目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年...目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年1月至2023年9月收治的84例CS后DAS患者进行回顾性研究,按治疗方案不同分为参照组(n=42)、研究组(n=42)。其中采用吞咽低频电刺激治疗的患者设为参照组,采用CTAR联合吞咽低频电刺激治疗的患者设为研究组。比较两组治疗前、治疗4周后吞咽功能障碍分级情况、标准吞咽功能评定量表(SSA)评分、功能性经口舌摄食量表(FOIS)评分、舌骨喉活动度、表面肌电图、吞咽障碍特异性生命质量量表(SWAL-QOL)评分。结果研究组治疗4周后吞咽功能障碍改善情况优于参照组(P<0.05);研究组治疗4周后SSA评分为(24.18±2.12)分,低于参照组(28.79±3.77)分,FOIS评分为(5.68±0.45)分,高于参照组(4.63±0.51)分(P<0.05);研究组治疗4周后舌骨前移、上移活动度分别为(11.47±2.55)mm、(17.38±4.59)mm,高于参照组(8.25±1.06)mm、(14.03±4.56)mm(P<0.05);研究组治疗4周后最大波幅为(725.38±55.02)V,高于参照组(605.98±49.65)V,吞咽时程为(1.11±0.15)s,短于参照组(1.33±0.21)s(P<0.05);研究组治疗4周后SWAL-QOL评分为(125.32±15.32)分,高于参照组(102.54±14.25)分(P<0.05)。结论CTAR联合吞咽低频电刺激治疗CS后DAS患者可有效提高舌骨喉活动度,改善吞咽、摄食功能,促进生活质量提升。展开更多
Background Functional electrical stimulation （FES） is known to promote the recovery of motor function in rats with ischemia and to upregulate the expression of growth factors which support brain neurogenesis.In this...Background Functional electrical stimulation （FES） is known to promote the recovery of motor function in rats with ischemia and to upregulate the expression of growth factors which support brain neurogenesis.In this study,we investigated whether postischemic FES could improve functional outcomes and modulate neurogenesis in the subventricular zone （SVZ） after focal cerebral ischemia.Methods Adult male Sprague-Dawley rats with permanent middle cerebral artery occlusion （MCAO） were randomly assigned to the control group,the placebo stimulation group,and the FES group.The rats in each group were further assigned to one of four therapeutic periods （1,3,7,or 14 days）.FES was delivered 48 hours after the MCAO procedure and divided into two 10-minute sessions on each day of treatment with a 10-minute rest between them.Two intraperitoneal injections of bromodeoxyuridine （BrdU） were given 4 hours apart every day beginning 48 hours after the MCAO.Neurogenesis was evaluated by immunofluorescence staining.Wnt-3 which is strongly implicated in the proliferation and differentiation of neural stem cells （NSCs） was investigated by Western blotting analysis.The data wera subjected to oneway analysis of variance （ANOVA）,followed by a Tukey/Kramer or Dunnett post hoc test.Results FES significantly increased the number of BrdU-positive cells and BrdU/glial flbrillary acidic protein doublepositive neural progenitor cells in the SVZ on days 7 and 14 of the treatment （P 〈0.05）.The number of BrdU/doublecortin （DCX） double-positive migrating neuroblast cells in the ipsilateral SVZ on day 14 of the FES treatment group （（522.77±33.32） cells/mm2） was significantly increased compared with the control group （（262.58±35.11） cells/mm2,P 〈0.05） and the placebo group （（266.17±47.98） cells/mm2,P 〈0.05）.However,only a few BrdU/neuron-specific nuclear protein-positive cells were observed by day 14 of the treatment.At day 7,Wnt-3 was upregulated in the ipsilateral SVZs of the rats receiving FES （（0.44±0.05）%） compared with those of the control group rats （（0.31±0.02）%,P 〈0.05） or the placebo group rats （（0.31±0.04）%,P 〈0.05）.At day 14,the corresponding values were （0.56±0.05）% in the FES group compared with those of the control group rats （（0.50±0.06）%,P 〈0.05） or the placebo group rats （（0.48±0.06）%,P 〈0.05）.Conclusion FES augments the proliferation,differentiation,and migration of NSCs and thus promotes neurogenesis,which may be related to the improvement of neurological outcomes.展开更多
文摘目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年1月至2023年9月收治的84例CS后DAS患者进行回顾性研究,按治疗方案不同分为参照组(n=42)、研究组(n=42)。其中采用吞咽低频电刺激治疗的患者设为参照组,采用CTAR联合吞咽低频电刺激治疗的患者设为研究组。比较两组治疗前、治疗4周后吞咽功能障碍分级情况、标准吞咽功能评定量表(SSA)评分、功能性经口舌摄食量表(FOIS)评分、舌骨喉活动度、表面肌电图、吞咽障碍特异性生命质量量表(SWAL-QOL)评分。结果研究组治疗4周后吞咽功能障碍改善情况优于参照组(P<0.05);研究组治疗4周后SSA评分为(24.18±2.12)分,低于参照组(28.79±3.77)分,FOIS评分为(5.68±0.45)分,高于参照组(4.63±0.51)分(P<0.05);研究组治疗4周后舌骨前移、上移活动度分别为(11.47±2.55)mm、(17.38±4.59)mm,高于参照组(8.25±1.06)mm、(14.03±4.56)mm(P<0.05);研究组治疗4周后最大波幅为(725.38±55.02)V,高于参照组(605.98±49.65)V,吞咽时程为(1.11±0.15)s,短于参照组(1.33±0.21)s(P<0.05);研究组治疗4周后SWAL-QOL评分为(125.32±15.32)分,高于参照组(102.54±14.25)分(P<0.05)。结论CTAR联合吞咽低频电刺激治疗CS后DAS患者可有效提高舌骨喉活动度,改善吞咽、摄食功能,促进生活质量提升。
文摘Background Functional electrical stimulation （FES） is known to promote the recovery of motor function in rats with ischemia and to upregulate the expression of growth factors which support brain neurogenesis.In this study,we investigated whether postischemic FES could improve functional outcomes and modulate neurogenesis in the subventricular zone （SVZ） after focal cerebral ischemia.Methods Adult male Sprague-Dawley rats with permanent middle cerebral artery occlusion （MCAO） were randomly assigned to the control group,the placebo stimulation group,and the FES group.The rats in each group were further assigned to one of four therapeutic periods （1,3,7,or 14 days）.FES was delivered 48 hours after the MCAO procedure and divided into two 10-minute sessions on each day of treatment with a 10-minute rest between them.Two intraperitoneal injections of bromodeoxyuridine （BrdU） were given 4 hours apart every day beginning 48 hours after the MCAO.Neurogenesis was evaluated by immunofluorescence staining.Wnt-3 which is strongly implicated in the proliferation and differentiation of neural stem cells （NSCs） was investigated by Western blotting analysis.The data wera subjected to oneway analysis of variance （ANOVA）,followed by a Tukey/Kramer or Dunnett post hoc test.Results FES significantly increased the number of BrdU-positive cells and BrdU/glial flbrillary acidic protein doublepositive neural progenitor cells in the SVZ on days 7 and 14 of the treatment （P 〈0.05）.The number of BrdU/doublecortin （DCX） double-positive migrating neuroblast cells in the ipsilateral SVZ on day 14 of the FES treatment group （（522.77±33.32） cells/mm2） was significantly increased compared with the control group （（262.58±35.11） cells/mm2,P 〈0.05） and the placebo group （（266.17±47.98） cells/mm2,P 〈0.05）.However,only a few BrdU/neuron-specific nuclear protein-positive cells were observed by day 14 of the treatment.At day 7,Wnt-3 was upregulated in the ipsilateral SVZs of the rats receiving FES （（0.44±0.05）%） compared with those of the control group rats （（0.31±0.02）%,P 〈0.05） or the placebo group rats （（0.31±0.04）%,P 〈0.05）.At day 14,the corresponding values were （0.56±0.05）% in the FES group compared with those of the control group rats （（0.50±0.06）%,P 〈0.05） or the placebo group rats （（0.48±0.06）%,P 〈0.05）.Conclusion FES augments the proliferation,differentiation,and migration of NSCs and thus promotes neurogenesis,which may be related to the improvement of neurological outcomes.
