神经肌肉电刺激对脑卒中后吞咽障碍患者吞咽功能及其表面肌电图的影响

被引：45

作者：

苏文华

阎文静

钟明华

林延敏

高呈飞

朱其秀

机构：

[1] 青岛,青岛大学附属医院康复科

来源：

中华物理医学与康复杂志 | 2015年 / 37卷 / 03期

关键词：

吞咽障碍; 神经肌肉电刺激; 脑卒中; 表面肌电图;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）]; R493 [医学康复（康复疗法）];

学科分类号：

100204 [神经病学]; 100232 [康复医学];

摘要：

目的观察神经肌肉电刺激(NMES)治疗脑卒中恢复期吞咽障碍患者的临床疗效, 并探讨表面肌电图在脑卒中患者吞咽障碍评估中的应用价值。方法将脑卒中恢复期吞咽障碍患者40例按随机数字表法随机分为实验组(20例)和对照组(20例), 2组患者均给予神经内科常规药物治疗和常规吞咽训练, 实验组患者在此基础上增加NMES治疗。2组患者均于治疗前和治疗2周后(治疗后)进行吞咽功能评定和sEMG检测。结果治疗后, 实验组患者的吞咽障碍评分为(7.65±0.88)分, 与组内治疗前的(2.75±0.64)分和对照组治疗后的(6.10±0.85)分比较, 差异均有统计学意义(P<0.05)。治疗后, 2组患者舌骨上肌群的sEMG最大波幅和吞咽时程较组内治疗前显著改善(P<0.05), 且实验组治疗后的sEMG最大波幅和吞咽时程均显著优于对照组治疗后(P<0.05)。结论 NMES结合常规吞咽训练可显著改善脑卒中恢复期吞咽障碍患者的吞咽功能, 且sEMG可作为评估脑卒中患者吞咽障碍的有效方法。

引用

共 18 条

[1]

Normal Muscular Activity During Swallowing as Measured by Surface Electromyography [J].

O'Kane, Lisa ;

Groher, Michael E. ;

Silva, Kathleen ;

Osborn, Lori .

ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 2010, 119 (06) :398-401

[2]

Sensory Transcutaneous Electrical Stimulation Improves Post-Stroke Dysphagic Patients [J].

Gallas, Syrine ;

Marie, Jean Paul ;

Leroi, Anne Marie ;

Verin, Eric .

DYSPHAGIA, 2010, 25 (04) :291-297

[3]

Surface electromyography and muscle force: Limits in sEMG–force relationship and new approaches for applications.[J].Catherine Disselhorst-Klug;Thomas Schmitz-Rode;Günter Rau.Clinical Biomechanics.2008, 3

[4]

Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal dysphagia [J].

Ludlow, Christy L. ;

Humbert, Ianessa ;

Saxon, Keith ;

Poletto, Christopher ;

Sonies, Barbara ;

Crujido, Lisa .

DYSPHAGIA, 2007, 22 (01) :1-10

[5]

Standardization of surface electromyography utilized to evaluate patients with dysphagia.[J].Vaiman Michael.Head & Face Medicine.2007, 1

[6]

Dysphagia after stroke - Incidence, diagnosis, and pulmonary complications [J].

Martino, R ;

Foley, N ;

Bhogal, S ;

Diamant, N ;

Speechley, M ;

Teasell, R .

STROKE, 2005, 36 (12) :2756-2763

[7]

Do dysphagic patients with an absent pharyngeal swallow have a shorter survival than dysphagic patients with pharyngeal swallow?: Prognostic importance of a therapeutic videoradiographic swallowing study (TVSS) [J].

Bülow, M ;

Olsson, R ;

Ekberg, O .

ACTA RADIOLOGICA, 2005, 46 (02) :126-131

[8]

Laryngeal elevation achieved by neuromuscular stimulation at rest..[J].Burnett Theresa A;Mann Eric A;Cornell Sonia A;Ludlow Christy L.Journal of applied physiology (Bethesda; Md. : 1985).2003, 1

[9]

Electrical stimulation for swallowing disorders caused by stroke..[J].Freed M L;Freed L;Chatburn R L;Christian M.Respiratory care.2001, 5

[10]

Regulation of glial cell line-derived neurotrophic factor expression by electroacupuncture after transient focal cerebral ischemia [J].

Wei, GW ;

Huang, YL ;

Wu, GC ;

Cao, XD .

ACUPUNCTURE & ELECTRO-THERAPEUTICS RESEARCH, 2000, 25 (02) :81-90

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