| 顾怡雯,舒锦.表面肌电生物反馈与神经肌肉电刺激对脑卒中吞咽障碍疗效及生活质量的影响[J].中国康复,2021,36(10):599-603 |
| 表面肌电生物反馈与神经肌肉电刺激对脑卒中吞咽障碍疗效及生活质量的影响 |
| Effects of surface electromyogram biofeedback and neuromuscular electrical stimulation on dysphagia after stroke and quality of life |
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| DOI： |
| 中文关键词: 脑卒中 吞咽障碍 表面肌电生物反馈 神经肌肉电刺激 吞咽功能 生活质量 |
| 英文关键词: stroke dysphagia surface electromyogram biofeedback neuromuscular electrical stimulation swallowing function quality of life |
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| 中文摘要: |
| 目的：探讨表面肌电生物反馈（sEMGBF）与神经肌肉电刺激（NMES）联合基础吞咽训练对脑卒中吞咽障碍的疗效，以及对生活质量的影响。方法:将脑卒中后吞咽障碍患者120例随机分为3组，基础吞咽康复训练组（A组），神经肌肉电刺激联合吞咽康复训练组（B组），表面肌电生物反馈联合吞咽康复训练组（C组），每组40名患者。比较3组患者治疗前后洼田饮水试验分级和临床疗效，观察2组治疗前后表面肌电图（sEMG）检测结果［颏下肌群肌电信号（平均波幅、吞咽时限）］、吞咽功能［标准吞咽功能评定量表（SSA）］、生活质量［吞咽相关生活质量量表（SWAL-QOL）］变化情况。结果：与治疗前比较，3组患者治疗后洼田饮水试验分级均有所改善（P＜0.05），且B组、C组均优于A组，差异均有统计学意义（P＜0.05）。C组治疗总有效率高于B组和A组（P＜0.05），B组高于A组（P＜0.05）。治疗3个月后，3组患者sEMG平均波幅、SWAL-QOL评分较治疗前升高，吞咽时限较治疗前缩短，SSA评分较治疗前降低，且组间比较差异有统计学意义（P＜0.05）；进一步两两比较，C组上述指标优于B组和A组，且B组优于A组（P＜0.05）。结论：表面肌电生物反馈与神经肌肉电刺激治疗均可显著改善脑卒中吞咽障碍患者的吞咽功能和生活质量，其中表面肌电生物反馈的疗效优于神经肌肉电刺激。 |
| 英文摘要: |
| Objective：To investigate the effects of surface electromyogram biofeedback (sEMGBF) and neuromuscular electrical stimulation (NMES) combined with basic swallowing training on dysphagia after stroke and quality of life. Methods：A total of 120 patients with dysphagia after stroke who were admitted to our department between June 2018 and December 2019 were selected and divided into three groups by random number table method: basic swallowing rehabilitation training group (group A), neuromuscular electrical stimulation combined with swallowing rehabilitation training group (group B) and sEMGBF combined with swallowing rehabilitation training group (group C), with 40 cases in each group. Water swallow test classification and clinical efficacy were compared among the three groups before and after treatment, and the results of sEMG ［submental muscle group electromyographic signal (average amplitude, swallowing time limit)］, swallowing function ［Standardized Swallowing Assessment (SSA)］ and quality of life ［Swallowing Quality-of-Life Questionnaire (SWAL-QOL)］ were observed before and after treatment. Results：As compared with before treatment, the water swallow test classification in the three groups was improved after treatment (P<0.05), and the classification in group B and group C was better than that in group A (P<0.05). The total effective rate of treatment in group C was higher than that in group B and group A (P<0.05), and that in group B was higher than that in group A (P<0.05). After 3 months of treatment, the average sEMG amplitude and SWAL-QOL score in the three groups were higher than those before treatment, and the swallowing time limit was shorter than that before treatment, and the SSA score was lower than that before treatment (P<0.05). Further pairwise comparison showed that the above indicators in group C were better than those in group B and group A, and the indicators in group B were better than those in group A (P<0.05). Conclusion： Both sEMGBF and neuromuscular electrical stimulation can significantly improve the swallowing function and quality of life of patients with dysphagia after stroke, and the efficacy of sEMGBF is better than neuromuscular electrical stimulation. |
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