| ObjectiveThe purpose of this study was to compare comprehensive rehabilitation training that included oral rehabilitation method and Shaker Exercise with neurology routine nursing care, in the part of swallowing function recovery of the patients with dysphagia caused by cerebral infarction before and after completion of the exercise regime.It was to evaluate of comprehensive rehabilitation training for the curative effect of swallowing disorder after cerebral infarction, at the same time to explore its effect on the incidence of pulmonary infection and quality of life.MethodsWe studied 120 dysphagic patients with cerebral infarction. 30 were randomized to traditional swallowing therapy group, 30 to the Shaker Exercise group, 30 to oral rehabilitation method group, and 30 to comprehensive rehabilitation training group. The patients in the traditional swallowing therapy group were treated with conventional treatment, while the patients in oral rehabilitation method group received oral rehabilitation method treatment in addition. The Shaker Exercise group accepted Shaker Exercise and conventional treatment, while the comprehensive rehabilitation training group accepted Oral rehabilitation method in addition. All of patients were assessed with video fluoroscopic swallowing study(VFSS) and swallowing-related quality of life(SWAL-QOL), at the same time they were accepted chest X-ray and blood cells analysis, before and after completion of 4-week assigned therapy regimen.ResultsPrior to either therapy there was no significant difference among the four groups in VFSS and SWAL-QOL scores(P >0.05).After completion of 4-week assigned therapy regimen the swallowing function had different degrees of improvement. The difference of VFSS score in the traditional swallowing therapy group was not statistically significant before and after completion of 4-week assigned therapy regimen(P =0.91), but it in the other three groups was statistically significant(P =0.00). After completion of 4-week assigned therapy regimen there was significant difference among the four groups in the change of VFSS score before and after the rehabilitation(P =0.00), and the comprehensive rehabilitation training group curative effect was significantly better than the other groups. The total effective rate was 96.67% in the comprehensive rehabilitation training group, 23.33% in the traditional swallowing therapy group, 66.67% in the oral rehabilitation method group, and 70.00% in the Shaker Exercise group.Before rehabilitation chest X-ray of the patients in four groups was all normal. And there was no significant difference among four the groups in the leukocyte count of blood routine inspection(P >0.05). After 4 weeks of rehabilitation training, all of the patients were accepted chest X-ray again. The result showed that four groups of patients were appeared pulmonary infection cases. The incidence of pneumonia were 53.33% in the traditional swallowing therapy group,40.00% in oral rehabilitation method group, 36.67% in Shaker Exercise group and 10.00% in comprehensive rehabilitation training group, respectively. The leukocyte count of the four groups of patients had varying degrees of increasement. And the comparative differences in the four groups were statistically significant before and after the rehabilitation(P < 0.05). After rehabilitation training, the change of leukocyte count between before and after the rehabilitation in the four groups was statistically significant(P < 0.05).But there was no significant difference between the oral rehabilitation method group and the Shaker Exercise group(P =0.93).In the SWAL-QOL score the comprehensive rehabilitation training group was higher than the other three groups. The average SWAL-QOL score was(187.30±10.68) in the comprehensive rehabilitation training group,(140.10±16.62) in the traditional swallowing therapy group,(161.47±24.53) in the oral rehabilitation method group, and(163.97±23.91) in the Shaker Exercise group. The difference of the SWAL-QOL score between before and after the rehabilitation from the four groups was statistically significant(P=0.00).The correlation analysis among the VFSS score, SWAL-QOL score and the leukocyte count from the four groups after the rehabilitation showed that VFSS scores and SWAL- QOL scale scores were positively correlated(P = 0.00), 0.97 in the correlation coefficient, while the correlation coefficient between the VFSS score and the leukocyte count of was- 0.54, a negative correlation(P = 0.00).ConclusionsApplication of Oral rehabilitation method combined with Shaker exercise in the patients with swallowing disorder caused by cerebral infarction could effectively improve the degree of swallowing disorder and the quality of life, and reduce the incidence of pneumonia. |
PDF Full Text Request