中国康复理论与实践2025，Vol.31Issue(6)：721-728,8.DOI:10.3969/j.issn.1006-9771.2025.06.013
复合电磁刺激联合下颌抗阻训练对卒中后吞咽障碍的效果
Effect of composite electromagnetic stimulation combined with chin tuck against resistance on post-stroke pa-tients with dysphagia
摘要
Abstract
Objective To explore the effect of composite electromagnetic stimulation combined with chin tuck against resistance(CTAR)on post-stroke dysphagia. Methods From January,2021 to December,2023,156 post-stroke patients with pharyngeal dysphagia in the First Peo-ple's Hospital of Yibin were randomly divided into CTAR group(n=51),neuromuscular electrical stimulation(NMES)+repetitive transcranial magnetic stimulation(rTMS)group(n=52)and combination group(n=53).On the basis of routine swallowing function training,they received CTAR,NMES+rTMS and NMES+rTMS+CTAR,respectively,for four weeks.They were assessed with Functional Oral Intake Scale(FOIS),Standardized Swal-lowing Assessment(SSA),Swallowing-Quality of Life(SWAL-QOL),Rosenbek Penetration Aspiration Scale(PAS),video fluoroscopic swallowing study(VFSS)(including the score of VFSS,pharyngeal transit time,and upward and forward displacement of hyoid bone),average surface electromyography(AMEG)of submental and hyoid muscles,before and after treatment. Results The inter-group effect,intra-group effect and interaction effect were significant in SSA,SWAL-QOL and AMEG of the two muscles(F>6.611,P<0.001).The inter-group effect and interaction effect were significant in FOIS,VFSS,pharyngeal transit time,upward displacement of hyoid bone and forward displacement of hyoid bone(F>3.451,P<0.05).Pairwise comparison results showed that pharyngeal transit time was shorter in the combination group than in NMES+rTMS group(P=0.048),forward displacement of hyoid bone was more in the combina-tion group than in CTAR group(P=0.002),and AMEG was higher in the combination group than in CTAR group and NMES+rTMS group(P<0.001).There was significant difference in the score of PAS among three groups(Hc=8.282,P=0.016),and it was the best in the combination group. Conclusion The combination of NMES+rTMS and CTAR is superior to single electromagnetic stimulation or CTAR in the treatment of post-stroke sysphagia.关键词
脑卒中/吞咽障碍/神经肌肉电刺激/重复经颅刺激/下颌抗阻训练Key words
stroke/dysphagia/neuromuscular electrical stimulation/repetitive transcranial magnetic stimulation/chin tuck against resistance分类
医药卫生引用本文复制引用
付国军,余秀芳,吕鑫,吉璐,刘华庆..复合电磁刺激联合下颌抗阻训练对卒中后吞咽障碍的效果[J].中国康复理论与实践,2025,31(6):721-728,8.基金项目
宜宾市科技局中医药研究课题(No.2023ZYY003) Supported by Traditional Chinese Medicine Research Project of Yibin Science and Technology Bureau(No.2023ZYY003) （No.2023ZYY003）
