文章摘要

下颏抗阻力训练与Shaker训练对脑梗死后吞咽障碍及心理状态的影响

作者: 1张娟, 2由丽, 1张素爱, 1宋春洪, 1张琦
1 淮安医院神经内科,江苏 淮安 223200
2 南京脑科医院康复医学科,南京 210029
通讯: 张娟 Email: hayyzj@163.com
DOI: 10.3978/j.issn.2095-6959.2020.10.022

摘要

目的:探讨下颏抗阻力训练(chin tuck against resistance,CTAR)以及Shaker训练对吞咽障碍及心理状态的影响。方法:以淮安医院住院治疗后的120例脑梗死后吞咽困难的患者为研究对象,随机分为对照组、CTAR组和Shaker训练组。对照组接受药物、传统康复训练、常规护理等常规治疗措施,CTAR组和Shaker组在对照组基础上,分别进行CTAR康复训练和Shaker康复训练。比较康复训练前后患者在视频荧光吞咽摄影检查(video fluoroscopic swallowing study,VFSS)评估、抑郁自评量表(Self-Rating Depression Scale,SDS)上的差异。结果:CTAR组和Shaker组在总有效率、干预4周和6周时的VFSS评分均优于对照组(P<0.05),且CTAR组优于Shaker组,差异有统计学意义(P<0.05)。3组干预4周、6周分别与干预前、干预2周比较,VFSS评分显著降低(P<0.05)。CTAR组和Shaker组干预6周时心理状态及SDS评分均较干预前明显改善,差异有统计学意义(P<0.05),且CTAR组SDS评分显著低于Shaker组,差异有统计学意义(P<0.05)。结论:对于脑梗死后意识清晰或可坐立的吞咽障碍患者,Shaker训练和CTAR训练均能改善吞咽功能及抑郁状态,且CTAR训练效果更佳。
关键词: 下颏抗阻力训练;Shaker训练;脑梗死;吞咽障碍;心理状态

Effect of chin tuck against resistance and Shaker training on dysphagia and mental state after cerebral infarction

Authors: 1ZHANG Juan, 2YOU Li, 1ZHANG Su’ai, 1SONG Chunhong, 1ZHANG Qi
1 Department of Neurology, Huai’an Hospital, Huai’an Jiangsu 223200, China
2 Department of Rehabilitation, Nanjing Brain Hospital, Nanjing 210029, China

CorrespondingAuthor: ZHANG Juan Email: hayyzj@163.com

Abstract

Objective: To investigate the effect of chin tuck resistance resistance (CTAR) and Shaker training on dysphagia and mental state. Methods: A total of 120 patients with dysphagia after cerebral infarction in Huai’an Hospital were randomly divided into a control group, a CTAR group and a Shaker training group. The control group received conventional treatments including drugs, traditional rehabilitation training, and other routine nursings. The CTAR group and the Shaker group performed CTAR rehabilitation training and Shaker rehabilitation training on the basis of the control group. The differences between the video fluoroscopic swallowing study (VFSS) and the Self-Rating Depression Scale (SDS) were compared before and after the rehabilitation. Results: The VFSS scores in the CTAR and Shaker groups were better than those in the control group at the 4th and 6th week of intervention (P<0.05), and the CTAR group was superior to the Shaker group. The difference was statistically significant (P<0.05). The VFSS scores were significantly lower in the 3 groups of interventions at 4 and 6 weeks, respectively, compared with 2 weeks before the intervention (P<0.05). The psychological status distribution and SDS scores of CTAR group and Shaker group at 6 weeks after the intervention were significantly improved compared with those before the intervention, which was statistically significant (P<0.05), and the SDS score of CTAR group was significantly lower than that of Shaker group, which was statistically significant (P<0.05). Conclusion: For patients with dysphagia with clear or conscious cerebral infarction, both Shaker training and CTAR training can improve swallowing function and depression, and CTAR training is better.
Keywords: chin tuck against resistance; Shaker training; cerebral infarction; dysphagia; mental state