Effects of digastric muscle low frequency modulated medium frequency electroacupuncture therapy and voice training for dysphagia in patients with aortic arch surgery: A randomized controlled trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

PENG Jihai ¹ ,  FAN Xiaoping ² , REN Qingyi ¹ , ZHANG Mingsheng ¹ , DU Jianru ¹ , TANG Huibing ¹

1. Department of Rehabilitation, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, P.R.China;
2. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China;

Corresponding author：

FAN Xiaoping, Email: fukui-hanson@hotmail.com

Keywords：

The low-frequency modulated medium frequency electricity; acupuncture; digastric; aortic arch surgery; dysphagia

DOI：

10.7507/1007-4848.201804035

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Objective To investigate the combined effects of digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training for dysphagia in patients who underwent aortic arch surgery. Methods Forty-two consecutive patients with dysphagia after aortic arch surgery between October 2014 and November 2017 were divided into two groups including an observation group and a control group. There were 21 patients in each group. There were 17 males and 4 females at age of 51.0±6.5 years in the observation group, while 18 males and 3 females at age of 49.8±7.3 years in the control group. The patients in the observation group underwent electroacupuncture therapy and voice training (20 min per day for each therapy, 2 weeks), while the patients in the control group only received safe swallowing education and rehabilitation guidance (2 weeks). The test results, such as fibrolaryngoscope and functional oral intake scale (FOIS) score, and the data of computer phonatory detection, before and after the intervention were compared. Results The fibrolaryngoscope of vocal cords significantly decreased and the FOIS score significantly increased after digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training in the observation group(6.30 vs. 4.60, P<0.05). Bucking was obviously reduced. The indicators of hoarse degree, such as median pitch, fundamental frequency, jitter (0.60%±0.96%vs. 1.99%±1.86%, P=0.033), shimmer (2.47%±4.26% vs. 5.89%±3.66%, P=0.043), maximum phonation time (15.31±9.10 s vs. 3.72±8.83 s, P=0.006), maximum and loud phonation time (9.30±5.73 s vs. 2.32±2.99 s, P=0.039), mean noise-to-harmonics ratio (23.99±10.17 vs .9.98±9.37, P=0.006) and mean harmonics-to-noise ratio (0.03±0.02 vs. 0.17±0.23, P=0.019) improved after the treatment in both groups. But the improvement in the observation group was significantly better than that in the control group. Conclusion The combination of digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training on dysphagia in patients who underwent aortic arch surgery can significantly improve the swallowing function of patients. Meanwhile, it also helps the recovery of phonic function and improves the ability of feeding and communication in these patients.

Citation： PENG Jihai, FAN Xiaoping, REN Qingyi, ZHANG Mingsheng, DU Jianru, TANG Huibing. Effects of digastric muscle low frequency modulated medium frequency electroacupuncture therapy and voice training for dysphagia in patients with aortic arch surgery: A randomized controlled trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(6): 489-494. doi: 10.7507/1007-4848.201804035 Copy

1.	李进让, 郭红光. 电子喉镜吞咽功能检查在声带麻痹定位诊断中的应用. 山东大学耳鼻喉眼学报, 2012, 26(5): 55-58.
2.	尚蔚, 刘楠, 闫晓蕾, 等. A 型主动脉夹层手术后早期并发症分析. 心肺血管病杂志, 2011, 30(3): 183-186.
3.	Kagaya H, Baba M, Saitoh E, et al. Hyoid bone and larynx movements during electrical stimulation of motor points in laryngealelevation muscles: a preliminary study. Neuromodulation, 2011, 14(3): 278-83.
4.	小正裕. 准备迎接将要来到的超高龄社会——口腔医疗的作用及进食、吞咽障碍方面的考虑. 中国国际口腔器材展览会暨学术研讨会, 2008.
5.	汪洁, 吴东宇. 吞咽障碍的电刺激治疗研究进展. 中国康复医学杂志, 2009, 24(6): 573-575.
6.	Rosen CA, Lee AS, Osborne J, et al. Development and validation of the voice handicap index-10. Laryngoscope, 2004, 114(9): 1549-1556.
7.	Cook IJ, Dodds WJ, Dantas RO, et al. Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing. Dysphagia, 1989, 4(1):8-15.
8.	Jacob P, Kahrilas PJ, Logemann JA, et al. Upper esophageal sphincter opening and modulation during swallowing. Gastroenterology, 1989, 97(6): 1469.
9.	Watts CR, Hamilton A, Toles L, et al. A randomized controlled trial of stretch‐and‐flow voice therapy for muscle tension Dysphonia. Laryngoscope, 2015, 125(6): 1420-1425.
10.	Robertson V, Ward A, Reed A, et al. Electrotherapy explained: Principles and practice. Physiotherapy, 2006, 77(5): 356.
11.	彭继海, 范小平, 张雷, 等. 二腹肌低频调制中频电针刺激对脑卒中后吞咽障碍舌骨位移的影响. 中国康复医学杂志, 2015, 30(6): 555-561.
12.	Bielamowicz S, Stager SV. Diagnosis of unilateral recurrent laryngeal nerve paralysis: laryngeal electromyography, subjective rating scales, acoustic and aerodynamic measures. Laryngoscope, 2006, 116(3): 359-364.
13.	曾晓. 嗓音训练对声带息肉术后嗓音恢复的疗效观察. 山西医科大学, 2016: 10-20.
14.	崔燕, 元小冬, 王淑娟, 等. 心理康复对脑卒中吞咽障碍并发认知和心理障碍患者的疗效. 中国康复理论与实践,2013, 19(12): 1167-1170.
15.	Köklü S, Köklü G, Ozgüçlü E, et al. Clinical trial: interferential electric stimulation in functional dyspepsia patients-a prospective randomized study. Aliment Pharmacol Ther, 2010, 31(9): 961-968.

1. 李进让, 郭红光. 电子喉镜吞咽功能检查在声带麻痹定位诊断中的应用. 山东大学耳鼻喉眼学报, 2012, 26(5): 55-58.
2. 尚蔚, 刘楠, 闫晓蕾, 等. A 型主动脉夹层手术后早期并发症分析. 心肺血管病杂志, 2011, 30(3): 183-186.
3. Kagaya H, Baba M, Saitoh E, et al. Hyoid bone and larynx movements during electrical stimulation of motor points in laryngealelevation muscles: a preliminary study. Neuromodulation, 2011, 14(3): 278-83.
4. 小正裕. 准备迎接将要来到的超高龄社会——口腔医疗的作用及进食、吞咽障碍方面的考虑. 中国国际口腔器材展览会暨学术研讨会, 2008.
5. 汪洁, 吴东宇. 吞咽障碍的电刺激治疗研究进展. 中国康复医学杂志, 2009, 24(6): 573-575.
6. Rosen CA, Lee AS, Osborne J, et al. Development and validation of the voice handicap index-10. Laryngoscope, 2004, 114(9): 1549-1556.
7. Cook IJ, Dodds WJ, Dantas RO, et al. Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing. Dysphagia, 1989, 4(1):8-15.
8. Jacob P, Kahrilas PJ, Logemann JA, et al. Upper esophageal sphincter opening and modulation during swallowing. Gastroenterology, 1989, 97(6): 1469.
9. Watts CR, Hamilton A, Toles L, et al. A randomized controlled trial of stretch‐and‐flow voice therapy for muscle tension Dysphonia. Laryngoscope, 2015, 125(6): 1420-1425.
10. Robertson V, Ward A, Reed A, et al. Electrotherapy explained: Principles and practice. Physiotherapy, 2006, 77(5): 356.
11. 彭继海, 范小平, 张雷, 等. 二腹肌低频调制中频电针刺激对脑卒中后吞咽障碍舌骨位移的影响. 中国康复医学杂志, 2015, 30(6): 555-561.
12. Bielamowicz S, Stager SV. Diagnosis of unilateral recurrent laryngeal nerve paralysis: laryngeal electromyography, subjective rating scales, acoustic and aerodynamic measures. Laryngoscope, 2006, 116(3): 359-364.
13. 曾晓. 嗓音训练对声带息肉术后嗓音恢复的疗效观察. 山西医科大学, 2016: 10-20.
14. 崔燕, 元小冬, 王淑娟, 等. 心理康复对脑卒中吞咽障碍并发认知和心理障碍患者的疗效. 中国康复理论与实践,2013, 19(12): 1167-1170.
15. Köklü S, Köklü G, Ozgüçlü E, et al. Clinical trial: interferential electric stimulation in functional dyspepsia patients-a prospective randomized study. Aliment Pharmacol Ther, 2010, 31(9): 961-968.

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Effects of digastric muscle low frequency modulated medium frequency electroacupuncture therapy and voice training for dysphagia in patients with aortic arch surgery: A randomized controlled trial

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