stroke - induced dysphagia mostly causes pneumonia or dehydration and these symptoms can lead 
 to other severe complications , or even death1 , 2 . stroke patients with dysphagia have been 
 treated with high priority within stroke care , and many kinds of interventions for dysphagia 
 have been studied3 . sensory stimulation , 
 thermotherapy , position change techniques , bio - feedback , maneuvers , neuromuscular electrical 
 stimulation therapy , and surgical approaches are being used as the preferred methods for 
 dysphagia interventions4 . most studies have identified deficiencies in dysphagia treatments , with the exception of 
 neuromuscular electrical stimulation therapy5 . however , neuromuscular electrical stimulation therapy ( tens ) 
 remains controversial , due to the fact that the muscular effect could be just a reflex 
 triggered by electric stimulation6 . practitioners have been demonstrating other 
 evidence - based treatments which have no side effects and are safe for treating dysphagia , 
 but conventional methods continue to be used8 . kinesio taping ( kt ) is a well - known clinical procedure which is widely used to treat 
 various neuromuscular symptoms . in according to kase et al.9 , kt allows more efficient blood circulation , lymph absorption and 
 joint fixation . a previous study showed that kt application with proper tension could reduce 
 pain , and improve the range of motion ( rom ) and proprioception10 . in spite of these advantages , no clinical trials using kt the main focus of this study was to conduct a kinematic analysis of the effects of kt on 
 the movement of the hyoid bone and the epiglottis of stroke patients with dysphagia . the 
 authors also used the functional dysphagia scale ( fds ) to evaluate the effect of kt in a 
 real swallowing situation . twenty - two subjects diagnosed as having dysphagia due to stroke participated in this study . 
 the patients were hospitalized in a rehabilitation ward and were scheduled for 
 videofluoroscopic study ( vfss ) every month . the subjects were 13 males ( mean age , 
 59.0  years ; range , 5478  years ) and 9 females ( mean age , 61.0  years ; range , 5173  years ) . the subjects were hemorrhagic ( 8 patients ) and infarction ( 14 patients ) , and the duration of 
 onset ( month ) was within 3 months for all of the subjects . when the patients entered the 
 vfss room , they were randomly allocated for radiographic inspection with kt or without kt 
 ( nkt ) by drawing lots . if a patients chose kt , he or she was treated with kt and then vfss 
 was conducted . the taping was applied to the external laryngeal muscles ( digastric posterior 
 bellies , mylohyoid and geniohyoid ) , the sternocleidomastoid ( scm ) and the upper trapezius . the tension of kt was set at 
 50% ( available tension is 100%)11 and 
 20  cm  5  cm strips of kinsiotape kt 545 ( visiocare s.r.l . , vedano al lambro , monza - brianza , 
 italy ) were applied to the neck and chin to affect the active range of motion ( arom)12 . kinematic analysis of the movement of the hyoid bone and the angular variation of the 
 epiglottis was performed using marosis m - view 5.4 ( fig 1.digital kinematic analysis of the hyoid bone ( left ) and the epiglottis ( right ) 
 through control frame of the x , y - coordinates . ) . the movement of the hyoid bone was measured in both horizontal and vertical 
 sections in the two consecutive frames ( frame for x , y - coordinates ; the upper left corner of 
 the square is the hyoid bone ; the line indicates the epiglottis on the right of the 
 image)13 . a lower 
 score means a higher level of performance in the spectrum of lip closure , bolus formation , 
 residue in the oral cavity , oral transit time , triggering of pharyngeal swallow , laryngeal 
 elevation and epiglottal closure , nasal penetration , residue in the valleculae , residue in 
 the pyriform sinuses , coating of pharyngeal wall after swallow , and pharyngeal transit 
 time . digital kinematic analysis of the hyoid bone ( left ) and the epiglottis ( right ) 
 through control frame of the x , y - coordinates . all of the subjects agreed to participate in the study and they provided their written 
 informed consent receiving sufficient explanation of the experimental procedures in 
 accordance with the ethical principles of the declaration of helsinki . the wilcoxon signed - rank test was 
 used to compare the values of the kt and nkt subjects . the differences in the variation of the displacement of the hyoid bone , the angular 
 variation of the epiglottis , and fds are shown in table 
 1table 1.comparison of the swallowing functions of the kt and nkt groupskt group ( n=22)nkt group ( n=22)horizontal excursion of the hyoid bone ( cm)2.01  0.681.83  0.61vertical excursion of the hyoid bone ( cm)2.50  0.732.06  0.64*rotation of the epiglottis ( )51.00  17.8041.00  20.16*fds25.72  10.0326.72  10.45kt : kinesio taping ; nkt : no kinesio taping ; fds : functional dysphagia scale . the kt group showed improvements in the vertical excursion of the hyoid bone 
 and rotation of the epiglottis , the differences were statistically significant ( p<0.05 ) . changes in the horizontal movement and fds were observed in the clinical assessment and 
 analysis but the differences were not statistically significant ( p>0.05 ) . kt : kinesio taping ; nkt : no kinesio taping ; fds : functional dysphagia scale . swallowing problems are mostly induced by dysfunction of the esophageal structures such as 
 the hyoid bone , suprahyoid muscle and infrahyoid muscle14 . kinematic analysis using vfss has the advantage of presenting the 
 mechanical changes of the laryngopharynx , and vfss studies of dysphagia have been 
 published . therapeutic methods have been used to change the external laryngeal muscles ( digastric 
 posterior bellies , mylohyoid , stylohyoid , geniohyoid ) , scm , and the upper trapezius , though 
 changes in head and neck position are also used as many researchers agree that anatomical 
 changes are important factors in swallowing function15 . from the perspective of this mechanical change concept , the 
 hypothesis of this study was that kt would affect the active range of motion ( arom)16 . worthy of close attention in this study is that results could be the first trial of using 
 kt for treating stroke patients with dysphagia . the kt has already been investigated by many 
 studies . related to this study , there is a published material that kt facilitates , provides , 
 supports , and gives stability to muscles and joints without restricting the body s range of 
 motion17 , and has positive 
 physiological effects on the skin , lymphatic , circulatory system , fascia , muscles , 
 ligaments , tendons , and joints18 . researchers have reported that usage of kt increases the functional abilities and manual 
 muscle testing scores of stroke patients19 . this study attempt to precisely analyze the movement of the hyoid bone and the angular 
 variation of the epiglottis , but some possible deviation in the sampling distribution 
 ( 0.10.8 mm ) could exist the c2c4 ( cervical 2 , cervical 4 ) plane as a standard coordinate to analyze the 
 displacement of the hyoid bone and the angular variation of the epiglottis following the 
 method of a recent study20 . future research should be performed with larger subject numbers and modification of the 
 taping techniques . the kinematic analysis of the hyoid bone and the epiglottis should 
 continue to be used as it is the optimal method for determining the effects of dysphagia 
 therapy approaches . therefore , future studies should examine not only clinical evaluation 
 tools but also kinematic analysis using vfss . with more evidence , kt for dysphagia patients 
 should be considered a possible treatment approach .
[ purpose ] the purpose of this study was to identify the effects of kinesio taping ( kt ) on 
 the swallowing function of stroke patients . [ subjects and methods ] twenty - two stroke 
 patients 
 were randomly assigned to two groups ; an experimental group which received kt , 
 and a control group which received no taping intervention . 
 two - dimensional kinematic 
 analysis was used to determine the displacement of the hyoid bone and the angular 
 variation of the epiglottis using human anatomy - based coordinates . 
 the functional 
 dysphagia scale ( fds ) was determined by a videofluoroscopic study ( vfss ) . 
 [ results ] the 
 experimental group presented statistically significant improvements in kinematic changes 
 of the vertical excursion of the hyoid bone and epiglottal rotation . 
 [ conclusion ] clinical 
 use of kt for dysphagia patients should be considered as a treatment approach . in future 
 research , more subjects and more diverse patterns 
 should be studied to accumulate further 
 evidence .