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吞咽治疗对吞咽困难的中风患者口腔肌肉质量、舌功能、吞咽及营养状况的影响

Swallowing Therapy Effects on Oral Muscle Mass, Tongue Function, Swallowing, and Nutrition in Stroke Patients with Dysphagia.

作者信息

Li Guan-Yi, Huang Yu-Chi, Wu Jia-Ying, Leong Chau-Peng, Cheng Chung-Hui

机构信息

Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

NeuroRehabilitation. 2025 Mar;56(2):164-174. doi: 10.1177/10538135241308773. Epub 2025 Feb 9.

Abstract

BackgroundDysphagia, common post-stroke, elevates clinical risks. Muscle atrophy and compromised function correlate with malnutrition and secondary sarcopenia.ObjectiveWe studied oral muscle thickness, tongue strength/endurance in post-stroke dysphagia (PSD) using sonography and Iowa Oral Performance Instrument (IOPI), and assessed swallowing therapy's impact.Methods17 healthy and 15 PSD participants were analyzed. Healthy subjects underwent baseline sonography and IOPI. PSD patients received a 3-week swallowing therapy including traditional methods, neuromuscular electrical stimulation, and IOPI-guided oral exercises. Pre/post-swallowing therapy sonography and swallowing-related evaluations were conducted.ResutlsPSD group exhibited significant differences in affected masseter muscle thickness (P = 0.001), tongue strength (P ≤ 0.001), but not posterior tongue endurance (P = 0.066). After swallowing therapy, PSD patients showed notable improvement in masseter muscle thickness (P = 0.011) and tongue strength (P = 0.005-0.009). Clinical metrics like Functional Oral Intake Scale (P = 0.004), Mini Nutritional Assessment (P = 0.007), and gait speed (P = 0.018) also improved.ConclusionsStroke-induced dysphagia correlates with reduced masseter muscle thickness, tongue strength, and endurance. Swallowing therapy enhanced masseter muscle thickness and tongue strength, potentially improving swallowing function, nutrition, and gait speed.

摘要

背景

吞咽困难是中风后常见的症状,会增加临床风险。肌肉萎缩和功能受损与营养不良及继发性肌肉减少症相关。

目的

我们使用超声检查和爱荷华口腔功能仪器(IOPI)研究了中风后吞咽困难(PSD)患者的口腔肌肉厚度、舌肌力量/耐力,并评估了吞咽治疗的效果。

方法

对17名健康参与者和15名PSD患者进行了分析。健康受试者接受了基线超声检查和IOPI测试。PSD患者接受了为期3周的吞咽治疗,包括传统方法、神经肌肉电刺激和IOPI引导的口腔锻炼。在吞咽治疗前后进行了超声检查和吞咽相关评估。

结果

PSD组在患侧咬肌厚度(P = 0.001)、舌肌力量(P≤0.001)方面存在显著差异,但舌后耐力无显著差异(P = 0.066)。吞咽治疗后,PSD患者的咬肌厚度(P = 0.011)和舌肌力量(P = 0.005 - 0.009)有显著改善。功能口服摄入量量表(P = 0.004)、微型营养评定量表(P = 0.007)和步态速度(P = 0.018)等临床指标也有所改善。

结论

中风引起的吞咽困难与咬肌厚度、舌肌力量和耐力降低相关。吞咽治疗可增加咬肌厚度和舌肌力量,可能改善吞咽功能、营养状况和步态速度。

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