Modulated Medium Frequency Electric Stimulation-Swallow Function Training On Dysphagia Following Stroke

Dysphagia is a momentous complication.During acute cerebral accident,the rate of dysphagia is about to 40%-50 %.Dysphagia often leads to aspiration pneumonia,anhydration, cacotrophia,bronchial spasm,airway obstruction even death. Therefore,it is important to improve patients' self-care ability, improve their quality of life and decrease the rate of pulmonary infection or death that efficient and prompt treatment to dysphagia and convalescence of swallowing function.Dysphagia means the disorder during food transported from oral cavity to stomach.The nerves related to swallowing include cerebral cortex,corticonuclear tract,brain stein nucleus,deglutition center;pairs ofⅤ,Ⅶ,Ⅸ,Ⅹ,Ⅻcranial nerves and C1-4,T1-12 spinal cords.Diseases of oral cavity,pharynx,esoph,cranial nerves,bulbus medullae,extractorticospinal tract and muscle can lead to dysphagia.Medium frequency electric current is a kind of alternating current which frequency is 2000-8000Hz.Modulated medium frequency electric stimulation means that the amplitude and the frequency of a kind of higher frequency kipp are changed by another kind of low-frequency kipp.The mechanism of action of the modulated medium frequency electric stimulation is:it can import the electrical signal into the target tissue,promoting motoneuron depolarization and the production of action potential,leading to contraction of the muscle fibers dominanted by the neuron,training muscles,raising tension of smooth muscle,stimulating sensory neuron,raising sense import,feedback regulating neurapophysis re-establishment.Additionally,modulated medium frequency electric stimulation can improve blood circulation,promoting lymphatic return,regulating nerve segmental reflexion,improving autonomic nerve function,eliminating inflammation and relieving pains,etc.There are some advantages of modulated medium frequency electric stimulation.For example:it passes through the body easily,deep site of action,less electrolytic action,less tolerance from body because of its adlibitum transforming wave shapes and frequency,simple operation,less influence of anthropic factor,etc.Objective:Therapy of modulated medium frequency electric stimulation has sufficient theory bases,identifying mechanism,being used to treat limbs paralysis widely.It has get better clinical results,but the utilization in treatment to dysphagia nowadays.This research combined the therapy of modulated medium frequency electric stimulation with swallowing function training to treat dysphagia following stroke and observed the effect of modulated medium-frequency electric stimulation - swallow function training combined therapy on dysphagia following stroke. Methods:60 patients with dysphagia following stroke were randomly divided into the treatment group and the control group with 30 cases in each group.The patients in the treatment group were treated by modulated medium frequency electrical stimulation and swallowing function training,and there are 10 days in one course of treatment.And the cases of the control group were treated by swallowing function training only.All patients were evaluated with the standard of swallowing function training effect reported by Tengdao- Lang(Japan)before treatment,the 10th day during treatment,the 23th day during treatment and the 36th day during treatment.And all patients were evaluated with the standard of motor function of muscles on head related to swallowing.ResuIts:There was no significant difference between two groups before treatment(P=0.34,P＞0.05).The score of swallowing function training effect reported by Tengdao- Lang(Japan)in the treatment group is higher than that in the control group by the 10th day during treatment(P=0.025,P＜0.05).The score of patients in the treatment group is obviously higher than that of patients in the control group by the 23th day during treatment(P=0.01,P＜0.05) and the score of patients in the treatment group is obviously higher than that of patients in the control group by the 36th day during treatment too(P=0.009,P＜0.01).After treatment,the total effective rate of the treatment group was 86.7%,that of the control group was 66.7%,there was a significant difference between two groups (P＜0.05).The motor function of muscles on head related to swallowing of patients in the treatment group is significantly better than that of the control group(P＜0.05)There are l patients with aspiration pneumonia,2 patients with cacotrophia,and no patients with dehydration,bronchial spasm and airway obstruction even death in the treatment group.There are 2 patients with aspiration pneumonia,4 patients with cacotrophia,one patient with airway obstruction,and no patients with dehydration,bronchial spasm and death in the control group.In the course of treatment,electrolysis reaction,laryngismus and changes of HR or cardiac rhythm did not happened in the treatment group.Conclusion:1.The effect of modulated medium-frequency electric stimulation - swallow function training combined therapy on dysphagia following stroke is better than swallowing function training only.2.Modulated medium-frequency electric stimulation -swallow function training combined therapy can improve the motor function of muscles on head related to swallowing for patients with dysphagia following stroke.And the therapeutic effect on dysphagia in oral stage is better than swallowing function training only.3.Modulated medium-frequency electric stimulation -swallow function training combined therapy can effectively decrease complications.Such as:aspiration pneumonia, cacotrophia,dehydration,bronchial spasm,airway obstruction even death.4.Modulated medium frequency electrical stimulation therapy is safer than direct current and low-frequency electric stimulation.It less leads to electrolysis reaction,laryngismus and changes of HR or cardiac rhythm.