adjunct to other physiotherapy methods for shoulder pathology and dysfunction treatment. Previous studies have evaluated the effect of taping techniques using dynamic tapes on shoulder function and pain. However, no study investigated the electromyographic (EMG) changes in the shoulder muscles. Objects: This study aimed to investigate the effect of the upper limb offload taping technique using a dynamic tape on EMG activities of the upper trapezius (UT), lower trapezius, serratus anterior (SA), and middle deltoid (MD) muscles during scaption plane elevation. Methods: A total of 26 healthy subjects (19.85 ± 6.40 years, male = 20) volunteered to participate in this study. The subjects were instructed to perform scaption elevation with and without dynamic taping on the shoulder. Shoulder elevation strength tests were performed at 100%, 75%, 50%, and 25%, for the maximal isometric contraction force. Results: There were statistically significant interaction effects between the taping application and shoulder scaption elevation force in EMG activities in the UT (p < 0.05) and MD (p < 0.05). EMG activities in the UT showed significant increases in 50%RVC (reference voluntary contraction, p < 0.05) and 25%RVC (p < 0.01). Furthermore, the EMG activity of the SA significantly increased in 50%RVC (p < 0.01) and 25%RVC (p < 0.01) after dynamic taping. For the MD, the EMG activity level significantly decreased in 100%RVC (p < 0.05). Conclusion: These results indicated that upper limb offload dynamic taping application affects the muscle activities of some shoulder muscles depending on different scaption elevation strength levels. Therefore, we suggest that the upper limb offload dynamic taping can be applied to the shoulders when patients need middle deltoid inhibition or upper trapezius facilitation, such as patients with shoulder impingement syndrome.

Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction. Objects: The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position. Methods: Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 ㎏, 1 ㎏, 1.5 ㎏, and 2 ㎏ at shoulder abduction angles of 0˚, 30˚, 60˚, and 90˚. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA. Results: There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at 0˚, 30˚ and weight of 2 ㎏ showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of 30˚, 60˚ and 90˚ (p<.05). For UT/SA, significant difference was only observed at 90˚ (p<.05). Conclusion: Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 ㎏ weights with abduction angles of 0˚ and 30˚ at shoulder protraction in supine position.

Background: In previous studies, changes in postural alignment were found when the slope was changed during walking. Downhill walking straightens the trunk by shifting the line of gravity backward. Objects: This study investigated the effect of the downhill treadmill walking exercise (DTWE) on thoracic angle and thoracic erector spinae (TES) activation in subjects with thoracic kyphosis. Methods: A total of 20 subjects with thoracic kyphosis were recruited for this study. All the subjects performed the DTWE for 30 minutes. A surface EMG and 3D motion capture system were used to measure TES activation and thoracic angle before and after the DTWE. Paired t-tests were used to confirm the effect of the DTWE (p<.05). Results: Both the thoracic angle and TES activation had significantly increased after the DTWE compared to the baseline (p<.05). An increase in the thoracic angle indicates a decrease in kyphosis. Conclusion: The DTWE is effective for thoracic kyphosis patients as it decreases their kyphotic posture and increases the TES activation. Future longitudinal studies are required to investigate the long-term effects of the DTWE.

본 연구의 목적은 플랫 벤치 프레스에서 하지를 지면에 지지한 자세와 하지를 벤치에 지지한 자세에서의 동작 수행 시 대흉근 및 척추기립근의 근 활성 분석을 통해 벤치 프레스 응용동작에 뒷받침 할 만 한 근거자료를 찾고, 운동수행에 관한 효율적인 기초자료를 제시하는데 있다. 대상자는 아마추어 보디빌더 4명, 헬스 트레이너 2명으로 선정하였다. 측정을 위해 연구대상들의 대흉근과 척추기립근에 표면전극을 부착하였다. 벤치 프레스에 대한 동작구간을 설정하고 하지를 지면에 지지한 동작과 하지를 벤치에 지지한 동작으로 나눠 피험자별 10RM으로 각각 1세트씩 실시하는 방식으로 진행하였다. 데이터는 SPSS 20.0을 통하여 분석하였으며 다음과 같은 결과를 얻었다. 플랫 벤치 프레스 동작 시 하지의 지지 유형이 대흉근에는 영향을 미치지 않았지만, 척추기립근에서는 차이가 나타났다.

Background: Lumbopelvic stability is highly important for exercise therapy for patients with low back pain and shoulder dysfunction. It can be attained using a pelvic compression belt. Previous studies showed that external pelvic compression (EPC) enhances form closure by reducing sacroiliac joint laxity and selectively strengthens force closure and motor control by reducing the compensatory activity of the stabilizer. In addition, when the pelvic compression belt was placed directly on the anterior superior iliac spine, the laxity of the sacroiliac cephalic joint could be significantly reduced. Objects: This study aimed to compare the effects of EPC on lumbopelvic and shoulder muscle surface electromyography (EMG) activities during push-up plus (PUP) and deadlift (DL) exercise, trunk extensor strength during DL exercise. Methods: Thirty-eight subjects (21 men and 17 women) volunteered to participate in this study. The subjects were instructed to perform PUP and DL with and without the EPC. EMG data were collect from serratus anterior (SA), pectoralis major (PM), erector spinae (ES), and multifidus (MF). Trunk extensor strength were tested in DL exercise. The data were collected during 3 repetitions of all exercise and the mean of root mean square was used for analysis. Results: The EMG activities of the SA and PM were significantly increased in PUP with pelvic compression as compared with PUP without pelvic compression (p<.05). In DL exercise, a significant improvement in trunk extensor strength was observed during DL exercise with pelvic compression (p<.05). Conclusion: The results of this study indicate that lumbopelvic stabilization reinforced with external pelvic compression may be propitious to strengthen PUP in more-active SA and PM muscles. Applying EPC can improve the trunk extensor strength during DL exercise. Our study shows that EPC was beneficial to improve the PUP and DL exercise efficiency.

Background: Improvement of lumbo-pelvic stability can reduce the compensatory action of the quadratus lumborum (QL) and selectively strengthen the gluteus medius (GM) during side-lying hip abduction (SHA). There are abdominal draw-in maneuver (ADIM) and abdominal bracing (AB) as active ways, and pelvic compression belt (PCB) as a passive way to increase of lumbo-pelvic stability. It is necessary to compare how these stabilization methods affect the selective strengthening of the GM. Objects: To investigate the effects of ADIM, AB, and PCB during SHA on the electromyography (EMG) activity of the GM, QL, external oblique (EO) and internal oblique (IO), and the GM/QL EMG activity ratio. Methods: A total of 20 healthy male adults participated in the study. The subjects performed three conditions in side-lying in random order: SHA with ADIM (SHA-ADIM), SHA with AB (SHA-AB), and SHA with PCB (SHA-PCB). To compare the differences among the three conditions, the EMG activities of the GM, QL, EO and IO, and GM/QL EMG activity ratio were analyzed using one-way repeated ANOVA. Results: The EMG activity of the QL was significantly higher in SHA-AB than in SHA-ADIM and SHA-PCB. The GM/QL activity ratio was significantly higher in SHA-PCB than in SHA-ADIM and SHA-AB. In addition, the figure for SHA-ADIM was significantly higher than that for SHA-AB. In the case of the EO, the figure for SHA-AB was significantly higher than corresponding values for the other two conditions. The figure for SHA-ADIM was significantly higher than that for SHA-PCB. The EMG activity of the IO was significantly higher in SHA-AH than in SHA-PCB. Conclusion: It can be suggested that wearing the PCB can more selectively strengthen the GM than to perform ADIM and AB during SHA. In addition, the ADIM can be recommended when there is a need to strengthen abdominal muscles during SHA.

목적 : 작업치료중재를 통한 유방암 환자의 신체기능과 근 활성도 및 삶의 질에 미치는 효과를 알아보고자 하였다. 연구방법 : 본 연구는 유방암 환자 15명을 대상으로 스트레칭, 치료적 활동 및 일상생활활동으로 구성된 작업 치료중재 프로그램을 40분씩 주 2회 총 12주 동안 실시하였다. 신체기능은 한국판 간이 피로 평가지 (Korean version of Brief Fatigue Inventory; BFI-K), 기본 호흡곤란 지표(Baseline Dyspnea Index; BDI)를, 근 활성도는 surface Electromyoghraphic (sEMG)를, 그리고 암 치료 관련 기능적 평가 - 유방 암(Functional Assessment Cancer Therapy-Breast; FACT-B)를 통하여 삶의 질을 측정하였다. 결과 : 신체기능에서 피로도와 호흡곤란 정도는 감소하였으며(p<.01), 근 활성도는 앞쪽․중간 어깨세모근, 큰가슴 근의 복장갈비머리 부분, 가시아래근에서 유의하게 증가하였다(p<.05). 삶의 질은 총점과 하위 영역 중 Physical Well-Being(PWB), Functional Well-Being(FWB), Breast Cancer Subscale(BCS)가 통계적 으로 유의한 차이를 나타냈다 (p<.001). 결론 : 중재 후 신체기능과 근 활성도, 삶의 질 모두에서 향상을 보였으며 이는 작업치료 중재가 유방절제 술 환자의 회복에 도움이 될 것으로 생각된다.

Background:To improve lumbo-pelvic stability, passive support devices (i.e., a pelvic belt) are recommended clinically. Nevertheless, to understand the influence of passive support on lumbo-pelvic stability, it is necessary to examine the influence of a pelvic belt on the abdominal and hip abductor muscles.Objects:To examine the effects of a pelvic belt on the forces of the hip adductor and abductor muscles and activity of the abdominal muscles during isometric hip adduction and abduction.Methods:This study recruited 14 healthy men. All subjects performed isometric hip adduction and abduction with and without a pelvic belt in a neutral hip position. Load cells, wrapped with a non-elastic belt, were placed above the medial and lateral malleoli of the dominant leg to measure the muscle forces of the hip adductors and abductors, respectively. The forces of the hip adductors and abductors were measured using a load cell during isometric hip adduction and abduction, while the electromyographic activities of the bilateral rectus abdominis, internal oblique, and external oblique muscles were measured.Results:The forces generated by the hip adductors and abductors were significantly greater with the pelvic belt than without (p<.05). No significant differences in abdominal muscle activities between the two conditions were found (p>.05).Conclusion:These findings suggest that use of a pelvic belt could lead to effective strengthening exercise of hip muscles in individuals with sacroiliac joint pain.

Background: Investigation in gender differences of kinetics and kinematics for individuals with patellar femoral pain syndrome (PFPS) was not sufficiently performed. Objects: The purpose of this study is that whether there is a difference depending on gender from muscle activity and strength and knee valgus angle during controlled single-leg squat which is widely used as clinical movement test for the patient with PFPS. Methods: 20 young adults (10 men, 20.0±2.1 years; 10 women, 20.4±2.1 years) with PFPS were voluntarily recruited in this study. Muscle activity and strength and knee valgus angle were collected during single-leg squat. Independent t-test and Mann-Whitney test were used to compare the differences between groups of male and female. Results: Rectus femoris (t=-2.204, p=.041) and vastus medialis oblique (t=-2.151, p=.045) muscle activity of women were significantly higher than male group. Normalized muscle strength of hip and knee muscles showed a significant difference between men and women (p<.05). Valgus angle of the knee in women (t=-2.450, p=.025) were increased significantly than men. Conclusion: The therapist would consider the characteristics of these gender differences during performing movement test, exercise, and education for the individuals with PFPS.

Objective : The purpose of this study was to investigate the effects of Expiratory Muscle Strength Training (EMST) on the suprahyoid muscle activation and swallowing function of stroke patients.Methods : This study randomly assigned 21 stroke patients to an experimental group and a control group. Four-week EMST was performed at resistance of 70% of the maximum expiratory pressure with the experimental group and at resistance of 20% of that with the control group. Evaluation was conducted using surface Electromyographic (sEMG), Videofluoroscopic Dysphagia Scale (VDS), and Penetration-Aspiration Scale (PAS) based on Videofluoroscopic Swallowing Study (VFSS).Results : There was a statistically significant difference in the activation of the suprahyoid muscles using sEMG of the experimental group (p<.05) while there was no significant difference in that of the control group. Both group showed significant difference in the pharyngeal phase of VDS and PAS. Also in the comparison of variation in VDS and PAS before and after the intervention, there were statistically.Conclusion : Finding from this study confirmed that EMST applied 70% maximum expiratory resistance would be a remedial method which could help activate pharyngeal dysphagia patients’ suprahyoid muscles and improve swallowing function.