Tang Anli, Chen Xuexian, Ma Jingjing, Xu Ruiyun, Luo Ziqiong, Chen JiaLi, Zhang Xuefei, Zhan Hongrui, Wu Wen
Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China.
Department of Rehabilitation, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong Province, China.
Clin Biomech (Bristol). 2022 Dec;100:105772. doi: 10.1016/j.clinbiomech.2022.105772. Epub 2022 Sep 27.
Dysphagia is one of the common complications after stroke. Dysphagia significantly increases the probability of serious adverse consequences. The purpose of this study was to compare the characteristics of submental muscles electromyography and hyoid motion parameters between patients with dysphagia after stroke and healthy controls, and whether there is a synergistic effect between the function of the submental muscles and the movement of the hyoid.
Fifteen patients with post-stroke dysphagia and fifteen healthy adults simultaneously underwent the videofluoroscopic and surface electromyography of the submental muscles while swallowing 5 ml of concentrated liquid barium sulphate. The electromyographic signal of the submental muscles was analysed along with parameters of hyoid movement.
Stage transition duration and duration of surface electromyographic activity were extended significantly in post-stroke dysphagia patients(P < 0.05). Surface electromyography amplitude and hyoid movement were significantly reduced in patients (P < 0.05). There was a significant correlation between the maximum hyoid movement distance and the peak sEMG amplitude in healthy controls (r = 0.660, P = 0.014), but not in patients with dysphagia after stroke (r = 0.425, P = 0.148).
Submental muscles electromyographic signal changes in patients may be the result of uncoordinated muscle contractions and decreased muscle strength. Furthermore, the reduced hyoid movement distance may be due to impaired function of the submental muscles. In addition, the submental muscles and hyoid movement or other swallowing structures functions were impaired to varying degrees, resulting in the disappearance of the correlation between the maximum movement distance of the hyoid and the peak amplitude.
吞咽困难是卒中后常见的并发症之一。吞咽困难显著增加了严重不良后果的发生概率。本研究的目的是比较卒中后吞咽困难患者与健康对照者颏下肌肌电图特征及舌骨运动参数,以及颏下肌功能与舌骨运动之间是否存在协同作用。
15例卒中后吞咽困难患者和15名健康成年人在吞咽5ml浓缩硫酸钡液时,同时接受颏下肌的视频荧光透视检查和表面肌电图检查。分析颏下肌的肌电信号以及舌骨运动参数。
卒中后吞咽困难患者的阶段转换持续时间和表面肌电活动持续时间显著延长(P<0.05)。患者的表面肌电图幅度和舌骨运动显著降低(P<0.05)。健康对照者的舌骨最大运动距离与表面肌电图峰值幅度之间存在显著相关性(r=0.660,P=0.014),但卒中后吞咽困难患者不存在这种相关性(r=0.425,P=0.148)。
患者颏下肌肌电信号变化可能是肌肉收缩不协调和肌力下降的结果。此外,舌骨运动距离缩短可能是由于颏下肌功能受损。此外,颏下肌和舌骨运动或其他吞咽结构功能不同程度受损,导致舌骨最大运动距离与峰值幅度之间的相关性消失。