Department of Behavioral Science and Community Health, University of Florida Health Center, University of Florida, Gainesville, FL 32610, USA.
Arch Phys Med Rehabil. 2010 May;91(5):743-9. doi: 10.1016/j.apmr.2010.01.013.
To compare the effectiveness of the McNeill Dysphagia Therapy Program, a systematic exercise-based rehabilitation framework for swallowing remediation, with traditional swallowing therapy techniques paired with surface electromyography (sEMG) biofeedback.
Matched case-control study.
University medical center.
Dysphagic patients referred to an outpatient swallowing therapy service.
Cases were individually matched to 2 separate controls for age, sex, and primary medical diagnosis (N=24). Cases were patients with dysphagia who entered the McNeill Dysphagia Therapy Program from September 2006 to October 2008. Controls entered a traditional swallowing therapy program augmented with sEMG biofeedback (traditional therapy with biofeedback group) from February 1994 to June 1999.
The primary outcome was the proportion of patients who improved clinical swallowing ability and functional oral intake. The secondary outcomes were the presence (or not) of tube feeding, physiologic change on instrumental swallowing studies, and occurrence of aspiration on posttreatment assessment.
Case patients were more likely to demonstrate dysphagia recovery at posttreatment re-evaluation (adjusted odds ratio for dysphagia recovery=13.0 [95% CI, 1.27-63.89]; Mantel-Haenszel chi(2)=6.7; P=.009; relative risk reduction=.69). Dysphagia was reduced by 69% in the McNeill Dysphagia Therapy Program treatment group compared with the traditional therapy with biofeedback group.
Both approaches facilitated improved swallowing function. The McNeill Dysphagia Therapy Program resulted in superior outcomes compared with traditional dysphagia therapy supplemented with sEMG biofeedback.
比较麦克尼尔吞咽疗法（一种基于系统性运动的吞咽康复框架，用于吞咽障碍的矫正）与传统吞咽治疗技术加表面肌电图（sEMG）生物反馈的疗效。
匹配病例对照研究。
大学医疗中心。
转介至门诊吞咽治疗服务的吞咽障碍患者。
将病例与年龄、性别和主要医疗诊断相匹配的 2 个独立对照（N=24）进行匹配。病例为 2006 年 9 月至 2008 年 10 月参加麦克尼尔吞咽疗法计划的吞咽障碍患者。对照组于 1994 年 2 月至 1999 年 6 月参加传统吞咽治疗计划并加用 sEMG 生物反馈（传统治疗加生物反馈组）。
主要结局是评估患者临床吞咽能力和经口摄食功能改善的比例。次要结局是管饲的存在（或不存在）、仪器吞咽研究中的生理变化以及治疗后评估中的误吸发生情况。
病例组在治疗后再评估时更有可能表现出吞咽障碍的恢复（吞咽障碍恢复的调整优势比=13.0[95%CI，1.27-63.89]；Mantel-Haenszel χ(2)=6.7；P=.009；相对风险降低=69%）。与传统治疗加 sEMG 生物反馈组相比，麦克尼尔吞咽疗法计划组的吞咽障碍减少了 69%。
两种方法都促进了吞咽功能的改善。与传统的加 sEMG 生物反馈的吞咽治疗相比，麦克尼尔吞咽疗法计划的结果更优。
