IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Lido di Venezia, Italy.
Otorhinolaryngology Unit, Department of Neurosciences, University of Padua, Via Giustiniani 5, 35128, Padua, Italy.
Dysphagia. 2022 Oct;37(5):1207-1216. doi: 10.1007/s00455-021-10385-2. Epub 2021 Nov 12.
Post-stroke dysphagia affects almost half of the survivors and severely influences quality of life, thus becoming swallowing rehabilitation of paramount importance. However, there is little adequate evidence on which the best rehabilitative strategy can be. Surface electromyography (sEMG) allows for recording swallowing muscles' activity and provides real time visual feedback, as a biofeedback adjunctive technique to improve treatment outcome. This study aimed to analyze the effectiveness of biofeedback rehabilitation of swallowing through sEMG compared to standard techniques, in post-stroke dysphagia.
A pilot-randomized controlled trial included 17 patients diagnosed with post-stroke dysphagia. Nine underwent sEMG-biofeedback rehabilitation; seven controls were submitted to control treatment, one dropout. The primary outcome was the functional oral intake scale (FOIS), secondary outcomes was pharyngeal clearance and safe swallowing, assessed through fiberoptic endoscopic evaluation of swallowing (FEES).
FOIS improved in all patients, regardless of treatment. sEMG-biofeedback rehabilitation led to improvements of the pharyngeal clearance and swallowing safety. The rehabilitative effects appeared stable at 2-months follow-up.
The application of biofeedback based on sEMG in post-stroke dysphagia patients resulted in an effective rehabilitative technique, in particular for pharyngeal clearance improvements and safe swallowing, thus reducing the risk of aspiration and malnutrition.
脑卒中后吞咽障碍影响近半数幸存者，严重影响生活质量，因此吞咽康复至关重要。然而，哪种康复策略最好尚缺乏充分证据。表面肌电图（sEMG）可记录吞咽肌活动，并提供实时视觉反馈，作为改善治疗效果的生物反馈辅助技术。本研究旨在分析 sEMG 生物反馈吞咽康复与标准技术相比，对脑卒中后吞咽障碍的疗效。
一项前瞻性随机对照试验纳入了 17 例诊断为脑卒中后吞咽障碍的患者。9 例接受 sEMG 生物反馈康复治疗；7 例对照患者接受常规治疗，1 例脱落。主要结局指标为功能性口腔摄入量表（FOIS），次要结局指标为通过纤维内镜吞咽评估（FEES）评估的咽部清除率和安全吞咽。
所有患者的 FOIS 均有改善，无论治疗方式如何。sEMG 生物反馈康复治疗可改善咽部清除率和吞咽安全性。康复效果在 2 个月随访时稳定。
sEMG 生物反馈在脑卒中后吞咽障碍患者中的应用是一种有效的康复技术，特别是可改善咽部清除率和安全吞咽，从而降低误吸和营养不良的风险。
