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吸气肌训练对缺血性脑卒中后吞咽困难患者误吸症状的影响

Impact of inspiratory muscle training on aspiration symptoms in patients with dysphagia following ischemic stroke.

作者信息

Liu Shan, Fan Zhenfeng, Fu Minke, Cheng Keling, Zhang Xin, Ni Jun, Wang ZhiYong

机构信息

Rehabilitation Traditional Chinese Medicine Department, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian 353000, China.

Department of Rehabilitation, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China.

出版信息

Brain Res. 2025 Mar 1;1850:149396. doi: 10.1016/j.brainres.2024.149396. Epub 2024 Dec 9.

Abstract

OBJECTIVE

To investigate the impact of inspiratory muscle training on lung function and swallowing function in patients with dysphagia-induced aspiration following ischemic stroke and to evaluate the effectiveness of inspiratory muscle training on aspiration symptoms.

METHODS

Fifty-eight inpatients with dysphagia-induced aspiration following ischemic stroke were selected and randomly divided into a control group (n = 29, conventional swallowing therapy) and a treatment group (n = 29, conventional swallowing therapy plus inspiratory muscle training). Both groups received conventional swallowing function training, including oral sensory training, oral motor training, airway safety protection training, and neuromuscular electrical stimulation therapy for 10-20 min per session, twice daily for 2 weeks. The treatment group additionally received inspiratory muscle resistance training using the POWERbreathe device for 20 min per session, twice daily for 2 weeks. Swallowing function was assessed using the Penetration-Aspiration Scale (PAS), Functional Dysphagia Scale (FDS), and Functional Oral Intake Scale (FOIS) based on the videofluoroscopic swallowing study (VFSS) before and after treatment. Lung function, including maximal peak expiratory flow rate (PEF) and forced vital capacity (FVC), was evaluated using the Miraclink X-SCRIBE cardiac stress testing system.

RESULTS

Before treatment, there were no significant differences in FOIS, FDS, and PAS scores between the two groups (P > 0.05), while post-treatment, both groups showed significant improvements in these indicators (P < 0.05), with the treatment group showing more significant improvements than the control group (P < 0.05). Further, before treatment, there were no significant differences in FVC and PEF scores between the two groups (P > 0.05), whereas post-treatment, the treatment group showed significant improvements in these indicators (P < 0.05) and the control group showed no significant changes (P > 0.05). The treatment group also showed more significant improvements than the control group (P < 0.05). Finally, a correlation analysis revealed a significant linear relationship between FVC and PEF in the post-treatment PAS in the treatment group (P < 0.05).

CONCLUSION

Inspiratory muscle training can improve lung function in patients with dysphagia following ischemic stroke, as it develops swallowing function more effectively than conventional swallowing function training alone. Moreover, inspiratory muscle training is effective in treating aspiration caused by dysphagia, with enhancements in aspiration related to improved lung function.

摘要

目的

探讨吸气肌训练对缺血性脑卒中后吞咽障碍所致误吸患者肺功能和吞咽功能的影响,并评估吸气肌训练对误吸症状的疗效。

方法

选取58例缺血性脑卒中后吞咽障碍所致误吸的住院患者,随机分为对照组(n = 29,常规吞咽治疗)和治疗组(n = 29,常规吞咽治疗加吸气肌训练)。两组均接受常规吞咽功能训练,包括口腔感觉训练、口腔运动训练、气道安全保护训练和神经肌肉电刺激治疗,每次训练10 - 20分钟,每天2次,共2周。治疗组还使用POWERbreathe设备进行吸气肌阻力训练,每次训练20分钟,每天2次,共2周。治疗前后基于视频荧光吞咽造影检查(VFSS),使用渗透-误吸量表(PAS)、功能性吞咽障碍量表(FDS)和功能性经口摄食量表(FOIS)评估吞咽功能。使用Miraclink X-SCRIBE心脏应激测试系统评估肺功能,包括最大呼气峰流速(PEF)和用力肺活量(FVC)。

结果

治疗前,两组FOIS、FDS和PAS评分无显著差异(P > 0.05);治疗后,两组这些指标均有显著改善(P < 0.05),且治疗组改善更显著(P < 0.05)。此外,治疗前,两组FVC和PEF评分无显著差异(P > 0.05);治疗后,治疗组这些指标有显著改善(P < 0.05),而对照组无显著变化(P > 0.05)。治疗组改善也比对照组更显著(P < 0.05)。最后,相关性分析显示治疗组治疗后PAS中FVC与PEF之间存在显著线性关系(P < 0.05)。

结论

吸气肌训练可改善缺血性脑卒中后吞咽障碍患者的肺功能,因为它比单纯常规吞咽功能训练更有效地改善吞咽功能。此外,吸气肌训练对治疗吞咽障碍所致误吸有效,误吸的改善与肺功能的提高有关。

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