Eimoto Kazuki, Nagai Koutatsu, Nakao Yuta, Uchiyama Yuki, Domen Kazuhisa
Department of Rehabilitation, Hyogo Medical University Hospital, Nishinomiya, JPN.
Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, JPN.
Cureus. 2024 Apr 29;16(4):e59256. doi: 10.7759/cureus.59256. eCollection 2024 Apr.
Sarcopenic dysphagia is defined as dysphagia caused by sarcopenia of the whole body and swallowing-related muscles. We present a case of sarcopenic dysphagia with improved swallowing function after strength training of swallowing-related muscles using neuromuscular electrical stimulation (NMES). A 78-year-old man was admitted to our hospital with an intraductal papillary mucinous tumor of the pancreatic duct. After admission, the patient developed aspiration pneumonia and was placed on strict bed rest without oral intake, which resulted in progressive malnutrition. At the start of swallowing rehabilitation, he had whole-body sarcopenia, nutritional impairment, and weakness in swallowing-related muscles, with a maximum tongue pressure of 21.4 kPa and an opening force of 5.1 kg. In the videofluoroscopic swallowing study, he aspirated 3 cc of a moderately thick liquid. Consequently, as part of swallowing rehabilitation, strengthening training of swallowing-related muscles with NMES was undertaken for about three weeks. As a result, the maximum tongue pressure and opening force improved to 28.4 kPa and 6.8 kg, respectively. A subsequent videofluoroscopic swallowing study showed no obvious aspiration during any procedure. The patient was discharged on the 86th day on a regular diet. As a component of swallowing rehabilitation, NMES may offer therapeutic benefits for patients with sarcopenic dysphagia.
肌少症性吞咽困难被定义为由全身及吞咽相关肌肉的肌少症引起的吞咽困难。我们报告一例肌少症性吞咽困难患者，在使用神经肌肉电刺激（NMES）对吞咽相关肌肉进行力量训练后吞咽功能得到改善。一名78岁男性因胰管内乳头状黏液瘤入院。入院后，患者发生吸入性肺炎，被严格卧床休息且禁止经口进食，这导致了进行性营养不良。在吞咽康复开始时，他存在全身肌少症、营养障碍以及吞咽相关肌肉无力，最大舌压为21.4 kPa，张口力为5.1 kg。在电视荧光吞咽造影检查中，他吸入了3 cc中度浓稠液体。因此，作为吞咽康复的一部分，使用NMES对吞咽相关肌肉进行了约三周的强化训练。结果，最大舌压和张口力分别提高到了28.4 kPa和6.8 kg。随后的电视荧光吞咽造影检查显示在任何操作过程中均无明显误吸。患者在第86天出院，恢复正常饮食。作为吞咽康复的一个组成部分，NMES可能对肌少症性吞咽困难患者具有治疗益处。
