| Objective：To investigate the effects of diaphragmatic electrical stimulation combined with respiratory muscle training on pulmonary ventilation, diaphragm function and swallowing function in patients with pseudobulbar palsy after stroke. Methods：A prospective randomized controlled study was used to enroll 60 patients with post-stroke pseudobulbar palsy admitted to the Rehabilitation Center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from July 2023 to December 2024, and the patients were divided into a control group and an experimental group with 30 cases in each group. All patients received conventional rehabilitation. The control group was supplemented with respiratory muscle training, and the experimental group was given diaphragmatic electrical stimulation in combination with respiratory muscle training. The duration of treatment was 3 weeks. Before and after 3 weeks of treatment, the pulmonary ventilation function of the patients was evaluated by a portable pulmonary function tester, and the main indicators included maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEF). At the same time, ultrasound technology was used to evaluate diaphragm mobility and diaphragm thickening rate to objectively reflect the functional status of diaphragm. In addition, tongue motor function was evaluated by ultrasound, and combined with the swallowing function scale (SSA) and swallowing-related quality of life scale (SWAL-QOL) scores, the improvement of swallowing function was comprehensively evaluated. Results：After 3 weeks of treatment, the pulmonary ventilation function indexes (MIP, MEP, FVC, FEV1 and PEF) in the two groups were significantly higher than those before treatment (P<0.01), and the diaphragm mobility and diaphragm thickening rate in the two groups were significantly higher than those before treatment (P<0.01). In the evaluation of swallowing function, the SSA score was significantly decreased, the SWAL-QOL score and the amplitude of tongue movement were significantly increased (P<0.01). The results showed that the improvement degree of the above indicators in the experimental group was significantly better than that in the control group, and the difference was statistically significant (P<0.01). Conclusion：The integrated therapeutic regimen combining diaphragmatic electrical stimulation with respiratory muscle rehabilitation exerts significant therapeutic effects on enhancing pulmonary ventilation capacity, diaphragmatic mobility, and swallowing coordination in post-stroke pseudobulbar palsy patients, thereby holding considerable value for widespread clinical implementation. |
