Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review

BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength and function and,most of them,found increase of muscle strength and improvement in muscle function after NMES.NMES was safe in all studies without any significant complication.CONCLUSION NMES is safe,feasible and has beneficial effects on muscle strength and function in patients after cardiac surgery,but has no significant effect on functional capacity.

Evaluating neuromuscular electrical stimulation for preventing and managing intensive care unit-acquired weakness:Current evidence and future directions

Intensive care unit-acquired weakness(ICU-AW)is a prevalent issue in critical care,leading to significant muscle atrophy and functional impairment.Aiming to address this,Neuromuscular Electrical Stimulation(NMES)has been explored as a therapy.This systematic review assesses NMES's safety and effectiveness in enhancing functional capacity and mobility in pre-and post-cardiac surgery patients.NMES was generally safe and feasible,with intervention sessions varying in frequency and duration.Improvements in muscle strength and 6-minute walking test distances were observed,particularly in preoperative settings,but postoperative benefits were inconsistent.NMES showed promise in preventing muscle loss and improving strength,although its impact on overall functional capacity remained uncertain.Challenges such as short ICU stays and body composition affecting NMES efficacy were noted.NMES also holds potential for other conditions like cerebral palsy and stroke.Further research is needed to optimize NMES protocols and better understand its full benefits in preventing ICU-AW and improving patient outcomes.

Analysis on the Effect of Yiqi Huoxue Decoction Combined with Neuromuscular Electrical Stimulation in Improving ICU-Acquired Debility in Mechanically Ventilated Patients

Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.

Effects of Neuromuscular Electrical Stimulation in Combination with Glutamine Administration on Skeletal Muscle Atrophy in Colon-26 Tumor-Bearing Mice

The depressed protein synthetic response,a phenomenon termed anabolic resistance,has been shown to be involved in muscle wasting induced by cancer cachexia.Moreover,a positive relationship between the protein synthetic rate and intracellular glutamine(GLN)concentration has been found in skeletal muscles.This study investigated the effects of neuromuscular electrical stimulation(ES)and GLN administration on muscle wasting and GLN metabolism in colon-26(C-26)tumor-bearing mice.CD2F1 mice were divided into 8 groups:control(CNT),CNT+ES,CNT+GLN,CNT+ES+GLN,C-26,C-26+ES,C-26+GLN,C-26+ES+GLN.Cancer cachexia was induced by subcutaneous injection of C-26 cells and developed for four weeks.ES was performed on the left plantar flexor muscles every other day,and GLN(1 g/kg)was administered daily intraperitoneally starting one day after the C-26 injection.Tumor-free body mass and fast-twitch gastrocnemius(Gas)muscle weight were lower in the C-26 group than in the CNT group(-19%and-17%,respectively).Neither ES training nor GLN administration,alone or in combination,ameliorated the loss of Gas muscle weight in the C-26 mice.However,ES training in combination with GLN administration inhibited the increased expression of GLN synthetase(GS)in the C-26 muscles.Thus,it is likely that GLN plays a critical role in muscle protein metabolism and,therefore,can be targeted as a tentative treatment of cancer cachexia.

Neuromuscular electrical stimulation and testosterone did not influence heterotopic ossification size after spinal cord injury: A case series

Neuromuscular electrical stimulation(NMES) and testosterone replacement therapy(TRT) are effective rehabilitation strategies to attenuate muscle atrophy and evoke hypertrophy in persons with spinal cord injury(SCI). However both interventions might increase heterotopic ossification(HO) size in SCI patients. We present the results of two men with chronic traumatic motor complete SCI who also had pre-existing HO and participated in a study investigating the effects of TRT or TRT plus NMES resistance training(RT) on body composition. The 49-year-old male, Subject A, has unilateral HO in his right thigh. The 31-year-old male, Subject B, has bilateral HO in both thighs. Both participants wore transdermal testosterone patches(4-6 mg/d) daily for 16 wk. Subject A also underwent progressive NMES-RT twice weekly for 16 wk. Magnetic resonance imaging scans were acquired prior to and post intervention. Cross-sectional areas(CSA) of thewhole thigh and knee extensor skeletal muscles, femoral bone, and HO were measured. In Subject A(NMES-RT + TRT), the whole thigh skeletal muscle CSA increased by 10%, the knee extensor CSA increased by 17%, and the HO + femoral bone CSA did not change. In Subject B(TRT), the whole thigh skeletal muscle CSA increased by 13% in the right thigh and 6% in the left thigh. The knee extensor CSA increased by 7% in the right thigh and did not change in the left thigh. The femoral bone and HO CSAs in both thighs did not change. Both the TRT and NMES-RT + TRT protocols evoked muscle hypertrophy without stimulating the growth of preexisting HO.

舌压抗阻训练联合NMES在卒中后吞咽障碍患者中的应用

目的探讨舌压抗阻训练联合神经肌肉电刺激(NMES)在卒中后吞咽障碍患者中的应用效果,并分析对功能性经口摄食量表(FOIS)评分、诱发电位、神经营养因子及并发症的影响。方法选取2022年1月至2023年3月就诊于湖南省人民医院/湖南师范大学附属第一医院的99例卒中后吞咽障碍患者作为研究对象,采用随机数字表法将分为联合组、对照A组、对照B组,每组33例。对照A组采取舌压抗阻训练,对照B组采取NMES,联合组采取舌压抗阻训练联合NMES,干预时间均为4周。观察并比较3组临床疗效、干预前后洼田饮水试验评分、FOIS评分、清蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TRF)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)、胰岛素样生长因子-1(IGF-1)水平及并发症情况。结果联合组总有效率(90.91%)高于对照A组(66.67%)、对照B组(69.70%),差异均有统计学意义(P<0.05)。重复测量方差分析结果显示,3组洼田饮水试验、FOIS评分均存在时间、组间、交互效应(P<0.05)。单因素重复测量方差分析结果显示,干预2周、4周后,3组洼田饮水试验评分均低于干预前,FOIS评分均高于干预前,差异均有统计学意义(P<0.05)。多变量方差分析结果显示,干预前,3组洼田饮水试验、FOIS评分比较,差异均无统计学意义(P>0.05);干预2周、4周后,联合组洼田饮水试验评分均低于对照A组、对照B组,FOIS评分高于对照A组、对照B组,差异均有统计学意义(P<0.05)。重复测量方差分析结果显示,3组血清ALB、PA、TRF水平均存在时间、组间、交互效应(P<0.05)。单因素重复测量方差分析结果显示,干预2周、4周后,3组血清ALB、PA、TRF水平均高于干预前,差异均有统计学意义(P<0.05)。多变量方差分析结果显示,干预前,3组血清ALB、PA、TRF水平比较,差异均无统计学意义(P>0.05)。干预2周、4周后,联合组血清ALB、PA、TRF水平高于对照A组、对照B组,差异均有统计学意义(P<0.05)。重复测量方差分析结果显示,3组血清BDNF、NGF、IGF-1水平均存在时间、组间、交互效应(P<0.05)。单因素重复测量方差分析结果显示,干预4周后,联合组、对照B组血清BDNF、NGF、IGF-1水平均高于干预前,差异均有统计学意义(P<0.05)。多变量方差分析结果显示,干预前,3组血清BDNF、NGF、IGF-1水平比较,差异均无统计学意义(P>0.05);干预2周、4周后,联合组、对照B组血清BDNF、NGF、IGF-1水平高于对照A组,差异均有统计学意义(P<0.05)。联合组并发症总发生率(6.06%)低于对照A组(30.30%)、对照B组(27.27%),差异均有统计学意义(P<0.05)。结论舌压抗阻训练联合NMES治疗卒中后吞咽障碍患者效果可靠,可有效调控神经营养因子,促进神经功能修复,从而改善吞咽障碍,增强机体营养状态,且安全性高。

Neuromuscular electrical stimulation for a dysphagic stroke patient with cardiac pacemaker using magnet mode change: A case report

BACKGROUND Electromagnetic interference(EMI),means disturbance to the operation of implanted electrical devices caused by external sources.If cardiac pacemaker is implanted into the body,the risk of EMI should be considered when performing neuromuscular electrical stimulation(NMES).So far,no case has been reported that clinical magnets are used to safely manage the EMI risk of patients with cardiac pacemaker in NMES.CASE SUMMARY A 72-year-old male with swallowing disorder due to pure motor lacunar syndrome was transferred to rehabilitation department six days after the symptom onset.EMI risk needed be considered when implementing NMES on pharyngeal muscles,since cardiac pacemaker was implanted on his left chest due to the sick sinus syndrome.In the first NMES,the function of the pacemaker was directly monitored using telemetric instruments.From the second day,by a simple method of placing a magnet on the pacemaker,we chose to move the pacemaker into a mode that the device was not influenced by external stimulus.This magnet method has been used repeatedly for a year for the safe NMES treatment.We could remove Levin tube four months after the initial symptom and dysphagia related symptoms had not been noted during two-year follow-up period.CONCLUSION This report is the first case of dysphagia rehabilitation that EMI risk was handled using mode change of pacemaker with magnet.This method is unfamiliar to doctors,but safe and easy approach.This paper could be guidance for clinicians who need to treat patients with EMI risk.

The Effect of Neuromuscular Electrical Stimulation in Treatment of Acute Cerebral Infarction with Dysphagia and Psychological Disorder

Objective:To explore the effect of neuromuscular electrical stimulation in treatment of acute cerebral infarction with dysphagia and psychological disorder.Methods:78 cases of patients with acute cerebral infarction with dysphagia and psychological disorder were selected and randomly divided into two groups.Control group were treated with conventional drug treatment and swallowing training while neuromuscular electrical stimulation was used to additionally treat the experimental group.Profile of Mood States(Poms)and Robson self-esteem questionnaire(RSEQ-30)scores were used to evaluate the effect of neuromuscular electrical stimulation in the two groups before and after treatment.Results:In control group,both Poms and RSEQ-30 scores were not significant different before treatment.In experimental group,Poms and RSEQ-30 scores were significantly lower and higher than before treatment(P<0.05),respectively.Similarly,after treatment,Poms and RSEQ-30 scores in the experimental group were significantly lower and higher than control group(P<0.05),respectively.Conclusion:Neuromuscular electrical stimulation in treatment of acute cerebral infarction with dysphagia and psychological disorder could eliminate the patient's psychological barriers and improve their quality of life.

Quantifying Neuromuscular Electrical Stimulation Dosage after Knee Arthroplasty

Recovering functional ability after total knee arthroplasty （TKA） requires recovery of strength and voluntary activation. Short-term recovery of strength and activation are enhanced following a protocol combining strength training with neuromuscular electrical stimulation （NMES）. The purpose of the study was to determine if a dose response curve could be constructed for patients who received NMES as part of their treatment after TKA. NMES dosage was quantified as the electrically evoked knee extensor torque, expressed as a percentage of the subject＇s maximal voluntary contraction. Dose-response curves were generated, with the associations between NMES training intensity and quadriceps strength, voluntary activation, and lean muscle cross-sectional area examined using Pearson Product-Moment Correlation Coefficients. Significantly, linear correlations were observed between NMES training intensity and both quadriceps strength and voluntary activation, but not lean muscle cross-sectional area. These results suggest that maximizing the elicited training force during rehabilitation will enhance short-term recovery following TKA.

NMES对脑卒中后上肢失用性肌萎缩的应用效果

目的:观察神经肌肉电刺激对脑卒中后患者上肢失用性肌萎缩的应用效果。方法:采用文献资料法、实验法、数理统计法,选取贵阳市白云区人民医院2023年1月—2024年1月脑卒中后上肢失用性肌萎缩患者20例,依据随机数表法将其分为对照组和实验组,每组10例。对照组给予常规康复治疗,实验组在常规康复治疗的基础上增加神经肌肉电刺激治疗,通过测量肌肉围度,以及采用MMT量表和简化版Fugl-Meyer运动功能能力量表来评估治疗疗效,并对实验数据进行统计分析。结果:治疗中期,实验组和对照组上肢肌肉围度、MMT比较,差异不具有统计学意义(P>0.05);Fugl-Meyer量表比较,差异具有统计学意义(P<0.01)。治疗末期,实验组和对照组上肢肌肉围度、MMT和Fugl-Meyer比较,差异具有统计学意义(P<0.05)。结论:神经肌肉电刺激能改善肌肉功能和有效治疗脑卒中后上肢失用性肌萎缩症状。

NMES联合循证护理在ICU-AW患者中的应用价值

目的:探讨神经肌肉电刺激(neuromuscular electrical stimulation,NMES)联合循证护理在ICU获得性衰弱(ICU-acquired weakness,ICU-AW)患者中的应用价值。方法:选取2021年8月-2023年8月南平市第一医院收治的98例ICU-AW患者。根据随机数表法将其分为观察组和对照组,各49例。对照组给予常规护理,观察组给予NMES联合循证护理。比较两组干预后肌力、日常生活能力、病情严重程度、睡眠情况,时间指标及不良事件。结果:干预后,观察组ICU-AW发生率和急性生理与慢性健康状况量表Ⅱ(acute physiology and chronic health status scaleⅡ,APACHEⅡ)评分均低于对照组,医学研究委员会(Medical Research Council,MRC)评分和Barthel评分均高于对照组,差异有统计学意义(P<0.05)。观察组机械通气时间和ICU治疗时间均短于对照组,匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分低于对照组,差异有统计学意义(P<0.05)。两组均无严重不良事件发生。结论:NMES联合循证护理可以改善ICU-AW患者的肌力和功能,降低ICU-AW发生率、缩短机械通气时间和ICU治疗时间,并改善睡眠质量,且未发生严重不良事件。

Clinical observation of acupoint injection combined with nerve electrical stimulation in the treatment of post-stroke dysphagia

Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medical workers have comprehensively studied post-stroke dysphagia as it easily induces inhalation pneumonia,asphyxia,and many other complications.At present,many methods for post-stroke dysphagia have been proved to be effective.With regard to comprehensive treatment effect,patient compliance,technology promotion difficulty,grassroots hospital operability,and other factors,we found that acupoint injection combined with nerve electrical stimulation is a good method worthy of promotion.Methods:A total of 130 patients with dysphagia after stroke were randomly divided into nerve electrical stimulation group(n=41),acupoint injection group(n=40),and comprehensive treatment group(nerve electrical stimulation plus acupoint injection,n=49).The therapeutic effect in each group was evaluated before treatment and 20 days after treatment using the improved water swallow test,video fluoroscopic swallowing study,and standardized swallowing assessment.Results:After 20 days of treatment,significant differences were noted in each group.The scores of improved water swallow test decreased from 4.10±0.74 to 2.12±0.95 in the nerve electrical stimulation group,4.00±0.78 to 2.28±1.04 in the acupoint injection group,and 4.16±0.77 to 1.73±0.79 in the comprehensive treatment group;video fluoroscopic swallowing study scores increased from 3.71±2.16 to 5.05±2.111 in the nerve electrical stimulation group,3.80±1.94 to 5.20±1.942 in the acupoint injection group,and 3.73±2.22 to 6.24±2.21 in the comprehensive treatment group;and standardized swallowing assessment scores of the three groups also decreased from 35.13±3.38 to 28.17±3.42,34.66±3.46,and 34.48±3.26 to 26.39±3.86,respectively.The overall scores of each group after treatment were significantly different from those before treatment(P<0.05),indicating that both nerve electrical stimulation and acupoint injection were effective for post-stroke dysphagia;the scores of nerve electrical stimulation group and acupoint injection group were similar,but those of the comprehensive treatment group were significantly better than the single treatments(P<0.05).It shows that the two treatment methods have synergistic effect,and combined treatments have more benefits.Conclusion:Nerve electrical stimulation and acupoint injection have a synergistic therapeutic effect on post-stroke dysphagia.The combined treatment is more beneficial to patients with post-stroke dysphagia than the single treatments.

Effects of Eccentric Contractions Induced Electrical Stimulation Training System on Quadriceps Femoris Muscle

We developed an eccentric contraction induced electrical stimulation (ES) training system. The purpose of this study was to investigate whether the eccentric contraction induced ES enhance the knee extension torque compared with typical ES. Twenty-two young untrained men (age: 23 ± 3 years) in the acute response trial (single training) and seven untrained men in the long period training trial (for 6 weeks) were studied. We measured muscle thickness and knee extension torque evoked by ES with eccentric contraction training system (ES + ECC) or ES alone for the quadriceps muscle of men. The levels of pain and discomfort were evaluated using numeric rating scale (NRS) and heart rate variability. The knee extension torque of ES + ECC was higher than that of ES alone in the acute response trial. There were no significant differences in the levels of pain and discomfort between ES and ES + ECC. Additionally, ES + ECC training for 6 weeks was effective on the quadriceps muscle thickness and knee extension torque. In contrast, the ES alone training failed to increase muscle thickness and knee extension torque. These results suggest that eccentric contraction induced ES would have the potential to become an effective intervention to promote muscle strengthening.

Early application of percutaneous neuromuscular electric stimulation in interfering motor function of limbs and difference in temperature of axilla of patients with ischemic stroke

BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.

评估强制性运动疗法(CIMT)+神经肌肉电刺激(NMES)应用在脑卒中偏瘫患者上肢功能康复中的临床价值

目的:探究对脑卒中偏瘫患者实施CIMT+NMES的效果。方法:在2021年1月-2023年1月,对80例脑卒中偏瘫患者实验。40例纳入实验组接受CIMT+NMES治疗;40例接受常规治疗记录为对照组。分别于治疗前后,比较患者上肢运动功能、日常生活活动能力。结果:相较于治疗前,两组患者的上肢运动功能、日常生活活动能力均明显改善,实验组优于对照组,差异有统计学意义(P<0.05)。结论:针对脑卒中偏瘫患者上肢功能康复的问题,以CIMT+NMES进行干预可获得理想效果。

Therapeutic efficacy of swallowing neuromuscular electrical stimulation combined with acupuncture for post-stroke dysphagia

Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group （group A, 58 cases） and swallowing neuromuscular electrical stimulation combined with acupuncture group （group B, 62 cases）. Two-group patients were given the same basic internal medical treatment. In addition, group A was given normal acupuncture treatment with the choice of local points： Junjin （金津 EX-HN 12）, Yuye（玉液 EX-HN 23）, Fengchi （风池 GB 20）, Yifeng （翳风 TE 17）, Lianquan （廉泉 CV 23）, Wangu （完骨 GB 12）. Group B was given swallowing neuromuscular electrical stimulation combined with acupuncture： GB 20, Fengfu （风夜 GV 16）, TE 17, Yiming （翳明 EX-HN 14）, Yamen （哑门 GV 15）, Tianrong（天容 SI 17）, Tianchuang （天窗 SI 16）, CV 23, the uniform reinforcing-reducing manipulation was used; EX- HN 12, EX-HN 13, the piercing and blood-letting method （1-2 mL blood） was used; at the same time, the swallowing neuromuscular electrical stimulation therapy device was used to electrically stimulate the nerves and muscles in the throat and neck at specific output pulse current （50-100 Hz）. Treatment was made twice a day, 30 minutes each time. Two weeks after the treatment, the patients were assessed in symptoms improvement and clinical efficacy. Results The total effective rate in group B was 91.4% and 75.8% in group A; in the total efficiency comparison in both groups, χ^2=5.232, P〈0.05. The difference in improvement of symptoms with post-stroke dysphagia treated with above mentioned combination treatment was statistically significant between both groups （P〈0.05）. Conclusion The above mentioned swallowing neuromuscular electrical stimulation combined with acupuncture treatment has a better clinical effect when compared with ordinary acupuncture.

NMES疗法及单纯吞咽训练对脑卒中后吞咽障碍的疗效观察

目的分析脑卒中后吞咽障碍患者采用神经肌肉电刺激疗法(NMES)联合单纯吞咽训练治疗的疗效。方法选取本科2013年1月至2015年1月的脑卒中后吞咽障碍患者90例,随机分为NMES联合治疗组和常规单纯运动训练组,常规单纯运动训练组予以单纯吞咽功能训练,NMES联合治疗组在常规单纯运动训练组基础上加用NMES疗法。对比两组患者治疗前后的各项吞咽功能评分和临床疗效。结果治疗3个疗程后,NMES联合治疗组和常规单纯运动训练组的洼田饮水试验分级、口面运动功能评分显著低于治疗前,吞咽X线电视透视检查(VFSS)评分、藤岛一郎吞咽疗效评分显著高于治疗前(P<0.05);治疗3个疗程后,NMES联合治疗组的洼田饮水试验、口面运动功能评分显著低于对照组,VFSS评分、藤岛一郎吞咽疗效评分显著高于常规单纯运动训练组(P<0.05)。治疗3个疗程后,NMES联合治疗组的总有效率为95.55%(43/45)显著高于常规单纯运动训练组77.78%(35/45)(P<0.05)。结论对于脑卒中后吞咽障碍患者单纯吞咽训练联合采用NMES疗法,疗效更佳。

咽部NMES联合吞咽康复训练对脑卒中后吞咽障碍患者吞咽功能改善的临床研究

目的探讨咽部神经肌肉电刺激(NMES)联合吞咽康复训练对脑卒中后吞咽障碍患者的吞咽功能的影响.方法将2020年10月—2021年9月就诊于本院的103例脑卒中后吞咽障碍患者作为研究对象,根据随机数字表法将其分为观察组和对照组.两组均采用常规药物治疗,在此基础上,对照组51例患者进行吞咽康复训练,观察组52例患者采用NMES治疗联合吞咽康复训练,两组均治疗5周.对比两组患者治疗前后的舌骨运动学指标和吞咽功能指标.结果治疗后,观察组的标准吞咽功能评价量表评分为(17.75±0.73)分,显著低于对照组的(25.11±2.49)分,差异有统计学意义(P<0.05).治疗后,观察组的影像透视吞咽障碍量表评分为(45.57±2.50)分,低于对照组的(55.44±2.84)分,差异有统计学意义(P<0.05).治疗后,观察组的舌骨垂直和水平位移距离分别为(1.73±0.15)cm、(1.75±0.10)cm,均大于对照组,组间差异有统计学意义(P<0.05).两组的不良反应率比较,差异无统计学意义(P>0.05).结论咽部NMES联合吞咽康复训练能够有效提高脑卒中后吞咽障碍患者的吞咽功能.

神经肌肉电刺激联合口腔感觉训练对重症病毒性脑炎合并吞咽障碍患儿的康复效果

目的探讨神经肌肉电刺激(NMES)联合口腔感觉训练对重症病毒性脑炎(SVE)合并吞咽障碍患儿的康复效果、吞咽功能、神经功能、营养状况的影响。方法选择河北省儿童医院2021-01—2023-03收治的SVE合并吞咽障碍患儿108例。随机数字表法分为口腔感觉训练组和NMES联合组各54例。2组患者均进行抗病毒、降颅内压、去高热、控制惊厥、保护脑神经等对症支持治疗。口腔感觉训练组给予口腔感觉运动训练,NMES联合组在口腔感觉训练基础上进行NMES康复治疗。比较2组患者康复效果、吞咽功能[吞咽障碍调查量表(DDS)]、神经功能指标[血清脑源性的神经营养因子(BDNF)、神经元特异性的烯醇化酶(NSE)水平]、营养状况[主观的综合性营养评分量表(SGA)]、生活质量[吞咽障碍特异性生存质量量表(SWAL-QOL)]。结果康复治疗4周后,NMES联合组康复总有效率为92.59%,高于口腔感觉训练组的72.22%(P<0.05);NMES联合组口腔期、咽期、食管期DDS评分、SGA评分、SWAL-QOL评分、血清BDNF水平明显高于口腔感觉训练组,血清NSE水平低于口腔感觉训练组(P<0.05)。结论NMES联合口腔感觉训练用于SVE合并吞咽障碍患儿的康复治疗,可有效提升康复效果,进一步改善吞咽功能和神经功能,改善患儿的营养不良状况,提升患儿生活质量。

神经肌肉电刺激系统联合康复训练在脑卒中后肢体功能障碍患者康复中的应用价值

目的:探究神经肌肉电刺激系统联合康复训练在脑卒中后肢体功能障碍患者康复中的应用价值。方法:选取2022年1—12月第九〇九医院收治的95例脑卒中后肢体功能障碍患者作为研究对象。按照随机数字表法分为对照组(n=47)和观察组(n=48)。观察组行康复训练联合神经肌肉电刺激系统干预,对照组仅接受康复训练干预,两组均持续干预3个月。比较两组干预前后改良Ashworth量表(MAS)评分、患肢各关节主动活动度、脑卒中康复运动功能评定量表(STREAM)评分。结果:干预前,两组MAS评分、患肢各关节主动活动度、STREAM评分比较,差异均无统计学意义(P>0.05);干预后,两组患侧上肢肌肉痉挛、下肢肌肉痉挛评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05);干预后,两组肩关节外展、肘关节屈曲、腕关节掌屈、手掌指关节屈曲、髋关节内外旋、膝关节屈伸主动活动度均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预后,两组上肢运动、下肢运动、基本活动评分及总分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。结论:在脑卒中后肢体功能障碍患者康复中应用神经肌肉电刺激系统联合康复训练可以有效缓解其肌肉痉挛情况,改善关节活动度,提高肢体运动功能。