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神经肌肉电刺激可改善中风后吞咽困难患者的吞咽启动能力。

Neuromuscular electrical stimulation improves swallowing initiation in patients with post-stroke dysphagia.

作者信息

Zhang Yao-Wen, Dou Zu-Lin, Zhao Fei, Xie Chun-Qing, Shi Jing, Yang Chen, Wan Gui-Fang, Wen Hong-Mei, Chen Pei-Rong, Tang Zhi-Ming

机构信息

Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Department of Rehabilitation Medicine, Yuedong Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Meizhou, China.

出版信息

Front Neurosci. 2022 Nov 14;16:1011824. doi: 10.3389/fnins.2022.1011824. eCollection 2022.

Abstract

OBJECTIVE

More than half of post-stroke patients develop dysphagia, which manifests as delayed swallowing and is associated with a high risk of aspiration. In this study, we aimed to investigate the immediate effect of neuromuscular electrical stimulation (NMES) on swallowing initiation in post-stroke patients using videofluoroscopic swallowing study (VFSS) data.

MATERIALS AND METHODS

This randomized, self-controlled crossover study included 35 patients with post-stroke dysphagia. All selected patients received real and sham NMES while swallowing 5 ml of thin liquid. Participants completed the conditions in random order, with a 10-min interval between conditions. The primary evaluation indicators included the Modified Barium Swallow Impairment Profile-6 (MBSImp-6) and Penetration-Aspiration Scale (PAS). Secondary indicators included oral transit time (OTT), pharyngeal transit time (PTT), and laryngeal closure duration (LCD).

RESULTS

Modified Barium Swallow Impairment Profile-6 ( = 0.008) and PAS ( < 0.001) scores were significantly lower in the Real-NMES condition than in the Sham-NMES condition. OTT ( < 0.001) was also significantly shorter during Real-NMES than during Sham-NMES. However, LCD ( = 0.225) and PTT ( = 0.161) did not significantly differ between the two conditions.

CONCLUSION

Neuromuscular electrical stimulation may represent a supplementary approach for promoting early feeding training in patients with post-stroke dysphagia.

CLINICAL TRIAL REGISTRATION

[https://clinicaltrials.gov/], identifier [ChiCTR2100052464].

摘要

目的

超过半数的中风后患者会出现吞咽困难,表现为吞咽延迟,并伴有较高的误吸风险。在本研究中,我们旨在利用视频荧光吞咽造影研究(VFSS)数据,调查神经肌肉电刺激(NMES)对中风后患者吞咽启动的即时影响。

材料与方法

这项随机、自身对照的交叉研究纳入了35例中风后吞咽困难患者。所有入选患者在吞咽5毫升稀液体时接受真实和假NMES治疗。参与者以随机顺序完成各项条件,条件之间间隔10分钟。主要评估指标包括改良钡剂吞咽障碍量表-6(MBSImp-6)和渗透-误吸量表(PAS)。次要指标包括口腔通过时间(OTT)、咽部通过时间(PTT)和喉关闭持续时间(LCD)。

结果

真实NMES条件下的改良钡剂吞咽障碍量表-6( = 0.008)和PAS( < 0.001)评分显著低于假NMES条件。真实NMES期间的OTT( < 0.001)也显著短于假NMES期间。然而,两种条件下的LCD( = 0.225)和PTT( = 0.161)没有显著差异。

结论

神经肌肉电刺激可能是促进中风后吞咽困难患者早期进食训练的一种辅助方法。

临床试验注册

[https://clinicaltrials.gov/],标识符[ChiCTR2100052464]。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91a4/9704362/8c203d1d2adc/fnins-16-1011824-g001.jpg

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