Department of Rehabilitation Medicine, Seongnam Citizen's Medical Center, Seongnam-si, South Korea.
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
J Neuroeng Rehabil. 2021 May 31;18(1):90. doi: 10.1186/s12984-021-00884-6.
To date, conventional swallowing therapies and 2-channel neuromuscular electrical stimulation (NMES) are standard treatments for dysphagia. The precise mechanism of 2-channel NMES treatment has not been determined, and there are controversies regarding the efficacy of this therapy. The sequential 4-channel NMES was recently developed and its action is based on the normal contractile sequence of swallowing-related muscles.
To evaluate and compare the rehabilitative effectiveness of the sequential 4-channel NMES with that of conventional 2-channel NMES.
In this prospective randomized case-control study, 26 subjects with dysphagia were enrolled. All participants received 2- or 4-channel NMES for 2-3 weeks (minimal session: 7 times, treatment duration: 300-800 min). Twelve subjects in the 4-channel NMES group and eleven subjects in the 2-channel NMES group completed the intervention. Initial and follow-up evaluations were performed using the videofluoroscopic dysphagia scale (VDS), the penetration-aspiration scale (PAS), the MD Anderson dysphagia inventory (MDADI), the functional oral intake scale (FOIS), and the Likert scale.
The sequential 4-channel NMES group experienced significant improvement in their VDS (oral, pharyngeal, and total), PAS, FOIS, and MDADI (emotional, functional, and physical subsets) scores, based on their pretreatment data. VDS (oral, pharyngeal, and total) and MDADI (emotional and physical subsets) scores, but not PAS and FOIS scores, significantly improved in the 2-channel NMES group posttreatment. When the two groups were directly compared, the 4-channel NMES group showed significant improvement in oral and total VDS scores.
The sequential 4-channel NMES, through its activation of the suprahyoid and thyrohyoid muscles, and other infrahyoid muscles mimicking physiological activation, may be a new effective treatment for dysphagia.
clinicaltrial.gov, registration number: NCT03670498, registered 13 September 2018, https://clinicaltrials.gov/ct2/show/NCT03670498?term=NCT03670498&draw=2&rank=1 .
迄今为止，常规吞咽治疗和 2 通道神经肌肉电刺激（NMES）是吞咽障碍的标准治疗方法。2 通道 NMES 治疗的确切机制尚未确定，并且该疗法的疗效存在争议。最近开发了顺序 4 通道 NMES，其作用基于吞咽相关肌肉的正常收缩顺序。
评估和比较顺序 4 通道 NMES 与常规 2 通道 NMES 的康复效果。
在这项前瞻性随机病例对照研究中，纳入了 26 名吞咽障碍患者。所有参与者均接受 2 或 4 通道 NMES 治疗 2-3 周（最少疗程：7 次，治疗时间：300-800 分钟）。4 通道 NMES 组 12 名和 2 通道 NMES 组 11 名患者完成了干预。使用视频荧光透视吞咽量表（VDS）、渗透-吸入量表（PAS）、MD 安德森吞咽障碍量表（MDADI）、功能性口腔摄入量表（FOIS）和李克特量表进行初始和随访评估。
根据基线数据，顺序 4 通道 NMES 组的 VDS（口腔、咽部和总分）、PAS、FOIS 和 MDADI（情绪、功能和身体亚量表）评分显著改善。2 通道 NMES 组治疗后 VDS（口腔、咽部和总分）和 MDADI（情绪和身体亚量表）评分显著改善，但 FOIS 和 PAS 评分无显著改善。当直接比较两组时，4 通道 NMES 组的 VDS 口腔和总分评分显著改善。
顺序 4 通道 NMES 通过激活舌骨上肌和舌骨下肌以及模仿生理激活的其他舌骨下肌，可能是治疗吞咽障碍的一种新的有效治疗方法。
clinicaltrial.gov，注册号：NCT03670498，注册日期：2018 年 9 月 13 日，https://clinicaltrials.gov/ct2/show/NCT03670498?term=NCT03670498&draw=2&rank=1 。
Zotero 插件
