Effects of high-frequency rTMS combined with swallowing and feeding training on EAT-10 score and swallowing safety in stroke patients with swallowing disorder

ZHAO Qifan; GUI Xiaotong; XU Chenxi; YAN Yaqi; YANG Ting; BU Lingling; XU Mei

Abstract：Objective To explore the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) combined with swallowing and feeding training on the scores of the Eating Assessment Questionnaire Tool (EAT-10) and swallowing safety in stroke patients with swallowing disorders (PSD). Methods According to the random number table method,120 PSD patients admitted to the Rehabilitation Medicine Department of Nanjing Hospital Affiliated to Nanjing Medical University from February 2021 to February 2024 were divided into a single group (P=60) and a combination group (n=60). The single group received swallowing and feeding training intervention,whereas the combination group received high-frequency rTMS combined with swallowing and feeding training intervention. The clinical efficacy,swallowing function[Swallowing Function Assessment Scale (SSA) score,EAT-10 score],swallowing safety[Modified Mann Swallowing Ability Assessment Scale (MMASA),Permeation Aspiration Scale (PAS)],and swallowing contrast imaging evaluation results[Swallowing Contrast Imaging (VFSS)]between these two groups of patients were compared and analyzed. Results The total effective rate of the combined treatment group was higher than that of the single group (91.67％ vs 78.33％) (P<0.05). After treatment,the SSA score and EAT-10 score of both groups decreased,with the combined group being lower (P<0.05). After treatment,WST score and PAS score decreased in both groups,with the combined group being lower (P<0.05). After treatment,the MMASA scores of both groups of patients increased,with the combined group being higher.. After treatment,both groups showed a decrease in oral transport,swallowing reaction,pharyngeal transport,and laryngeal closure time,with the combined group having lower oral transport,swallowing reaction,and pharyngeal transport time (P<0.05). There was no statistically significant difference in laryngeal closure time between the two groups (P>0.05). Conclusions High frequency rTMS combined with swallowing and feeding training has shown good efficacy in the treatment of PSD patients,significantly improving their swallowing function,shortening their swallowing time,and enhancing the swallowing safety.