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神经肌肉电刺激对帕金森病合并吞咽困难患者的影响:一项随机、单盲、安慰剂对照试验。

Effects of neuromuscular electrical stimulation in patients with Parkinson's disease and dysphagia: A randomized, single-blind, placebo-controlled trial.

作者信息

Park Ji-Su, Oh Dong-Hwan, Hwang Na-Kyoung, Lee Jung-Hoon

机构信息

Department of Rehabilitation Science, Graduate School, Inje University, Gimhae, Republic of Korea.

Department of Occupational Therapy, Kyung-dong University, Wonju, Republic of Korea.

出版信息

NeuroRehabilitation. 2018;42(4):457-463. doi: 10.3233/NRE-172306.

Abstract

BACKGROUND

Neuromuscular electrical stimulation has been used to improve swallowing function in neurologic patients with dysphagia, but its effect on patients with dysphagia and Parkinson's disease remains unclear.

OBJECTIVES

This study aimed to identify the effect of effortful swallowing combined with neuromuscular electrical stimulation as a novel treatment approach in dysphagic patients with Parkinson's disease.

METHODS

Participants were randomly allocated to an experimental group (n = 9) or a placebo group (n = 9). The experimental group simultaneously received neuromuscular electrical stimulation with effortful swallowing, while the placebo group received sham neuromuscular electrical stimulation with effortful swallowing. All participants received the treatment for 30 min/day at five sessions per week for 4 weeks. Both groups also received the same conventional dysphagia therapy.

RESULTS

The experimental group showed significant differences in horizontal movement (p = 0.038) and vertical movement (p = 0.042) compared to the placebo group, but showed no significant differences in the oral (p = 0.648) or pharyngeal phase (p = 0.329) of the Videofluoroscopic Dysphagia Scale compared to the placebo group, except for the Penetration-Aspiration Scale (p = 0.039).

CONCLUSIONS

We demonstrated that neuromuscular electrical stimulation applied to the infrahyoid region combined with effortful swallowing effectively increased hyoid bone movement and reduced aspiration in dysphagic patients with Parkinson's disease.

摘要

背景

神经肌肉电刺激已被用于改善吞咽功能障碍的神经系统疾病患者的吞咽功能,但其对吞咽功能障碍合并帕金森病患者的影响尚不清楚。

目的

本研究旨在确定用力吞咽联合神经肌肉电刺激作为一种新的治疗方法对帕金森病吞咽困难患者的疗效。

方法

将参与者随机分为实验组(n = 9)或安慰剂组(n = 9)。实验组在用力吞咽的同时接受神经肌肉电刺激,而安慰剂组在用力吞咽的同时接受假神经肌肉电刺激。所有参与者每天接受30分钟的治疗,每周5次,共4周。两组均接受相同的传统吞咽困难治疗。

结果

与安慰剂组相比,实验组在水平运动(p = 0.038)和垂直运动(p = 0.042)方面有显著差异,但在电视荧光吞咽障碍量表的口腔期(p = 0.648)或咽期(p = 0.329)与安慰剂组相比无显著差异,除了渗透-误吸量表(p = 0.039)。

结论

我们证明,对帕金森病吞咽困难患者,在下颌下区域应用神经肌肉电刺激联合用力吞咽可有效增加舌骨运动并减少误吸。

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