目的 观察基于力量和技能训练生物反馈(BiSSkiT)理论的强化咽喉上升电子生物反馈训练联合表面肌电生物反馈对脑卒中恢复期患者吞咽障碍的影响。 方法 选取脑卒中恢复期吞咽障碍患者60例，采用随机数字表法将其分为生物反馈组、咽喉上升组和联合组，每组患者20例。3组患者均给予常规吞咽功能训练，生物反馈组在此基础上增加表面肌电生物反馈训练(每日1次，每次20 min)，咽喉上升组在常规吞咽功能训练的基础上增加基于BiSSkiT理论的咽喉上升强化训练器的训练(每日1次，每次20 min)，联合组则在吞咽功能训练的基础上增加表面肌电生物反馈训练和基于BiSSkiT理论的咽喉上升强化训练仪的训练。于治疗前和治疗4周后(治疗后)对3组患者进行X光荧光透视检查(VFSS)检查，并采用VFSS量表、吞咽功能评定量表(SSA)、吞咽功能障碍预后和严重程度量表(DOSS)评估3组患者的吞咽功能。 结果 治疗后，3组患者的VFSS评分、SSA评分和DOSS评分较组内治疗前均显著改善(P<0.05)。治疗后，联合组患者的VFSS评分、SSA评分和DOSS评分分别为(5.85±0.88)分、(35.45±1.90)分和(4.1±1.10)分，均显著优于生物反馈组和咽喉上升组治疗后(P<0.05)，而咽喉上升组的VFSS评分、SSA评分和DOSS评分亦均显著优于生物反馈组治疗后，差异均有统计学意义(P<0.05)。 结论 基于BiSSkiT理论的强化咽喉上升电子生物反馈训练联合表面肌电生物反馈可显著改善脑卒中恢复期患者的吞咽功能。 Objective To observe any effect of combining surface electromyography biofeedback with intensive pharyngeal ascending e-biofeedback training on dysphagia among stroke survivors. Methods Sixty stroke survivors with dysphagia were randomly divided into a biofeedback group, a pharyngeal ascending group and a combination group, each of 20. In addition to routine swallowing training, the biofeedback group received 20 minutes of surface electromyographic biofeedback training daily while the pharyngeal ascending group did pharyngeal rising reinforcement training based on biofeedback for strength and skill training (BiSSkiT) theory. The combination group was given both. Before and after 4 weeks of the interventions, videofluoroscopy was used to evaluate everyone′s swallowing. The Swallowing Function Assessment Scale (SSA) and the Dysphagia Outcome and Severity Scale (DOSS) were also applied. Results Significant improvement was observed in all 3 groups in terms of their average VFSS, SSA and DOSS scores. The average videofluoroscopy, SSA and DOSS results of the combination group were then significantly better than the other two groups′ averages, and those of the pharyngeal ascending group were significantly superior to those of the biofeedback group. Conclusion Combining intensive pharyngeal ascending electronic biofeedback training with surface EMG biofeedback can significantly improve the swallowing function of stroke survivors.
Biofeedback training can significantly improve dysphagia among stroke survivors
Objective To observe any effect of combining surface electromyography biofeedback with intensive pharyngeal ascending e-biofeedback training on dysphagia among stroke survivors. Methods Sixty stroke survivors with dysphagia were randomly divided into a biofeedback group, a pharyngeal ascending group and a combination group, each of 20. In addition to routine swallowing training, the biofeedback group received 20 minutes of surface electromyographic biofeedback training daily while the pharyngeal ascending group did pharyngeal rising reinforcement training based on biofeedback for strength and skill training (BiSSkiT) theory. The combination group was given both. Before and after 4 weeks of the interventions, videofluoroscopy was used to evaluate everyone′s swallowing. The Swallowing Function Assessment Scale (SSA) and the Dysphagia Outcome and Severity Scale (DOSS) were also applied. Results Significant improvement was observed in all 3 groups in terms of their average VFSS, SSA and DOSS scores. The average videofluoroscopy, SSA and DOSS results of the combination group were then significantly better than the other two groups′ averages, and those of the pharyngeal ascending group were significantly superior to those of the biofeedback group. Conclusion Combining intensive pharyngeal ascending electronic biofeedback training with surface EMG biofeedback can significantly improve the swallowing function of stroke survivors.
StrokeDysphagiaPharyngeal rise biofeedbackElectromyographic biofeedbackStrength training, Skill training
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