肌电生物反馈对卒中后吞咽障碍患者疗效的Meta分析

The Meta-analysis of the effect of electromyographic biofeedback therapy on recovery of dysphagia after stroke

目的 系统评价肌电生物反馈训练对卒中后吞咽障碍患者的疗效。方法 计算机检索The Cochrane Library、PubMed、Web of Science、Embase、CNKI、维普、万方自建库以来到2021年12月31日,查找与肌电生物反馈治疗脑卒中后吞咽功能障碍相关的随机对照试验,并应用RevMan 5.4软件进行数据分析。结果 共纳入相关研究20篇,1 544例患者,Meta分析结果显示,吞咽功能水平[MD=-0.72(95%CI:-0.83~-0.60),P<0.01]、经口摄食能力[MD=0.86(95%CI:0.69~1.03),P<0.01]、表面肌电图平均波幅[MD=6.34(95%(CI:5.44~7.25),P<0.01]、吸入性肺炎发生率[RR=0.22(95%(CI:0.10~0.48),P<0.01]、血清白蛋白水平[MD=3.34(95%CI:2.34~4.35),P<0.01]、生活质量量表评分[SMD=2.18(95%CI:1.85~2.51),P<0.01]均优于对照组。结论 肌电生物反馈训练有助于促进卒中后吞咽障碍患者的康复,建议未来卒中康复和护理领域开展进一步研究。

Objective:To evaluate the efficacy of electromyographic biofeedback in patients with dysphagia after stroke.Methods:Computer search was made in the Cochrane Library,PubMed,Web of Science,Embase,CNKI,VIP,Wanfang from their establishment to the end of 2021.The RCT related to EMG biofeedback in the treatment of dysphagia after stroke were searched.Data analysis was performed using RevMan 5.4 software.Results:A total of 1544 patients were included in 20 studies.Meta-analysis results showed that the swallowing function level[MD=-0.72(95%CI:-0.83,-0.60),P<0.01],functional Oral intake scale score[MD=0.86(95%CI:0.69,1.03),P<0.01],average surface EMG amplitude[MD=6.34(95%CI:5.44,7.25),P<0.01],incidence of aspiration pneumonia[RR=0.22(95%CI:0.10,0.48),P<0.01]serum albumin levels[MD=3.34(95%CI:2.34,4.35),P<0.01],and the quality of life[SMD=2.18(95%CI:1.85,2.51),P<0.01].The experimental group was superior to the control group in each outcome index.Conclusion:EMG biofeedback training can promote the rehabilitation of patients with swallowing disorders after stroke.It is suggested that further research be carried out in the field of stroke rehabilitation and nursing in the future.