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BACKGROUND: Studies have shown that functional patch has a long-lasting effect on the treatment of dysphagia, and surface electromyographic biofeedback has also been confirmed to relieve dysphagia. OBJECTIVE: To analyze the clinical efficacy of functional patch combined with surface electromyographic biofeedback in patients with dysphagia after stroke. METHODS: One hundred patients with dysphagia after stroke were randomly divided into a control group, a functional patch group, a surface electromyographic biofeedback group and a combined treatment group (functional patch plus surface electromyographic biofeedback), each group containing 25 patients. The therapeutic effects were compared between groups by repetitive saliva swallowing test, video fluoroscopic swallow study and clinical efficacy evaluation before, 1 and 2 months after treatment. The implementation of the study protocol complied with the relevant ethical requirements of the First Affiliated Hospital of Jinzhou Medical University (approval No. 201918), and informed consent was obtained from all patients and their families prior to the initialization of the study. RESULTS AND CONCLUSION: After treatment, there was an increasing trend in the repetitive saliva swallowing test, a decreasing trend in the video fluoroscopic swallow study, and a significant improvement in the clinical efficacy in each group (P < 0.05). Compared with the control group, significantly increased frequency of saliva swallowing, significantly shortened time of epiglottis movement during swallowing and significantly improved clinical benefit rate were observed in the functional patch, surface electromyographic biofeedback group and combined treatment groups (all P < 0.05). More significant improvements in the above-mentioned indexes were observed in the combined treatment group (P < 0.05). These findings indicate that both functional patch and surface electromyographic biofeedback have certain curative effect on dysphagia after stroke, and the combination of the two therapies has better clinical effect.
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OBJECTIVE: To observe the clinical effectiveness of acupoint catgut embedding and surface electromyogram biofeedback therapy (sEMGBF) in the treatment of stroke patients complicated with shoulder-hand syndrome (SHS). METHODS: A total of 90 stroke patients with SHS were randomly divided into acupoint catgut embedment (ACE), sEMGBF and ACE+sEMGBF (combined treatment) groups (n=30 cases/group). The catgut embedment was performed at Jianliao (LI 14), Jianyu (LI 15), Quchi (LI 11), Waiguan (TE 5) on the affected side, once every 3 weeks, twice altogether. The electromyographic biofeedback therapy (30-50 Hz, pulse duration 200 µs, 6 s-on and 10 s-off, appropriate strength) was applied to the skin area co-vering the deltoid muscle, flexor muscle of wrist and wrist extensor for 20 min, once per day, 5 times/week, for 6 weeks. The total effective rate was assessed by using Liao's and Zhu's methods (1996), the pain severity assessed using visual analogue scale (VAS), and Fugl-Meyer assessment (FMA, 66-points) scale and the patients' activities of daily living function (ADL, 100-points) were also scored. RESULTS: Before treatment, the VAS, FMA and ADL points of the three groups were not significantly different (P>0.05). After the treatment, the total effective rate (93.33%), FMA and ADL scores of the combined treatment group were significantly higher than those of the ACE and sEMGBF groups (P0.05). The VAS score of the ACE group was markedly lower than that of the sEMGBF group (P<0.05). CONCLUSION: The combined administration of ACE and sEMGBF has a better therapeutic effect for stroke patients complicated with SHS relevant to simple ACE and simple sEMGBF therapy in improving the upper limb function, relieving pain, and enhancing the daily life quality.
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Objective To investigate clinical effect of sEMG-BFB training combined with swallowing training for dysphagic patients with cerebral infarction,to provide a reference for life quality improvement of dysphagic patients.Methods 48 patients with cerebral infarction combined swallowing disorder were selected.According to the digital table,patients were divided into the control group and observation group,24 cases in each group.Patients in the control group were given training such as routine training and behavioral swallowing training,while patients in the observation group were given sEMG-BFB training based on training of the control group.FOIS score,Kubota's water drinking test grade,SSA score and SWAL-QOL score were compared between two groups.Results After treatment,FOIS score,SSA score and SWAL-QOL score of the observation group were (3.82 ± 1.04),(19.97 ± 8.17),(158.23 ± 10.27),which were significantly higher than those of the control group [(2.82 ± 1.21),(24.21 ± 6.31),(139.23±7.32),t =4.394,4.115,5.642,all P ＜ 0.05] ; Kubota's water drinking test grade of the observation group was better than the control group,the difference was statistically significant (U =283.43,P ＜ 0.05).Conclusion sEMG-BFB training combined with swallowing training is helpful for dysphagic patients with cerebral infarction to improve swallowing ability and life quality.
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Objective To observe the effect of surface electromyographic biofeedback on the pharyngeal phase activities in patients with dysphagia after stroke. Methods Seventy-six consecutive patients with pharyngeal dysphagia after stroke admitted to the departments of rehabilitation and neurology,brain hospital affiliated to nanjing medical university from August 2014 to February 2015 were enrolled retrospectively. After excluding 40 patients,the remaining 36 patients were divided into either a conventional training group (n =19)or a biofeedback group (n =17)by using the random number table. The patients of the conventional training group received swallowing function training only,while those of the biofeedback group also received the surface electromyographic biofeedback treatment on the basis of the therapy program of the conventional training group. The patients of both groups were treated 6 times a week for 4 weeks. The assessment of swallowing angiography,the digital measurement and analysis were performed before and after treatment. The outcome measures included the degree of openness of upper esophageal sphincter (UES),0pharyngeal transit time (PTT),and the maximum displacement of the hyoid bone (HmaxD). Results (1)The proportions of UES complete opening of the conventional training group before and after training were 26. 3% (5 / 19)and 47. 4% (9 / 19)respectively. There was significant difference between before and after training (χ2 = 5. 08, P =0.020). The proportions of UES complete opening of the biofeedback group before and after training were 47.1% (8/ 17)and 82.4% (14/ 17)respectively. There was significant difference between before training and after training (χ2 =11.46,P = 0. 001). There was no significant difference in the degrees of UES complete opening before training between the conventional training group and the biofeedback group (P >0. 05). There was significant difference in the degree of UES complete opening after training between the 2 groups (χ2 =4. 63,P = 0. 040). (2)PTT of the conventional training group before and after training was 0.24 ±0.07 and 0.19 ±0.06 s respectively. PTT of the biofeedback before and after training was 0.23 ±0.06 and 0. 15 ± 0. 05 s. There was significant difference between before training and after training (F = 154. 50,P = 0. 000). There was no significant difference in PTT before training between the conventional training group and the biofeedback group (P > 0. 05). There was significant difference in PTT after training between the 2 groups (F =4.66,P = 0. 038). (3)The HmaxD distances of the conventional training group before and after training were 0. 5 ± 0. 4 and 0. 9 ± 0. 4 cm respectively,the PTT of the biofeedback training before and after training was 0. 6 ± 0. 4 and 1. 3 ± 0. 6 cm respectively. There was significant difference between before training and after training (F = 137. 56,P = 0. 000). There was no significant difference in the HmaxD distance of the conventional training group and the biofeedback training group before training (P > 0. 05). There was significant difference in the HmaxD distance after training between the 2 groups (F = 4. 29,P = 0. 033). Conclusion The surface electromyographic biofeedback therapy in combination with the conventional swallowing training for the treatment of dysphagia after stroke has the synergistic efficacy.
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Objective To observe the effect of surface electromyographic biofeedback (sEMG-BFB) combined with routine swallow training on dysphagic patients with cerebral infarction at recovery stage.Methods Fiftyone dysphagic patients with cerebral infarction were randomly divided into two groups:control group (26 cases) and biofeedback training group (25 cases).The control group was given routine training including orofacial function training,balloon dilatation and behavioral swallowing training,while the biofeedback training group was given behavioral swallowing training was conducted with the guidance of sEMG-BFB in addition to the routine training.Before and after the treatment,videofluoroscopy swallowing study (VFSS) was performed to observe the opening of upper esophageal sphincter (UES).Functional oral intake scale (FOIS) was used to evaluate swallow function.Results Before treatment,there were no significant difference between the two groups in terms of FOIS score and UES opening (P ＞0.05).The FOIS score increased in both groups after treatment (P ＜ 0.05),and the FOIS score was higher in the biofeedback training group than that of the control group (P ＜ 0.05).After treatment,the number of UES complete opening and incomplete opening was 18 and 8,respectively,in the control group,versus 20 and 5,respectively,in the biofeedback training group.UES opening improved in both groups after treatment (P ＜ 0.05).Conclusion Routine swallowing training combined with sEMG-BFB can benefit the dysphagic patients with cerebral infarction for their UES opening and swallowing ability at recovery stage.