CAJ | 학술논문

目的探讨神经肌肉电刺激联合吞咽训练对脑卒中后吞咽障碍患者吞咽功能恢复的影响.方法选取脑卒中3个月后伴吞咽障碍患者150例,按随机数字表法分为常规训练组(常规吞咽训练)、电刺激组(神经肌肉电刺激)和综合治疗组(神经肌肉电刺激联合常规吞咽训练),每组50例.3组患者均于治疗前和治疗4周后(治疗后)评定其吞咽功能(SSA)、表面肌电信号(sEMG)、吞咽障碍程度(VFSS)和生活质量(SWAL-QOL).结果治疗后,3组患者的sEMG最大波幅与组内治疗前比较,差异均有统计学意义(P＜0.01),且综合治疗组的sEMG的最大波幅值与常规训练组和电刺激组治疗后比较,差异均有统计学意义(P＜0.01).治疗后,3组患者的SSA、VFSS和SWAL-QOL评分与组内治疗前比较,差异均有统计学意义(P＜0.01),且综合治疗组的SSA、VFSS和SWAL-QOL评分分别为(21.34 ±3.61)分、(6.98±1.62)分和(438 ±37)分,与常规训练组治疗后的(30.22 ±3.71)分、(5.34±1.63)分和(627±51)分以及电刺激组的治疗后的(28.14±3.92)分、(5.69±1.58)分和(637±56)分比较,差异均有统计学意义.对3组患者治疗前、后的sEMG最大波幅以及SSA、VFSS、SWAL-QOL评分进行相关系数分析,发现各项指标两两之间均具有一定的相关性(P＜0.01).结论神经肌肉电刺激联合吞咽训练有助于脑卒中3个月后患者吞咽功能的恢复.
목적 탐토신경기육전자격연합탄인훈련대뇌졸중후탄인장애환자탄인공능회복적영향.방법 선취뇌졸중3개월후반탄인장애환자150례,안수궤수자표법분위상규훈련조(상규탄인훈련)、전자격조(신경기육전자격)화종합치료조(신경기육전자격연합상규탄인훈련),매조50례.3조환자균우치료전화치료4주후(치료후)평정기탄인공능(SSA)、표면기전신호(sEMG)、탄인장애정도(VFSS)화생활질량(SWAL-QOL).결과 치료후,3조환자적sEMG최대파폭여조내치료전비교,차이균유통계학의의(P＜0.01),차종합치료조적sEMG적최대파폭치여상규훈련조화전자격조치료후비교,차이균유통계학의의(P＜0.01).치료후,3조환자적SSA、VFSS화SWAL-QOL평분여조내치료전비교,차이균유통계학의의(P＜0.01),차종합치료조적SSA、VFSS화SWAL-QOL평분분별위(21.34 ±3.61)분、(6.98±1.62)분화(438 ±37)분,여상규훈련조치료후적(30.22 ±3.71)분、(5.34±1.63)분화(627±51)분이급전자격조적치료후적(28.14±3.92)분、(5.69±1.58)분화(637±56)분비교,차이균유통계학의의.대3조환자치료전、후적sEMG최대파폭이급SSA、VFSS、SWAL-QOL평분진행상관계수분석,발현각항지표량량지간균구유일정적상관성(P＜0.01).결론 신경기육전자격연합탄인훈련유조우뇌졸중3개월후환자탄인공능적회복.
Objective To investigate the effects of neuromuscular electrical stimulation (NMES) combined with swallowing training for relieving dysphagia in stroke patients.Methods A total of 150 chronic stroke patients at least 3 months post-stroke who were afflicted with dysphagia were randomly and evenly divided into a conventional swallowing training group,an NMES group,and an NMES combined with conventional swallowing training group.Prior to and after treatment,surface electromyography (sEMG) signals from the swallowing muscles were detected,swallowing function was evaluated using the standardized swallowing assessment (SSA),their swallowing was studied videofluoroscopically (VFSS),and a swallowing-related quality of life questionnaire (SWAL-QOL) was administered.Results There were significant differences in the maximum amplitude of sEMG signals,and the scores on the SSA,VFSS and SWAL-QOL in both groups between prior to and after treatment.After 4 weeks of treatment,the maximum amplitude of the sEMG signals and all three assessment scores were significantly higher where NMES had been combined with conventional swallowing training group compared with the other two groups.Indeed,there was no significant difference between the group which had received conventional swallowing training and the NMES groups.The analysis of coefficients revealed correlation between sEMG maximum amplitude and the SSA,VFSS and SWALQOL results.Conclusions NMES combined with conventional swallowing training is helpful for improving swallowing function in chronic stroke patients with dysphagia.