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吞咽阻力电刺激训练结合主动吞咽可改善脑卒中后吞咽困难患者的咽缩功能。

Effortful swallow with resistive electrical stimulation training improves pharyngeal constriction in patients post-stroke with dysphagia.

作者信息

Kim H, Park J-W, Nam K

机构信息

Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Gyeonggi-do, Korea.

出版信息

J Oral Rehabil. 2017 Oct;44(10):763-769. doi: 10.1111/joor.12538. Epub 2017 Jul 10.

Abstract

This study aimed to evaluate the effect of effortful swallow combined with surface electrical stimulation as a form of resistance training on pharyngeal constriction function in post-stroke patients with dysphagia. Nineteen patients post-stroke with dysphagia received 20 min effortful swallow training with resistive electrical stimulation for 5 days per week for 4 weeks. Electrical stimulation was applied on the infrahyoid area as resistance against hyoid elevation. Stimulation intensity was adjusted daily up to the maximum tolerable level of the participant. Blinded biomechanical measurements of the extent of hyoid elevation were taken and the pharyngeal constriction ratio (PCR) determined after training. The change of the PCR and the relationship between hyoid elevation and the PCR were evaluated. The post-training PCR was significantly decreased compared to pre-training PCR (P < 0·05). There was a high inverse correlation between the hyoid elevation and the PCR (r = -1·992, P < 0·05). Effortful swallow with resistive electrical stimulation training increases pharyngeal constriction. It can be used as a treatment to improve pharyngeal constriction in patients with dysphagia.

摘要

本研究旨在评估用力吞咽联合表面电刺激作为一种抗阻训练形式对脑卒中后吞咽困难患者咽缩功能的影响。19例脑卒中后吞咽困难患者接受了每周5天、为期4周、每次20分钟的用力吞咽训练及抗阻电刺激。电刺激施加于舌骨下区域以对抗舌骨上抬。刺激强度每天进行调整,直至达到参与者的最大耐受水平。在训练后进行了舌骨上抬程度的盲法生物力学测量,并测定了咽缩率(PCR)。评估了PCR的变化以及舌骨上抬与PCR之间的关系。与训练前相比,训练后的PCR显著降低(P < 0.05)。舌骨上抬与PCR之间存在高度负相关(r = -1.992,P < 0.05)。用力吞咽联合抗阻电刺激训练可增加咽缩。它可作为改善吞咽困难患者咽缩功能的一种治疗方法。

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