肌电生物反馈联合舌压抗阻反馈训练促进脑梗死后吞咽障碍患者的康复效果

Effect of electromyographic biofeedback combined with tongue pressure resistance feedback training on rehabilitation of cerebral infarction patients with dysphagia

目的探究肌电生物反馈和舌压抗阻反馈训练联合在脑梗死后吞咽障碍患者中的康复效果。方法采用回顾性研究,选择2021年1月至2022年3月接受康复治疗的106例脑梗死后吞咽障碍患者病历资料,根据康复治疗方案的不同进行分组,将采用常规康复治疗+舌压抗阻反馈训练的53例患者资料纳入对照组,采用常规康复治疗+肌电生物反馈+舌压抗阻反馈训练的53例患者资料纳入观察组。比较2组康复效果、干预前后舌骨活动度、吞咽功能[标准吞咽功能评价量表(SSA评分)、吞咽障碍特异性生命质量量表(SWAL-QOL评分)]以及并发症情况。结果干预后,2组患者洼田饮水试验分级较前均有所降低,且观察组1级与2级患者占比高于对照组,差异无统计学意义(P>0.05);观察组总有效率高于对照组(P<0.05);干预后,2组患者舌骨向上及向前移位均有提高,且观察组高于对照组(P<0.05);2组患者SSA评分及SWAL-QOL评分均降低,且观察组更低(P<0.05);2组患者FOIS评分均升高,且观察组更高(P<0.05);2组并发症比较差异无统计学意义(P>0.05)。结论肌电生物反馈联合舌压抗阻反馈训练可以缓解脑梗死后吞咽障碍患者吞咽障碍症状,提高舌骨活动度,改善吞咽功能,提高生活质量。

Objective To explore the rehabilitation effect of electromyographic biofeedback and tongue pressure resistance feedback training on cerebral infarction patients with dysphagia.Methods It was a retrospective study involving 106 patients with dysphagia after cerebral infarction who received rehabilitation treatment at our hospital from January 2021 to March 2022.According to the different rehabilitation treatment schemes,patients(n=53)managed by routine rehabilitation treatment plus tongue pressure resistance feedback training were included in the control group,and another patients(n=53)managed by routine rehabilitation treatment,electromyographic biofeedback and tongue pressure resistance feedback training were included in the observation group.The rehabilitation effect,hyoid activity,swallowing function that was assessed by the Standardized Swallowing Assessment(SSA)and the Swallowing Quality of Life Questionnaire(SWAL-QOL)and complications of the two groups before and after the intervention were compared.Results After the intervention,the Water-Swallowing Test(WST)grading in the two groups was significantly reduced than that before the intervention.The proportion of grade 1 and grade 2 WST patients in the observation group was higher than that in the control group,although a significant difference was not detectable(P>0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After the intervention,the upward and forward displacement of the hyoid bone in the two groups were improved,which was significantly higher in the observation group than that of the control group(P<0.05).The SSA score and SWAL-QOL score of patients in both groups decreased,which were significantly lower in the observation group than those of control group(P<0.05).The Functional Oral Intake Scale(FOIS)score of patients in both groups was higher than that before the intervention,which was significantly higher in the observation group than that of control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Electromyographic biofeedback combined with tongue pressure resistance feedback training can alleviate the symptoms of dysphagia in cerebral infarction patients,which improves the activity of hyoid bone,swallowing function and the quality of life.