Lee Kyeong Woo, Kim Sang Beom, Lee Jong Hwa, Lee Sook Joung, Park Jin Gee, Jang Kyung Won
Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Korea.
Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea.
Ann Rehabil Med. 2019 Feb;43(1):11-18. doi: 10.5535/arm.2019.43.1.11. Epub 2019 Feb 28.
To determine positive effect of neuromuscular electrical stimulation (NMES) in conventional dysphagia therapy on masseter muscle oral dysfunction of patients after subacute stroke.
Among subacute stroke patients who were diagnosed as oropharyngeal dysphagia by videofluoroscopy swallowing study (VFSS), those with oral dysfunction were enrolled. They were randomly assigned to a study group or a control group. The study group received NMES on masseter muscle and suprahyoid muscle simultaneously, while the control group received NMES only on suprahyoid muscle. NMES therapy session as applied 30 minutes each time, two times per day for a total of 20 sessions. Both groups received conventional dysphagia therapy for 2 weeks. All enrolled patients were evaluated by VFSS after 2 weeks. Oropharyngeal swallowing function was evaluated by Penetration-Aspiration Scale, Functional Dysphagia Scale (FDS), and American Speech-Language-Hearing Association National Outcome Measurement System swallowing scale based on results of VFSS.
Patients were randomly assigned to the study group (n=20) or the control group (n=20). There were no significant differences in baseline characteristics or initial values between the two groups. After 2 weeks of NMES, both groups showed improvement in scores of total FDS and pharyngeal phase FDS. Additionally, the study group showed improvement in oral phase FDS. Changes in all measurements were similar between the two groups.
In this preliminary study, NMES for masseter muscle has a therapeutic effect on oral dysfunction of patients after subacute stroke.
确定神经肌肉电刺激(NMES)在传统吞咽障碍治疗中对亚急性脑卒中患者咬肌口腔功能障碍的积极作用。
在通过电视荧光吞咽造影检查(VFSS)诊断为口咽吞咽障碍的亚急性脑卒中患者中,纳入有口腔功能障碍的患者。将他们随机分为研究组或对照组。研究组同时接受咬肌和舌骨上肌群的NMES治疗,而对照组仅接受舌骨上肌群的NMES治疗。NMES治疗每次应用30分钟,每天两次,共20次。两组均接受2周的传统吞咽障碍治疗。所有纳入患者在2周后通过VFSS进行评估。根据VFSS结果,采用渗透-误吸量表、功能性吞咽障碍量表(FDS)和美国言语-语言-听力协会国家结局测量系统吞咽量表评估口咽吞咽功能。
患者被随机分为研究组(n = 20)或对照组(n = 20)。两组之间的基线特征或初始值无显著差异。NMES治疗2周后,两组的总FDS评分和咽期FDS评分均有所改善。此外,研究组的口腔期FDS评分有所改善。两组所有测量指标的变化相似。
在这项初步研究中,咬肌的NMES对亚急性脑卒中患者的口腔功能障碍具有治疗作用。