The effect of feeding training combined with neuromuscular electrical stimulation on post-stroke dysphagia patients
Objective To explore the effect of feeding training combined with neuromuscular electrical stimulation(NMES)in the treatment of post-stroke dysphagia(DAS)based on improved volumetric viscosity testing evaluation.Method A retrospective analysis was conducted on the clinical data of 63 patients with post-stroke dysphagia at Dongyang People's Hospital in Zhejiang Province from January to December 2021.All patients received routine swallowing training and were di-vided into feeding training group,MES group,and combination group according to different treatment plans,with 21 cases in each group.The feeding training group received feeding training evaluated under the modified volumetric viscosity test,which divided the liquid into low viscosity,medium viscosity,and high viscosity.Each viscosity was tested in the order of 3mL,5mL,and l0mL,following the sequence of medium viscosity,low viscosity,and high viscosity.The NMES group used VitalStim neuromuscular electrical stimulators to place electrode pads on both sides of the midline of the neck,under the chin,and on the upper part of the hyoid bone,with 4 pads placed on each side.In swallowing recovery mode,the current intensity was gradually increased from 0mA,usually between 6.3-13.2mA,once a day,every 30 minutes,for 6 consecutive weeks of treatment;Combine the above two methods for treatment.Results(1)Clinical efficacy.The difference in total effec-tive rate among the three groups was statistically significant(x2=6.705,P=0.004),with the combined group having a higher total effective rate than the feeding training group and NMES group(P＜0.05);(2)Swallowing function.After treatment,the three groups of Wada drinking water test and SSA scores decreased compared to before treatment,with the combination group showing the most significant improvement,which was better than the feeding training group and NMES group(P＜0.05).There was no statistically significant difference between the feeding training group and NMES group(P＞0.05);(3)Quality of life.After treatment,there was a statistically significant difference in SWAL-QOL scores among the three groups(F=4.533,P=0.015),and the combination group was superior to the feeding training group and NMES group(P＜0.05).There was no statis-tically significant difference between the feeding training group and NMES group(P＞0.05),and SWAL-QOL scores in all groups improved compared to before treatment(P＜0.01);(4)Complications.There was no statistically significant difference in the incidence of aspiration pneumonia,aspiration,and hypoalbuminemia among the three groups(P＞0.05).Conclusion The combination of feeding training and neuromuscular electrical stimulation based on improved volumetric viscosity testing has a significant therapeutic effect on post-stroke swallowing disorders.It can improve swallowing function,ensure nutrient absorp-tion,improve quality of life,and the intervention has high safety.
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