基于吞咽造影检查探讨脑卒中后吞咽障碍患者颏下肌群表面肌电图参数与误吸风险的相关性OA

Objective To investigate the parameters of submental muscle surface electromyography(sEMG)in patients with post-stroke dysphagia based on videofluoroscopic swallowing study(VFSS),and to explore their correlation with aspiration risk.Methods A total of 47 patients diagnosed with post-stroke dysphagia who were hospitalized in the Department of Rehabilitation Medicine,Shijiazhuang People's Hospital from July 2023 to July 2024 and met the above inclusion criteria were selected.The Pa-tients were evaluated using the Rosenbek Penetration-Aspiration Scale(PAS).Patients with PAS grades 1-4 were assigned to the non-aspiration group(n=15),and those with PAS grades 5-8 were assigned to the aspiration group(n=32).VFSS was utilized to dy-namically observe the swallowing process of different food consistencies(e.g.,thin liquid,paste),and PAS was applied to assess the aspiration risk.sEMG was employed to record the myoelectric activity of the bilateral submental muscles during swallowing of 5 mL of warm water in order to obtain surface electromyographic signals.The root mean square(RMS),average electromyographic amplitude(AEMG),and swallowing duration were compared between the unaffected and affected sides in both groups.Spearman correlation analysis was performed to evaluate the correlations between the PAS grade and the RMS,AEMG,and swallowing dura-tion of the bilateral submental muscles.Results A total of 15 patients(31.91%)were assigned PAS grades 1-4,and 32 patients(68.09%)had PAS grades 5-8.Compared with the affected submental muscles,both groups showed significantly higher RMS and AEMG values on the unaffected side(P<0.05).There was no statistically significant difference in swallowing duration on the unaf-fected side between the two groups(P>0.05).Compared with the non-aspiration group,the aspiration group exhibited significantly higher RMS and AEMG values on the unaffected submental muscle(P<0.05),as well as significantly longer swallowing duration on both the affected and unaffected sides(P<0.05).PAS grade was negatively correlated with RMS on the affected submental muscles(rs=-0.303,P=0.039),and positively correlated with the swallowing duration on both the affected and unaffected submental muscles(rs=0.625,P<0.001;rs=0.661,P<0.001).Conclusion There are distinct differences in sEMG parameters of the submental muscles between the affected and unaffected sides in patients with post-stroke dysphagia.The compensatory effect of the unaffected submen-tal muscles is more prominent in the aspiration group.Aspiration risk is negatively correlated with the RMS on the affected submen-tal muscles,and positively correlated with the swallowing duration on both the affected and unaffected submental muscles.