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呼吸肌训练对脑卒中患者吞咽功能的影响:系统评价和荟萃分析。

The Effect of Respiratory Muscle Training on Swallowing Function in Patients With Stroke: A Systematic Review and Meta-Analysis.

机构信息

School of Nursing, Jilin University, Changchun, China.

出版信息

West J Nurs Res. 2024 May;46(5):389-399. doi: 10.1177/01939459241242533. Epub 2024 Mar 28.

Abstract

BACKGROUND

The improvement of swallowing function after stroke is a significant challenge faced by patients and health care professionals. However, the current evidence synthesis of the effects of respiratory muscle training (RMT) on swallowing function is limited.

OBJECTIVE

To assess the effectiveness of RMT on swallowing recovery in patients undergoing stroke.

METHODS

The CKNI, WanFang Data, PubMed, CINAHL, Web of Science, Embase, MEDLINE, and Cochrane Library databases were searched for studies evaluating RMT interventions' effect on swallowing outcomes. Risks of bias were evaluated using the approach recommended by the Cochrane Collaboration tool and a summary of findings table was generated using the GRADE approach. Outcomes were synthesized using a random-effects meta-analysis model.

RESULTS

RMT interventions reduced the risk of aspiration (SMD = 1.19; 95% CI, 0.53-1.84), the recovery process of water swallowing function (RR = 1.22; 95% CI, 1.05-1.42), and the activity of the swallowing muscles (SMD = 2.91; 95% CI, 2.22-3.61). However, there was no significant effect of RMT on the functional level of oral intake (SMD = 0.70; 95% CI, -0.03 to 1.42).

CONCLUSIONS

RMT can be regarded as an innovative, auxiliary means in the near future to better manage and improve swallowing function, given its improving effect on work outcomes in this review.

摘要

背景

改善脑卒中后吞咽功能是患者和医护人员面临的重大挑战。然而,目前关于呼吸肌训练(RMT)对吞咽功能影响的证据综合有限。

目的

评估 RMT 对脑卒中患者吞咽恢复的效果。

方法

检索中国知网、万方数据、PubMed、CINAHL、Web of Science、Embase、MEDLINE 和 Cochrane Library 数据库,评估 RMT 干预对吞咽结局影响的研究。采用 Cochrane 协作工具推荐的方法评估偏倚风险,并使用 GRADE 方法生成总结发现表。使用随机效应荟萃分析模型综合结局。

结果

RMT 干预降低了误吸风险(SMD=1.19;95%CI,0.53-1.84)、水吞咽功能恢复过程(RR=1.22;95%CI,1.05-1.42)和吞咽肌肉活性(SMD=2.91;95%CI,2.22-3.61)。然而,RMT 对口腔摄入的功能水平没有显著影响(SMD=0.70;95%CI,-0.03 至 1.42)。

结论

鉴于本综述中 RMT 对工作结局的改善效果,RMT 可以被视为一种创新的、辅助手段,用于更好地管理和改善吞咽功能。

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