Article

OBJECTIVE: To evaluate and compare the effects of neuromuscular electrical
stimulation (NMES) acting on the sensory input or motor muscle in treating
patients with dysphagia with medullary infarction. DESIGN: Prospective randomized
controlled study. SETTING: Department of physical medicine and rehabilitation.
PARTICIPANTS: Patients with dysphagia with medullary infarction (N=82).
Participants were randomized over 3 intervention groups:
traditional swallowing therapy, sensory approach combined with traditional
swallowing therapy, and motor approach combined with traditional swallowing
therapy. Electrical stimulation sessions were for 20 minutes, twice a day, for
5d/wk, over a 4-week period. MAIN OUTCOME MEASURES: Swallowing function was
evaluated by the water swallow test and Standardized Swallowing Assessment, oral
intake was evaluated by the Functional Oral Intake Scale, quality of life was
evaluated by the Swallowing-Related Quality of Life (SWAL-QOL) Scale, and
cognition was evaluated by the Mini-Mental State Examination (MMSE). RESULTS:
There were no statistically significant differences between the groups in age,
sex, duration, MMSE score, or severity of the swallowing disorder (P>.05). All
groups showed improved swallowing function (P</=.01);
the sensory approach
combined with traditional swallowing therapy group showed significantly greater
improvement than the other 2 groups, and the motor approach combined with
traditional swallowing therapy group showed greater improvement than the
traditional swallowing therapy group (P<.05). SWAL-QOL Scale scores increased
more significantly in the sensory approach combined with traditional swallowing
therapy and motor approach combined with traditional swallowing therapy groups
than in the traditional swallowing therapy group, and the sensory approach
combined with traditional swallowing therapy and motor approach combined with
traditional swallowing therapy groups showed statistically significant
differences (P=.04). CONCLUSIONS: NMES that targets either sensory input or motor
muscle coupled with traditional therapy is conducive to recovery from dysphagia
and improves quality of life for patients with dysphagia with medullary
infarction. A sensory approach appears to be better than a motor approach.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS