Transcutaneous Electrical Stimulation on the Submental Area: The Relations of Biopsychological Factors with Maximum Amplitude Tolerance and Perceived Discomfort Level.
Transcutaneous Electrical Stimulation on the Submental Area: The Relations of Biopsychological Factors with Maximum Amplitude Tolerance and Perceived Discomfort Level.
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DOI：
10.1007/s00455-019-10029-6
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发表时间：
2020-04
期刊：
影响因子：
2.6
通讯作者：
Crary M
中科院分区：
文献类型：
--
作者：
Barikroo A;Hegland K;Carnaby G;Bolser D;Manini T;Crary M
经皮电刺激(TES)是吞咽困难康复中常用的辅助手段。刺激更深的吞咽肌肉需要更高的TES幅度。然而，TES幅度受到最大幅度容差(MAT)的限制。以前的研究已经报道了关于垫和感觉到的不适感的高度个体间差异。这种可变性可能是基于TES的吞咽研究结果相互矛盾的潜在原因之一。垫和感觉到的不适受多种生物心理因素的影响。这些因素对吞咽应用的影响还知之甚少。本研究探讨生物心理因素与MAT的关系，以及与潜伏区TES相关的知觉不适。对30名60岁至70岁的社区老年人进行了便利抽样，为这项研究提供了数据。对每个受试者的性别、颧下脂肪组织厚度、知觉疼痛敏感度和疼痛应对策略进行评估。随后，使用TES对智下区进行测试，以确定MAT和感觉不适程度。采用Pearson和Spearman相关分析及Mann-Whitney U检验，分析不同生物心理变量与MAT和不适程度的关系。结果表明，性别和脂肪厚度与垫和感觉不适感无关。在所研究的疼痛应对策略中，灾难性与MAT显著相关(r=−.552，P<；.002)。分心与感觉到的不适程度显著相关(r=−.561，P<；.002)。鉴于疼痛灾变对MAT的负面影响和分心对感知不适的积极影响，这些应对策略应该被视为基于TES的吞咽困难康复中的限制幅度和缓解不适的因素。
Transcutaneous Electrical Stimulation (TES) is a frequently used adjunctive modality in dysphagia rehabilitation. Stimulating deeper swallowing muscles requires higher TES amplitude. However, TES amplitude is limited by maximum amplitude tolerance (MAT). Previous studies have reported high interindividual variability regarding MAT and perceived discomfort. This variability might be one of the potential reasons of conflicting outcomes in TES-based swallowing studies. MAT and perceived discomfort are influenced by a variety of biopsychological factors. The influence of these factors related to swallow applications is poorly understood. This study explored the relation of biopsychological factors with MAT and perceived discomfort related to TES in the submental area. A convenience sample of thirty community-dwelling older adults between 60 to 70 years of age provided data for this study. Gender, submental adipose tissue thickness, perceptual pain sensitivity, and pain coping strategies were evaluated for each subject. Subsequently, MAT and perceived discomfort level were determined using TES on the submental area. Relation of different biopsychological variables with MAT and discomfort level was examined using Pearson and Spearman correlation, and Mann–Whitney U test. Results indicated that neither gender nor adipose thickness was related to MAT and perceived discomfort. Among studied pain coping strategies, catastrophizing was significantly related to MAT(r = −.552, P<.002). Distraction was significantly related to perceived discomfort level (r = −.561, P<.002). Given the negative impact of pain catastrophizing on MAT and the positive impact of distraction on perceiving discomfort, these coping strategies should be considered as amplitude-limiting and discomfort-moderating factors in TES-based dysphagia rehabilitation.
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