Background: The chin tuck exercise is a therapeutic approach for improving swallowing function in patients with dysphagia. However, the clinical evidence of the effect is still lacking. Objectives: To investigate the effect of a multidirectional chin tuck exercise on swallowing function in patients with post-stroke dysphagia. Design: A two-group prospective study. Methods: In total, 14 patients with post-stroke dysphagia were enrolled and assigned to either the experimental or control group. The experimental group performed the chin tuck exercise in the vertical and diagonal directions, whereas the control group performed the exercise only in the vertical direction. The intervention was performed 20 minutes a day, 5 times a week, for 4 weeks. Videofluoroscopic Dysphagia Scale (VDS) and Penetration–Aspiration Scale (PAS) scores determined via a videofluoroscopic swallowing study were the outcome measures used for evaluating swallowing function. Results: Post-intervention, the experimental group exhibited significantly better improvement in the pharyngeal phase score of VDS and PAS score than the control group. Conclusion: This study demonstrated that the multidirectional chin tuck exercise is more effective than the vertical chin tuck exercise in improving the swallowing function in patients with post-stroke dysphagia.

Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, 24.0±5.0 years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.

목적 : 본 연구에서는 연하장애를 동반한 뇌졸중 환자를 대상으로 저항성 고개 숙이기 운동이 연하기능에 미치는 영향을 알아보고자 하였다. 연구방법 : 본 연구는 뇌졸중 환자 58명을 무작위로 저항성 고개 숙이기 운동군과 두부거상 운동군으로 할당하였다. 실험군은 저항성 고개 숙이기 운동을 실시하였다. 반면 대조군은 두부거상 운동을 실시하였 으며 중재기간은 하루 15분간 일 2회, 주 5회, 6주 간 실시하였다. 결과 : 본 연구 결과 실험군과 대조군 모두 비디오 투시 연하장애 척도(Videofluoroscopic Dysphagia Scale; VDS)의 총 점수와 인두기 점수, 침습-흡인 척도(Penetration-Aspiration Sclae; PAS) 그리고 기능적 구강 섭취 척도(Functional Oral Intake Scale; FOIS) 모두에서 유의한 향상을 보였다(p<.05). 하지만 두 군의 중재 전-후 변화량을 비교한 결과 비디오 투시 연하장애 척도와 침습-흡인 척도에서 유의한 차이를 보였다(p=.04, p=.00). 결론 : 본 연구를 통해 저항성 고개 숙이기 훈련은 기존에 연하치료의 교정적 방법으로 사용되고 있던 두 부거상 운동과 유사한 효과가 있음을 확인하였다.

Adolescence is the most important period of healthy development. The purpose of this study was to evaluate the food recognition, snack preference, and dietary behavior of 1st grade of middle and high school boys and girls. Subjects were 5,554 students from 16 schools with healthy tuck shop and 3,406 students from 9 schools without healthy tuck shop in Seoul, Korea. Students from schools with healthy tuck shop are significantly higher than control group for facility satisfaction and hygiene satisfaction (all p<0.05). For fruit, the preference (p<0.05) and recognition (attitude, p<0.001: intention, p<0.05: eating habit, p<0.001: social-environment, p<0.001: self-efficacy, p<0.001) of students in schools with healthy tuck shop are significantly higher than those in schools without healthy tuck shop. For the habit of checking the manufacturer, students in schools with healthy tuck shop were significantly higher than students in schools without healthy tuck shop (p<0.05). The result suggested that we have to create an environment in which fruits can be purchased easily at a tuck shop and to educate adolescents for the importance of healthy food purchasing behavior. In conclusion, healthy school tuck shop had a positive effect on accessibility to healthy food.

This present study investigated the effects of the abdominal drawing-in maneuver (ADIM) and chin tuck (CT) on middle thoracic erector spinae, lower thoracic erector spinae, and lumbar erector spinae muscle activity during three prone thoracic extension (PTE) exercises. Twelve healthy subjects performed preferred PTE, ADIM PTE, and ADIM-CT PTE. Surface electromyography was used to collect data on the muscle activity of dominant middle and lower thoracic erector spinae muscles and the lumbar erector spinae. Middle and lower thoracic erector spinae muscle activity significantly increased when ADIM and CT was performed (p<.05). However, lumbar erector spinae muscle activity significantly decreased in ADIM PTE compared to preferred PTE (p=.017) and significantly increased in ADIM-CT PTE compared to ADIM PTE (p=.004). In conclusion, ADIM-CT PTE effectively increased middle and lower thoracic erector spinae muscle activity, and ADIM PTE decreased lumbar erector spinae muscle activity. Hence, ADIM PTE could be a recommended exercise maneuver to strengthen thoracic erector spinae without over activation of lumbar erector spinae.