Novel Neuromuscular Electrical Stimulation System for Treatment of Dysphagia after Brain Injury
Novel Neuromuscular Electrical Stimulation System for Treatment of Dysphagia after Brain Injury
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DOI：
10.2176/nmc.oa.2013-0341
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发表时间：
2014-07-01
影响因子：
1.9
通讯作者：
Kawahira, Kazumi
中科院分区：
文献类型：
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作者：
Toyama, Keiichi;Matsumoto, Shuji;Kawahira, Kazumi
本研究的目的是比较一种新的神经肌肉电刺激(NMES)与传统治疗方法对脑损伤后吞咽困难患者的疗效。26例患者随机分为实验组(n=12)和对照组(n=14)。试验组接受NMES干预，然后进行常规治疗，包括热-触觉刺激，高强度重复干-燕子任务。对照组给予常规治疗，不加NMES治疗。采用高压脉冲电流仪，对靶肌运动点以上的皮肤区域，即双侧颧舌骨、二腹肌肌筋膜/前腹和甲状腺舌骨肌，进行NMES，脉冲宽度为50 mU，频率为50 Hz。两组每天接受一次40分钟的治疗，每周5天，为期8周。在治疗前和治疗8周后，根据视频透视吞咽困难评分(VDS)、舌骨和喉的前移和上移以及功能性口腔摄入评分来评估疗效。两组均有改善，但实验组舌骨和喉部移位、VDS总分、VDS咽部评分较对照组改善更显著。结果提示，NMES联合常规治疗对颅脑损伤后吞咽困难患者的疗效优于单纯常规治疗。需要进一步的研究来检验NMES对更多不同类型疾病患者的影响。
The purpose of this study was to compare the effects of a novel neuromuscular electrical stimulation (NMES) to the effects of conventional treatment in patients with dysphagia after brain injury. In total, 26 patients were non-randomly divided into an experimental group (n = 12) and a control group (n = 14). The experimental group received NMES intervention followed by conventional treatment, including thermal-tactile stimulation with intensive repetition of a dry-swallow task. The control group received conventional treatment without NMES. NMES at a fixed pulse duration of 50 mu s and a frequency of 50 Hz was delivered over the skin areas above the motor point of the target muscles, i.e., the bilateral geniohyoid, mylohyoid/anterior belly of the digastric, and thyrohyoid muscles, using a high-voltage pulsed-current device. The two groups received 40-min treatments once a day, 5 days per week, for 8 weeks. Outcome, assessed before and 8 weeks after treatment, was evaluated with regard to the videofluoroscopic dysphagia scale (VDS), the anterior and superior displacement of the hyoid bone and larynx, and the functional oral intake scale. Both groups exhibited improvement, but the experimental group exhibited more significant improvement in the displacement of the hyoid bone and larynx, VDS-total score, and VDS-pharyngeal score than the control group did. The results suggest that NMES combined with conventional treatment is superior to conventional treatment alone in patients with dysphagia following treatment for brain injury. Further investigations are necessary to examine the effects of NMES in patients with more varied types of diseases.