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Objective:To investigate the effectiveness of basic swallowing training for tracheotomy patients using a speech valve after severe cranial injury.Methods:Thirty brain injury patients were randomly divided into a control group and an observation group, each of 15. In addition to conventional drug therapy, those in the control group were given basic swallowing training, while those in the observation group received the same swallowing training wearing a speech valve. The basic swallowing training included ice stimulation, tongue movement training and cough training twice a day, five days a week, for four weeks. The patients in the observation group were also trained to wear a speech valve on the same schedule. The subjects′ swallowing function was evaluated laryngoscopically using Saito′s dysphagia rating scale and the Rosenbek leakage aspiration rating scale before and after the 4 weeks of treatment.Results:Significant improvement was observed in both groups, with significantly greater improvement in the observation group, on average.Conclusions:Basic swallowing training when wearing a speech valve can improve the swallowing function of patients with severe brain injury after a tracheotomy and reduce aspiration during swallowing.
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Objective@#To evaluate the relationship between bolus volume and hyoid displacement in dysphagia patients with nasopharyngeal carcinoma after radiation therapy.@*Methods@#Twenty-three nasopharyngeal carcinoma patients with dysphagia were recruited and their swallowing of 3, 5, 10 and 20ml of liquid food was studied fluoroscopically. The vertical and horizontal displacement of the hyoid as well as its time in motion were measured, and the relationship between the bolus volume, hyoid displacement and time in motion time was evaluated.@*Results@#The largest vertical displacement of the hyoid (1.01±0.65cm) was observed when swallowing a 10ml bolus. The hyoid showed the smallest average horizontal displacement (0.39±0.34cm), when swallowing a 3ml bolus. The average motion time of the hyoid was (2.11±0.65) seconds. It was shorter when swallowing a 10 or 20ml bolus than when dealing with a smaller one. Hyoid motion time was negatively correlated with the horizontal displacement of the hyoid bone, and the volume of a swallow was negatively correlated with the hyoid motion time but positively correlated with the penetration-aspiration scale score.@*Conclusion@#Bolus volume affects hyoid displacement and hyoid motion time in nasopharyngeal carcinoma patients with dysphagia after radiation therapy. For patients with a penetration-aspiration scale score of 5 or less, the optimum bolus volume is 5 to 10ml.
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Objective To evaluate the relationship between bolus volume and hyoid displacement in dys-phagia patients with nasopharyngeal carcinoma after radiation therapy. Methods Twenty-three nasopharyngeal car-cinoma patients with dysphagia were recruited and their swallowing of 3, 5, 10 and 20ml of liquid food was studied fluoroscopically. The vertical and horizontal displacement of the hyoid as well as its time in motion were measured, and the relationship between the bolus volume, hyoid displacement and time in motion time was evaluated. Results The largest vertical displacement of the hyoid (1.01±0.65cm) was observed when swallowing a 10ml bolus. The hyoid showed the smallest average horizontal displacement (0.39±0.34cm), when swallowing a 3ml bolus. The average motion time of the hyoid was (2.11±0.65) seconds. It was shorter when swallowing a 10 or 20ml bolus than when dealing with a smaller one. Hyoid motion time was negatively correlated with the horizontal displacement of the hyoid bone, and the volume of a swallow was negatively correlated with the hyoid motion time but positively correlated with the penetration-aspiration scale score. Conclusion Bolus volume affects hyoid displacement and hyoid motion time in nasopharyngeal carcinoma patients with dysphagia after radiation therapy. For patients with a penetration-aspiration scale score of 5 or less, the optimum bolus volume is 5 to 10ml.
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Objective To study the effect of low frequency electric stimulation on tongue muscles in nasopharyngeal carcinoma (NPC) patients after radiation therapy.Methods Forty-three nasopharyngeal carcinoma patients with dysphagia after radiation therapy were randomly divided into a control group of 21 and a test group of 22.The control group received low frequency electric stimulation on external tongue muscles for 15 minutes a day while the test group received low frequency electric stimulation on external tongue muscles for 20 minutes a day,5 days a week for 4 weeks.Before and after the treatment,the range of motion of tongues was evaluated.Results Before the treatment,there was no significant difference between the two groups in all the measurements (P＞0.05).After the treatment,the protraction of the tongue improved significantly in both groups,with a significantly more improvement in the test group than in the control group.Significant improvement was observed in the side-to-side movement of the tongue in the test group,but not in the control group after the treatment.However,no significant improvement was observed in the up-and-down motion of the tongue in both groups after the treatment (P＞0.05).Conclusion Low frequency electric stimulation on internal and external tongue muscles can improve the protractive and side-to-side motion of the tongue in NPC patients after radiotherapy.
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Objective To explore the effect of vaginal pressure feedback combined with pelvic floor muscle resistant training on stress urinary incontinence (SUI). Methods 125 women with SUI in our hospital from February, 2014 to May, 2015 were randomized into control group (n=65) and experimental group (n=60). The control group took Kegel exercise, which asked for patients to contract their pelvic floor muscles, while the experimental group first received biofeedback electrical stimulation for 20 minutes with XFT-2002 pelvic floor stimula-tor, then instructed the patients to contract their pelvic floor muscles and pressed the pneumatic probe which placed in vagina according to the voice navigation of XFT-0010 pelvic floor muscle stimulator after they learnt the contraction skill. Both groups received training with 10 seconds' contraction and 10 seconds' rest 30 minutes per day for 30 days in total. They were assessed by GRRUG and International Consulta-tion Incontinence Questionnaire-UI Short Form (ICIQ-SF). Results After treatment, the muscle strength of the pelvic floor (t=-3.570) and the scores of ICIQ (t=4.198) improved significantly in both groups (P<0.01), and was higher in the experimental group than in the control group (t=6.833, t=-2.445, P<0.01), as well as the therapeutic efficiency (Z=63.954, P<0.001). Conclusion Vaginal pressure feedback com-bined with pelvic floor muscle resistant training can further improve stress urinary incontinence in women.
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Objective To investigate the effects of surface anesthesia on assisted balloon dilatation when treating dysphagia caused by radiotherapy for nasopharyngeal carcinoma.Methods Fifty-four patients with dysphagia after radiotherapy were divided randomly into an anesthesia group and a non-anesthesia group.The anesthesia group received anesthetics before treatment while the non-anesthesia group did not.All of the patients were treated with low-frequency electrical stimulation and assisted balloon dilatation for 3 weeks.They were then assessed using videofluoroscopy and self-reports of difficulty in swallowing before and after the treatment.Results After the treatment, significant improvement was observed in pharyngeal delay time, in cricopharyngeal opening, and in laryngeal elevation and forwardness.There was also a significant decrease in self-reported swallowing difficulty and failed swallows in both groups compared with before the treatment.The improvements in the non-anesthesia group were significantly greater than in the anesthesia group.After the treatment, the average aspiration rate of the anesthesia group was significantly higher than before treatment and higher than that of the non-anesthesia group.The improvement in oral intake of the non-anesthesia group was significantly better than that of the anesthesia group.Conclusion Balloon dilatation and low-frequency electrical stimulation have a synergistic effect and can improve patients' swallowing after radiation-induced cranial nerve damage, thus promoting survival.Assisted balloon dilatation without anesthesia has a better effect than when surface anesthesia is used.
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Objective To study the effect of low frequency electric stimulation and urethral catheter balloon dilatation therapy on dysphagia in nasopharyngeal carcinoma(NPC)patients after radiation therapy. Methods Eighteen dysphagic NPC patients who had received radiation therapy were studied.They included 15 males and 3 females with a mean age of 49.5 years.Thirteen were being fed with a nasogastric tube and 5 with a gastmstomy tube.Low frequency electric stimulation was applied to the swallowing muscles and urethral catheter balloon dilatation therapy was used for the crieopharygeus muscle.Before and after treatment the effects were evaluated with a videofluoroscopic study of swallowing.Results Most swallowing function improved after treatment.After treatment the pharyngeal transit time of paste iodine and fluid iodine(diatriazoate)through the mouth and hypopharynx showed significant improvement.Displacement of the hyoid bone was significantly greater after treatment.Before treatment the incidence of pyriform sinus stasis and aspiration were 100%:after treatment these were 44.4%and 16.6% respectively.Videofluoroscopy showed that 7 cases had been cured(38.9%),9 cases had improved(50.0%)and 2 cases showed no effect(11.1%).In 15 cases the nasogastric or gastrostomy tube could be removed. Conclusion Low frequency electric stimulation and urethral catheter balloon dilatation can improve swallowing in NPC patients with dysphagia after radiation therapy.This treatment was easy to administer,safe and reliable.
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Objective To compare the effect of acupuncture and swallowing training on dysphagia in recove-ring stroke patients. Methods One hundred and thirty-two subacute stroke inpatients,73 males and 59 females,with a mean age of(67.9±9.0)years,26 cerebral hemorrhage patients and 106 cerebral infarct patients,participa-ted in the study.The patients were divided into a swallowing training group(ST,n=53)treated with thermal-tactile stimulation,deglutition exercises and food swallowing training;an acupuncture group(AP,n=48) treated with acu-puncture at the Fengchi(GB20),Lianquan(RN23),Bailao(EX-HN15),Jinjing(EX-HN12) and Yuye (EX-HN13)acupoints;and a control group(CG,n=31).The interventions were administered once a day,6 times a week.Before and after treatment,the patients were evaluated with a water-swallowing test and the"Any Two"test,and the arterial oxygen saturation(SpO_2) was monitored by pulse oximetry. Results The ST and AP groups showed significant improvement in water-swallowing and on the"Any Two"test after the treatment regimen,and were significantly better than the control group.There was no significant difference between the ST and AP groups.The average decrease in SpO_2 during water-swallowing was under 2%.After treatment,the baseline SpO_2 and post-water-swallowing SpO_2 of the ST group were significantly higher than those of the control group.The post-water-swallowing SpO_2 of the AP group was also significantly higher than that of the control group. Conclusions Acupuncture and swallowing training have similar effects in treating dysphagic stroke patients.Swallowing function and misaspiration cannot be predicted based on decreases in SpO_2.