From the Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea (DP); and Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea (JHS, HYK, JSR).
Am J Phys Med Rehabil. 2019 Dec;98(12):1051-1059. doi: 10.1097/PHM.0000000000001241.
The purpose of this study was to evaluate the effectiveness of the sequential four-channel neuromuscular electrical stimulation system.
As a prospective case-control study, ten healthy subjects and ten patients with dysphagia were prospectively enrolled. Swallowing with and without sequential four-channel neuromuscular electrical stimulation (suprahyoid, infrahyoid muscles) was evaluated via videofluoroscopic swallowing study and high-resolution manometry.
Results showed that the sequential four-channel neuromuscular electrical stimulation significantly improved the videofluoroscopic dysphagia scale during thick-fluid swallowing in patients with dysphagia. Furthermore, the kinematic analysis of videofluoroscopic swallowing study showed a tendency that neuromuscular electrical stimulation reduced duration of hyoid bone movement during thin- or thick-fluid swallowing. The high-resolution manometry parameters-maximal pressure of velopharynx, tongue base, cricopharyngeal pressure, minimal upper esophageal sphincter pressure, area of velopharynx, upper esophageal sphincter activity time, and duration of nadir upper esophageal sphincter-during thin-fluid swallowing were significantly improve in both groups compared with the high-resolution manometry parameters without neuromuscular electrical stimulation.
The sequential four-channel neuromuscular electrical stimulation may help improve the parameters of videofluoroscopic swallowing study, kinematic analysis of the hyoid bone movement, and high-resolution manometry during swallowing. Further investigations are needed to better examine the effects of neuromuscular electrical stimulation in patients with dysphagia.
本研究旨在评估序贯四通道神经肌肉电刺激系统的有效性。
作为一项前瞻性病例对照研究，前瞻性纳入了 10 名健康受试者和 10 名吞咽困难患者。通过视频透视吞咽研究和高分辨率测压法评估吞咽时使用和不使用序贯四通道神经肌肉电刺激（舌骨上、下肌）的情况。
结果表明，序贯四通道神经肌肉电刺激可显著改善吞咽困难患者吞咽稠液时的视频透视吞咽障碍评分。此外，视频透视吞咽研究的运动学分析显示，神经肌肉电刺激可使吞咽稀、稠液时舌骨运动的持续时间缩短。与不使用神经肌肉电刺激时相比，高分辨率测压法参数（软腭最大压力、舌根最大压力、环咽肌压力、食管上括约肌最小压力、软腭面积、食管上括约肌活动时间、食管上括约肌最低点持续时间）在两组患者吞咽稀液时均显著改善。
序贯四通道神经肌肉电刺激可能有助于改善吞咽时视频透视吞咽研究、舌骨运动的运动学分析和高分辨率测压法的参数。需要进一步研究以更好地检查神经肌肉电刺激对吞咽困难患者的影响。
