Observation on the effect of free-drinking water training combined with low-frequency pulse electrical stimulation in treatment of post-stroke dysphagia

ZHONG Xiuwen; YOU Fei; MA Zhaoyang; XIAO Pei; ZHENG Jinkun; LIU Lian; CHEN Qiao

doi:10.3969/j.issn.1674-3806.2025.08.13

Abstract：Objective To observe the effect of free-drinking water training combined with low-frequency pulse electrical stimulation in treatment of post-stroke dysphagia(PSD).Methods One hundred and twelve patients with PSD who were admitted to the Central Hospital of Wuhan from March 2022 to March 2024 were recruited and divided into observation group and control group by random number table method,with 56 patients in each group.In addition to the conventional rehabilitation training methods such as ice water stimulating the soft palate and tongue root,perioral muscle training,respiratory function training and pronunciation training,the control group was treated with low-frequency pulse electrical stimulation,while the observation group was treated with free-drinking water training on the basis of the same treatment as the control group.The treatment course was 2 months in both groups.The results of water swallow test(WST),Dysphagia Handicap Index(DHI)scores,Eating Disorder Quality of Life Scale(EDQoL)scores,Barthel Index scores and Eating Assessment Tool-10(EAT-10)scores were compared between the two groups.The anterior displacement distance of the hyoid bone,the upward displacement distance of the hyoid bone,the anterior displacement distance of the thyroid cartilage and the upward displacement distance of the thyroid cartilage were measured by using video-fluoroscopic swallowing study(VFSS).The levels of serum brain-derived neurotrophic factor(BDNF),substance P(SP),neuron-specific enolase(NSE),nerve growth factor(NGF)and S100β protein were determined by using enzyme-linked immunosorbent assay(ELISA).Results The effective rate of rehabilitation therapy in the observation group was significantly higher than that in the control group(85.71％vs 69.64％;x2=4.171,P=0.041).After the rehabilitation therapy,the scores of the emotional,physiological and functional dimensions of DHI,as well as the EDQoL scores and EAT-10 scores in the observation group were significantly lower than those in the control group(P＜0.05),and the Barthel index scores in the observation group were significantly higher than those in the control group(P＜0.05).After the rehabilitation therapy,the anterior displacement distance of the thyroid cartilage,the upward displacement distance of the thyroid cartilage,the anterior displacement distance of the hyoid bone,the upward displacement distance of the hyoid bone in the observation group were significantly greater than those in the control group(P＜0.05).After the rehabilitation therapy,the levels of serum BDNF,SP and NGF in the observation group were higher than those in the control group,while the levels of S100β protein and NSE in the observation group were lower than those in the control group,with statistically significant differences between the two groups(P＜0.05).Conclusion Free-drinking water training combined with low-frequency pulse electrical stimulation can effectively improve the patients'PSD,promote the recovery of neurological function,and improve their living quality.