Kinematic Effects of Hyolaryngeal Electrical Stimulation Therapy on Hyoid Excursion and Laryngeal Elevation
Kinematic Effects of Hyolaryngeal Electrical Stimulation Therapy on Hyoid Excursion and Laryngeal Elevation
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DOI：
10.1007/s00455-013-9465-x
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发表时间：
2013-12-01
期刊：
影响因子：
2.6
通讯作者：
Han, Tai Ryoon
中科院分区：
文献类型：
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作者：
Nam, Hyung Seok;Beom, Jaewon;Han, Tai Ryoon
本研究的目的是通过影像透视吞咽研究（VFSS）的定量运动学分析，评估反复电刺激治疗（EST）对获得性脑损伤吞咽困难患者颈部肌肉刺激部位的影响。我们分析了一家三级医院的50名患者，他们被随机分为两个不同的治疗组。一组仅在舌骨上肌（SM）上进行EST刺激，另一组在舌骨上肌和舌骨下肌（SI）上分别进行一对电极刺激。所有患者在2-3周内接受10-15次EST治疗。治疗前后分别进行VFSS。采用二维运动分析方法分析吞咽过程中舌骨偏移和喉抬高的时空参数。SM组（n = 25）最大舌骨前偏移距离（平均+/- a = 1.56 +/- a 0.52 mm, p = 0.008）和速度（8.76 +/- a 3.42 mm/s, p = 0.017）显著增加，但喉部抬高没有显著增加。然而，SI组（n = 25）显示喉上最大偏移距离（2.09 +/- a 0.78 mm, p = 0.013）和最大绝对偏移距离（2.20 +/- a 0.82 mm, p = 0.013）显著增加，但舌骨偏移无显著增加。两组在舌骨前最大偏移距离（p = 0.130）、速度（p = 0.254）、喉上最大抬高距离（p = 0.525）的变化无显著差异。舌骨上肌的EST刺激引起舌骨前偏移增加，舌骨下刺激引起喉上抬高增加。刺激部位不同，喉部结构运动不同程度增加。基于病理生理的定向电刺激是必要的。
The purpose of this study was to assess the effect of repeated sessions of electrical stimulation therapy (EST) on the neck muscles with respect to the stimulation site by using quantitative kinematic analysis of videofluoroscopic swallowing studies (VFSS) in dysphagia patients with acquired brain injury. We analyzed 50 patients in a tertiary hospital who were randomly assigned into two different treatment groups. One group received EST on the suprahyoid muscle only (SM), and the other group received stimulation with one pair of electrodes on the suprahyoid muscle and the other pair on the infrahyoid muscle (SI). All patients received 10-15 sessions of EST over 2-3 weeks. The VFSS was carried out before and after the treatment. Temporal and spatial parameters of the hyoid excursion and laryngeal elevation during swallowing were analyzed by two-dimensional motion analysis. The SM group (n = 25) revealed a significant increase in maximal anterior hyoid excursion distance (mean +/- A SEM = 1.56 +/- A 0.52 mm, p = 0.008) and velocity (8.76 +/- A 3.42 mm/s, p = 0.017), but there was no significant increase laryngeal elevation. The SI group (n = 25), however, showed a significant increase in maximal superior excursion distance (2.09 +/- A 0.78 mm, p = 0.013) and maximal absolute excursion distance (2.20 +/- A 0.82 mm, p = 0.013) of laryngeal elevation, but no significant increase in hyoid excursion. There were no significant differences between the two groups with respect to changes in maximal anterior hyoid excursion distance (p = 0.130) and velocity (p = 0.254), and maximal distance of superior laryngeal elevation (p = 0.525). EST on the suprahyoid muscle induced an increase in anterior hyoid excursion, and infrahyoid stimulation caused an increase in superior laryngeal elevation. Hyolaryngeal structural movements were increased in different aspects according to the stimulation sites. Targeted electrical stimulation based on pathophysiology is necessary.