Therapeutic effects of deep pharyngeal electrical stimulation combined with modified masako maneuver on aspiration in patients with stroke.

BACKGROUND: Stroke patients often experience difficulty swallowing. OBJECTIVE: To assist in the improvement of dysphagia symptoms by introducing a novel approach to the treatment of patients with post-stroke aspiration. METHODS: A total of 60 patients with post-stroke aspiration were enrolled and divided into an experimental group (n = 30) and a control group (n = 30). The control group received standard treatment, sham intraoral stimulation, and the Masako maneuver, while the experimental group was administered standard treatment, deep pharyngeal electrical stimulation (DPES), and a modified Masako maneuver. Changes in their Functional Oral Intake Scale (FOIS) and Rosenbek scale scores were observed. RESULTS: The FOIS scores of both groups increased significantly after treatment (p < 0.01, respectively). The Rosenbek scale scores of both groups decreased significantly after treatment, with the experimental group scoring significantly lower than the control group (1.01±0.09 vs. 2.30±0.82) (p < 0.05). After treatment, the overall response rate in the experimental group (93.33%) was significantly higher than that in the control group (83.33%) (p < 0.001). CONCLUSION: In terms of effectively improving dysphagia in aspiration patients after stroke, DPES combined with modified Masako maneuver is clinically recommended.

Altered functional connectivity in language and non-language brain networks in patients diagnosed with acute post-stroke aphasia.

OBJECTIVE: A resting-state functional magnetic resonance imaging (rs-fMRI) approach was used to explore functional connectivity (FC) in language and non-language brain networks in acute post-stroke aphasia (PSA) patients, with a specific focus on the relationship between these fMRI results and patient clinical presentation. METHODS: In total, 20 acute PSA patients and 30 age-, sex-, and education level-matched healthy control (HC) participants were recruited and subjected to rs-fMRI imaging. In addition, western aphasia battery analyses（WAB） were used to compute aphasia quotient (AQ) values for PSA patients. Granger causality was employed to examine connections among cognition-associated resting-state brain networks, and the right middle frontal gyrus (RMFG),the mirror brain regions of Broca's area and the Wernicke's area, the right superior temporal gyrus were selected as regions of interest (ROIs). The REST plus software was then used to perform FC analyses of these regions to analyze changes in FC related to PSA pathogenesis. RESULTS: Relative to HC individuals, PSA patients exhibited significantly higher levels of intra-network FC between the right middle frontal gyrus (RMFG) and the left middle occipital gyrus (LMOG), with such FC being positively correlated with the AQ scores (P = 0.018). Moreover, reduced FC was detected between the Broca's area homolog and the left middle frontal gyrus (LMFG), while FC was enhanced between the Wernicke's area homolog and cerebellar vermis, and this FC was similarly positively correlated with patient AQ scores (P = 0.0297). CONCLUSION: These results suggest that FC between the bilateral hemispheres of the brain is significantly disrupted in acute PSA patients, interfering with the normal non-specific language network. Aphasia severity was further found to correlate with FC among many of the analyzed regions of the brain.

Effects of extracorporeal shock wave therapy combined with isokinetic strength training on spastic calf triceps in patients after a stroke: a double-blinded randomised controlled trial.

OBJECTIVES: To evaluate the antitetanic effects of extracorporeal shock wave therapy (ESWT) combined with isokinetic strength training (IST) on calf triceps spasm in patients after a stroke. METHODS: Forty-five patients with hemiplegia after a stroke and lower extremity spasms were randomly assigned into three groups: a control group (n = 15), an ESWT group (n = 15) and an ESWT+IST group (n = 15). All patients agreed to conventional rehabilitation therapy, while the ESWT and ESWT+IST groups received ESWT of 2.0-3.0 bar once a week for four weeks. In addition, the ESWT+IST group underwent four weeks of ankle IST. All groups were assessed using the modified Ashworth scale (MAS) and surface electromyography before and after four weeks of treatment. The ankle passive movement of all groups was measured using the BIODEX isokinetic system at angular velocities of 60°/s, 120°/s, 180°/s and 240°/s. RESULTS: After four weeks of treatment, compared with the control group, the ESWT+IST groups showed a significant reduction in MASscores (P = 0.030). The ESWT+IST group had significantly lower MAS scores than the baseline (P = 0.002), while the ESWT group did not show a significant difference (P = 0.072). The average electromyography (AEMG) analysis demonstrated a significant difference among the groups after four weeks (P = 0.001), with the ESWT+IST group having lower AEMG values compared with the control group (P < 0.001) and the ESWT group (P = 0.042). Peak resistive torque significantly decreased in both the ESWT and ESWT+IST groups at all velocities (60°/s: P = 0.030, 120°/s: P = 0.039, 180°/s: P = 0.030 and 240°/s: P = 0.042). CONCLUSIONS: Extracorporeal shock wave therapy combined with IST can significantly improve calf triceps spasm in patients after a stroke.