江苏盛泽医院

Objective To explore the effect of visual deprivation training combined with proprioceptive training on balance function of hemiplegic patients after stroke. Methods A total of 80 stroke patients with hemiplegia in Jiangsu Shengze Hospital were selected from May,2022 to March,2024,and randomly divided into control group(n=20),proprioceptive training group(n=20),visual de-privation group(n=20)and combined group(n=20).All the groups received routine rehabilitation training,while the proprioceptive training group added proprioceptive training,the visual deprivation group added balance training under visual deprivation,and the combined group added visual deprivation training and proprioceptive training,for four weeks.They were assessed with ProKin Balance Test and Training System,Berg Balance Scale(BBS),10-metre walking test(10MWT),Fugl-Meyer Assessment-Lower Extremities(FMA-LE)and Functional Gait Assessment(FGA)before and after treatment. Results The intra-group effect(F>96.618,P<0.001)and interaction effect(F>5.444,P<0.01)were significant in mean longitudinal velocity and mean horizontal velocity.The intra-group effect(F>177.671,P<0.001),inter-group effect(F>3.761,P<0.05)and interaction effect(F>7.555,P<0.001)were significant in movement el-lipse area and movement length both with eyes open and closed.The intra-group effect(F>221.902,P<0.001)and interaction effect(F>7.586,P<0.001)were significant in the time of 10MWT,and the scores of BBS,FMA-LE and FGA;and the inter-group effect were significant in FGA score(F=5.258,P<0.01).Post Hoc test showed that all the indicators were better in the combined group and the visual deprivation group than in the con-trol group(P<0.05);as well as in the proprioceptive training group than in the control group(P<0.05)except mean longitudinal velocity with eyes open,mean horizontal velocity with eyes closed,and movement length with eyes open;while all the indicators were better in the combined group than both in the visual deprivation group and the proprioceptive training group(P<0.05);there was no significant difference between the visual depriva-tion group and the proprioceptive training group for all the indicators(P>0.05). Conclusion Both visual deprivation training and proprioceptive training can improve balance,lower limb motor function and walking of hemiplegic stroke patients,and the combination is more effective.

Objective To study the effect of respiratory muscle weakness on the activity of swallowing-related muscle groups during swallowing in stroke patients with dysphagia by surface electromyography(sEMG),and to investigate the correlation between activity of swallowing-related muscle groups and respiratory muscle function.Methods A total of forty patients with dysphagia after stroke who met the inclusion criteria from December 2022 to October 2023 at Jiangsu Shengze Hospital of Nanjing Medical University were selected as the research group,and another 15 healthy individuals with matched data were selected as the control group.Maximum inspiratory pressure(MIP)and maximum expiratory pressure(MEP)of all subjects were assessed using a pulmonary function tester.The 40 stroke patients were divided into non-respiratory muscle weakness group(MIP≥70%and/or MEP≥70%of predicted values)of 15 patients and respiratory muscle weakness group(MIP<70%and MEP<70%of predicted values)of 25 patients based on the results of MEP and MIP tests.sEMG was used to collect the signals from the submental muscles and infra-hyoid muscles on both the healthy and affected sides of all subjects while swallowing 5 mL of water.The root mean square values and peak amplitudes were compared among the three groups and between the healthy and affected sides,and a correlation analysis was performed between the sEMG signals and respiratory muscle function in the study group.Results MIP and MEP of the respira-tory muscle weakness group were significantly lower than those of the non-respiratory muscle weakness group and the control group(P<0.05).The root mean square and peak amplitude of sEMG signals from submental muscles of the affected side in the respiratory muscle weakness group were significantly lower than those in the non-respiratory muscle weakness group and the control group(P<0.05),and the peak amplitude of sEMG signals from submental muscles of the healthy side in the respiratory muscle weakness group was significantly lower than that of the control group(P<0.05).The root mean square and peak amplitude of the sEMG sig-nals from the submental muscles on the affected side in the respiratory muscle weakness group were significantly lower than those on the healthy side(P<0.05).The root mean square and peak amplitude of the submental muscles on the affected side,and the peak amplitude of the submental muscles on the healthy side were significant and positively correlated with MIP(r=0.366,r=0.415,r=0.317,P<0.05).The root mean square and peak amplitude of the affected submental muscles,the healthy submental muscles and the affected infrahyoid muscles were positively correlated with MEP(r=0.534,r=0.595,r=0.332,r=0.455,r=0.323,r=0.375,P<0.05).Conclusion Patients with post-stroke dysphagia who have respiratory muscle weakness exhibit a significant decrease in the strength of the submental muscle group,and there is a correlation between swallowing-related muscle group activity and respiratory muscle function in stroke patients with dysphagia.