Umay Ebru, Gurcay Eda, Ozturk Erhan Arif, Unlu Akyuz Ece
Ankara Diskapi Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, University of Health Sciences, Altindag, Ankara, Turkey.
Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, Ankara, Turkey.
Acta Neurol Belg. 2020 Oct;120(5):1097-1105. doi: 10.1007/s13760-018-01071-6. Epub 2019 Jan 2.
Dysphagia is one of the common findings in children with cerebral palsy (CP). Electrical stimulation (ES) has been demonstrated to positively contribute to swallowing functions, particularly in adult patients with various neurological disorders. Therefore, the objective of this study was to assess the effects of sensory-level ES treatment combined with conventional dysphagia rehabilitation in pediatric age group CP patients who had any oropharyngeal dysphagia symptoms and/or findings. Participants were randomly assigned to either the experimental group (Group 1, n = 52) who underwent intermittent galvanic stimulation to bilateral masseter muscles for 5 days/week, for 4 weeks combined with conventional dysphagia rehabilitation or the control group (Group 2, n = 50) who received sham stimulation with conventional dysphagia rehabilitation. The experimental group achieved significantly more improvement in swallowing functions including drooling, tongue movements, chewing, eating large food ability, feeding duration, as well as dysphagia screen test and dysphagia level, compared to control group. This study suggested that sensory-level ES might be a useful and safe therapeutic modality to improve oropharyngeal symptoms, symptom severity and dysphagia level in children with CP and dysphagia. Further research is needed to determine the long-term effects of ES on dysphagia, especially in different neurological disorders such as CP.
吞咽困难是脑瘫(CP)患儿的常见症状之一。电刺激(ES)已被证明对吞咽功能有积极作用,尤其是在患有各种神经系统疾病的成年患者中。因此,本研究的目的是评估感觉水平电刺激治疗联合传统吞咽困难康复治疗对有任何口咽吞咽困难症状和/或体征的小儿脑瘫患者的效果。参与者被随机分为实验组(第1组,n = 52),接受每周5天、共4周的双侧咬肌间歇性直流电刺激,并联合传统吞咽困难康复治疗;或对照组(第2组,n = 50),接受假刺激并联合传统吞咽困难康复治疗。与对照组相比,实验组在吞咽功能方面有显著改善,包括流口水、舌头运动、咀嚼、吃大块食物的能力、进食时间,以及吞咽困难筛查测试和吞咽困难程度。本研究表明,感觉水平电刺激可能是一种有效且安全的治疗方式,可改善脑瘫合并吞咽困难患儿的口咽症状、症状严重程度和吞咽困难程度。需要进一步研究以确定电刺激对吞咽困难的长期影响,尤其是在脑瘫等不同神经系统疾病中的影响。