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.	李進讓, 郭紅光. 電子喉鏡吞咽功能檢查在聲帶麻痹定位診斷中的應用. 山東大學耳鼻喉眼學報, 2012, 26(5): 55-58.
2.	尚蔚, 劉楠, 閆曉蕾, 等. A 型主動脈夾層手術后早期并發癥分析. 心肺血管病雜志, 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. 準備迎接將要來到的超高齡社會——口腔醫療的作用及進食、吞咽障礙方面的考慮. 中國國際口腔器材展覽會暨學術研討會, 2008.
5.	汪潔, 吳東宇. 吞咽障礙的電刺激治療研究進展. 中國康復醫學雜志, 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.	彭繼海, 范小平, 張雷, 等. 二腹肌低頻調制中頻電針刺激對腦卒中后吞咽障礙舌骨位移的影響. 中國康復醫學雜志, 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.	曾曉. 嗓音訓練對聲帶息肉術后嗓音恢復的療效觀察. 山西醫科大學, 2016: 10-20.
14.	崔燕, 元小冬, 王淑娟, 等. 心理康復對腦卒中吞咽障礙并發認知和心理障礙患者的療效. 中國康復理論與實踐,2013, 19(12): 1167-1170.
15.	K?klü S, K?klü G, Ozgü?lü 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. 李進讓, 郭紅光. 電子喉鏡吞咽功能檢查在聲帶麻痹定位診斷中的應用. 山東大學耳鼻喉眼學報, 2012, 26(5): 55-58.
2. 尚蔚, 劉楠, 閆曉蕾, 等. A 型主動脈夾層手術后早期并發癥分析. 心肺血管病雜志, 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. 準備迎接將要來到的超高齡社會——口腔醫療的作用及進食、吞咽障礙方面的考慮. 中國國際口腔器材展覽會暨學術研討會, 2008.
5. 汪潔, 吳東宇. 吞咽障礙的電刺激治療研究進展. 中國康復醫學雜志, 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. 彭繼海, 范小平, 張雷, 等. 二腹肌低頻調制中頻電針刺激對腦卒中后吞咽障礙舌骨位移的影響. 中國康復醫學雜志, 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. 曾曉. 嗓音訓練對聲帶息肉術后嗓音恢復的療效觀察. 山西醫科大學, 2016: 10-20.
14. 崔燕, 元小冬, 王淑娟, 等. 心理康復對腦卒中吞咽障礙并發認知和心理障礙患者的療效. 中國康復理論與實踐,2013, 19(12): 1167-1170.
15. K?klü S, K?klü G, Ozgü?lü 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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