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中风早期和晚期口腔内刺激对面部功能障碍和吞咽能力的影响。

Effects on facial dysfunction and swallowing capacity of intraoral stimulation early and late after stroke.

作者信息

Hägg Mary K D, Tibbling Lita I E

机构信息

Speech & Swallowing Centre, Department of Otorhinolaryngology, Hudiksvall Hospital, Sweden Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.

Department of Otorhinolaryngology, Linköping University, Linköping, Sweden.

出版信息

NeuroRehabilitation. 2015;36(1):101-6. doi: 10.3233/NRE-141197.

Abstract

BACKGROUND

Most patients with post-stroke dysphagia are also affected by facial dysfunction in all four facial quadrants. Intraoral stimulation can successfully treat post-stroke dysphagia, but its effect on post-stroke facial dysfunction remains unknown.

OBJECTIVE

This study aimed to investigate whether intraoral stimulation after stroke has simultaneous effects on facial dysfunction in the contralateral lower facial quadrant and in the other three facial quadrants, on lip force, and on dysphagia.

METHODS

Thirty-one stroke patients were treated with intraoral stimulation and assessed with a facial activity test, lip force test, and swallowing capacity test at three time-points: before treatment, at the end of treatment, and at late follow-up (over one year after the end of treatment).

RESULTS

Facial activity, lip force, and swallowing capacity scores were all improved between baseline and the end of treatment (P < 0.001 for each), with these improvements remaining at late follow-up. Baseline and treatment data did not significantly differ between patients treated short and late after stroke.

CONCLUSIONS

Treatment with intraoral stimulation significantly improved post-stroke dysfunction in all four facial quadrants, swallowing capacity, and lip force even in cases of long-standing post-stroke dysfunction. Furthermore, such improvement remained for over one year after the end of treatment.

摘要

背景

大多数中风后吞咽困难患者的四个面部象限也存在面部功能障碍。口腔内刺激可成功治疗中风后吞咽困难,但其对中风后面部功能障碍的影响尚不清楚。

目的

本研究旨在调查中风后口腔内刺激是否对患侧下半面部象限及其他三个面部象限的面部功能障碍、唇力和吞咽困难有同步影响。

方法

31例中风患者接受口腔内刺激治疗,并在三个时间点进行面部活动测试、唇力测试和吞咽能力测试评估:治疗前、治疗结束时和后期随访(治疗结束后一年以上)。

结果

治疗结束时,面部活动、唇力和吞咽能力评分均较基线有所改善(每项P<0.001),后期随访时这些改善依然存在。中风后早期和晚期接受治疗的患者,其基线和治疗数据无显著差异。

结论

即使是长期存在的中风后功能障碍,口腔内刺激治疗也能显著改善四个面部象限的中风后功能障碍、吞咽能力和唇力。此外,治疗结束后这种改善持续了一年以上。

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