The Study Of Surface Electromyography Biofeedback Combined And Swallowing Training In Dysphagic Patients With Nasopharyngeal Carcinoma After Radiation Therapy

ObjectiveRadiotherapy is one of the primary methods for the treatment of nasopharyngeal carcinoma.Swallowing disorders are increasingly troubling patients with nasopharyngeal carcinoma after radiation therapy.Symptoms such as loss of appetite,prolonged eating time and difficulty swallowing seriously affect patients'quality of life.At present,only swallowing training can not completely solve the symptoms of dysphagia.The patient has serious psychological problems.Search for a new treatments is becoming more urgent and important.To study the clinical effect of surface electromyography biofeed-back(sEMG-BF)combined with swallowing training on dysphagia in NPC after radiation therapy.To analyze the mechanism of sEMG-BF in improving dysphagia and patients' quality of life.It is hoped that the study could improve the swallowing function of patients with NPC after radiation therapy.We hope to improve patients' quality of life and mental health through the treatment.Hope to obtain the theoretical basis of rehabilitation intervention for swallowing disorder.MethodsFrom Nov.2017 to Oct.2018,40 cases of patients in nasopharyngeal carcinoma with dysphagia after radiation therapy that had been confirmed by the pathological without distant metastasis and dysphagia previously.The severity of dysphagia was determined using the Rosenbek' s penetration-aspiration scale(PAS)and functional oral intake scale(FOIS).The assessment of patients to PAS is more then 2 level and FOIS 3 or below.The patients were aged between 33 to 76 years old.All the patients had been signed the informed consent and would cooperate with the treatment.40 patients were randomly divided into experimental group and control group by table of random Numbers.The experimental group has 20 patients,as same as the control group.The control group was treated by swallowing training,and the experimental group was based on swallowing training and sEMG-BF.The efficacy was evaluated by Video Fluorograhic Swallowing Study(VFSS),functional oral ingestion score(FOIS)and swallowing quality of life scale(SWAL-QOL).Student's t test was applied for parametric data,The therapeutic efficacy was analyzed with the ?2 test.P<0.05 was chosen as the level of statistical significance.An intention-to-treat analysis was applied.SPSS 19.0 was used to carry out the analysis.ResultsCompare the swallowing function between the experimental group and control group.Before the treatment,there were no differences in swallowing time,functional oral feeding score and swallowing quality of life scale.Pharyngeal transit time was significantly shortened,P<0.05 compared with the control group.The difference between the two groups before and after treatment was significant,P<0.05.FOIS score in biofeedback group increased significantly,and the difference was significant by P<0.05.It is suggested that sEMG-BF can significantly shorten the pharyngeal passage time and improve the Oral feeding capacity.In the quality of life,the total scores of the SWAL-QOL after treatment were higher than before,P<0.05,the difference was significant.Among the dimensions of anxiety,fear,mental health and social interaction,the biofeedback group showed more pioneer(P<0.05).The total effective rate for swallowing function was 70%,compared with only 35%in the control group.In the FOIS field,the total effective rate was 85%in the biofeedback group and 50%in the control group.ConclusionBecause of the complexity and irreversibility of postradiotherapy swallowing disorders,single swallowing therapy can only improve symptoms to a limited extent.sEMG-BF combined with swallowing training is superior to pure swallowing training in improving swallowing function by patients with NPC after radiation therapy.The biofeedback treatment mode can strengthen swallowing training,relieve patients' progressive dysphagia after NPC radiotherapy,and improve patients' quality of life.Cognitive behavioral therapy(CBT)is of positive significance in improving patients' anxiety and depression,allowing them to reshape their healthy psychological state and social interaction activities.