Application Of Music Therapy Combined With Swallowing Training In Patients With Dysphagia After Stroke

Objective: Dysphagia after stroke can easily cause aspiration,aspiration pneumonia,dehydration,malnutrition and other problems,seriously affecting the quality of life of patients,extended hospital stay,increasing the disability rate and death risk of patients.Considering that dysphagia after stroke is mainly manifested in oral stage and pharyngeal stage,and vocalization,singing,chanting or playing an instrument in music therapy can effectively improve oral movement and respiratory control,this paper aims to explore the effect of music therapy combined with swallowing training on dysphagia after stroke.Methods: A total of 20 stroke patients with dysphagia who met the inclusion and exclusion criteria in the rehabilitation department of XiangYang first people's hospital from June 2019 to November 2019 were selected and randomly divided into test group and control group according to the admission order,with 10 patients in each group.The control group received routine swallowing training,while the test group received music therapy combined with swallowing training.Both the control group and the test group were trained for 30 min each time,6 times a week for 2 weeks.Each subject was assessed on the functional oral feeding scale,Frenchay dysarticulation scale and surface electromyography of the suprahyoid group before and after treatment,respectively.SPSS22 was used for statistical analysis of the data: Paired sample T test was used to compare the indexes of the experimental group and control group after treatment with those before treatment to evaluate the effectiveness of music therapy combined with swallowing training and routine swallowing training.The independent sample T test was used to analyze the differences between the experimental group and the control group after treatment to evaluate whether music therapy combined with swallowing training is superior to conventional swallowing training.Results: FOIS scores in both the experimental group and the control group after treatment were significantly higher than those before treatment(P<0.001),while FOIS scores in the experimental group after treatment were higher than those in the control group,but the difference was not statistically significant.After treatment,five items on the Frenchay dysarthria rating scale,including reflex,breathing,lip movement,laryngeal movement,and tongue movement,were significantly improved in the treatment group and control group(P<0.001).After treatment,the function of breathing(P=0.027),lip movement(P=0.045)and laryngeal movement(P=0.040)in the experimental group was significantly better than that in the control group.After treatment,the AEMG value of sEMG of the affected side of the two groups significantly decreased compared with that before treatment(P<0.001).The AEMG value of the affected side of the experimental group was significantly lower than that of the control group(P=0.023)when empty swallowing after treatment,and the AEMG value of the affected side of the experimental group was significantly lower than that of the control group when swallowing 2ml of water after treatment(P=0.041).Conclusion: The combination of music therapy and swallowing training improved the coordination of respiratory function,lip movement,larynx movement and suprahyoid muscles better than traditional swallowing training.Music therapy can be used as an adjunctive therapy for patients with dysphagia after stroke to promote the improvement of dysphagia.