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肌功能疗法对非典型性吞咽患者的疗效。

The efficacy of myofunctional therapy in patients with atypical swallowing.

机构信息

Department of Biomedical, Surgical and Dental Sciences, University of Milan, via Luigi Mangiagalli 31, 20136, Milan, Italy.

Department of Biomedical and Clinical Sciences, Luigi Sacco", University of Milan, Via Gian Battista Grassi 57, Milan, Italy.

出版信息

Eur Arch Otorhinolaryngol. 2020 Sep;277(9):2501-2511. doi: 10.1007/s00405-020-05994-w. Epub 2020 May 4.

Abstract

PURPOSE

The myofunctional treatment (MFT) is a conventional therapy in the treatment of oral disease like atypical swallowing (AS). Functional (standardized surface electromyographic analysis-ssEMG) and clinical ("orofacial muscular evaluation with score" protocol-OMES) analyses were conducted to detect the effects of MFT (10 weeks session) in a group of patients with AS.

METHODS

ssEMG was performed to analyze the activity of masseter (MM), temporalis (TA), and submental (SM) muscles before (T1) and after (T2) the MFT in a group of 15 patients. OMES was completed at the same timepoints. A Student-t test was carried out to detect differences between T1 and T2 for ssEMG data, and a signed RANK test was used for OMES ones. One-way ANOVA variance test was performed to detect any differences between the different couples of muscles at each timepoint.

RESULTS

After MFT, patients showed a shorter duration of the whole act of swallowing (p < .0001), higher intensity of the SM activity (p < .01) than at T1. At T2 masticatory muscles showed lower values for the activation index (ANOVA, p < .0001) and for the spike position (ANOVA, p < .01) than SM. The OMES protocol showed a significant increase for the total evaluation score (p < .01), appearance-posture (p < .01) and functions (p < .001).

CONCLUSIONS

MFT permits a shortening of the muscular activation pattern and an increase in SM activity. The improvement of oral functionalities is possible and identifiable thanks to the use of standardized protocols.

摘要

目的

肌功能治疗(MFT)是治疗口腔疾病(如非典型吞咽)的常规疗法。对一组患有非典型吞咽的患者进行了功能(标准表面肌电图分析-ssEMG)和临床(“口面肌肉评估评分”协议-OMES)分析,以检测 MFT(10 周疗程)的效果。

方法

在 MFT 前后(T1 和 T2),对 15 名患者的咀嚼肌(MM)、颞肌(TA)和颏下肌(SM)的肌电活动进行了 ssEMG 分析。同时完成了 OMES。采用学生 t 检验检测 ssEMG 数据 T1 与 T2 之间的差异,采用符号秩检验检测 OMES 数据的差异。采用单因素方差分析检验每个时间点不同肌肉对之间的差异。

结果

MFT 后,患者的吞咽总时长(p<0.0001)缩短,SM 活动强度(p<0.01)高于 T1。T2 时,咀嚼肌的激活指数(ANOVA,p<0.0001)和尖峰位置(ANOVA,p<0.01)值均低于 SM。OMES 方案的总评估评分(p<0.01)、外观-姿势(p<0.01)和功能(p<0.001)均显著增加。

结论

MFT 可缩短肌肉激活模式,增加 SM 活动。使用标准化方案可以改善口腔功能,并能够识别这种改善。

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