口腔感觉功能包括本体感觉对脑卒中患者吞咽的影响。

IF 2.4 4区 医学 Q1 REHABILITATION American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-08-01 Epub Date: 2025-02-04 DOI:10.1097/PHM.0000000000002702
So-Hyun Park, Dae-Hoon Ham, Joon-Ho Shin
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引用次数: 0

摘要

目的:探讨脑卒中患者口腔感觉缺损及其与咀嚼和吞咽的关系。设计:本前瞻性观察研究在一家康复医院的脑卒中科室进行。纳入标准为首次卒中伴单侧病变。患者接受了口腔感觉测试,包括触觉(轻触,两点辨别)和本体感觉,以及通过视频透视吞咽研究(VFSS)和咀嚼和吞咽固体测试(TOMASS)进行咀嚼和吞咽评估。结果:36例患者中,对侧口腔感觉功能(轻触、两点辨别和唇部本体感觉)较同侧下降(p = 0.003, p = 0.001, p = 0.046)。口腔本体感觉与咀嚼、吞咽呈负相关。舌本体感觉值与咀嚼量呈负相关(p = 0.035),牙、唇、舌本体感觉值与每次吞咽时间呈负相关。对侧轻触和两点辨别影响TOMASS的吞咽项目和VFSS的咽相项目。结论:脑卒中患者表现为对抗性口腔感觉障碍,与咀嚼和吞咽功能受损有关。口腔本体感觉与咀嚼和吞咽相关,而触觉与咽相相关。
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Impact of Oral Sensory Function Including Proprioception on Swallowing in Patients With Stroke.

Objective: The aim of the study was to assess oral sensory deficits and their correlation with mastication and swallowing in patients with stroke.

Design: This prospective observational study was conducted in the stroke unit of a rehabilitation hospital. The inclusion criterion was first occurrence of stroke with a unilateral lesion. Patients underwent oral sensory tests, including tactile sensation (light touch, two-point discrimination) and proprioception, along with mastication and swallowing assessments via videofluoroscopic swallowing study and Test of Masticating and Swallowing Solids.

Results: Among 36 patients, contralesional sides exhibited reduced oral sensory function (light touch, two-point discrimination, and proprioception of lips) compared with ipsilesional sides ( P = 0.003, P = 0.001, P = 0.046, respectively). Oral proprioception was negatively correlated with mastication and swallowing. Proprioception of tongue showed negative correlation with mastication ( P = 0.035), while combined value of proprioception of teeth, lip, and tongue showed negative correlation with time per swallow. Contralesional light touch and two-point discrimination influenced swallow items in Test of Masticating and Swallowing Solids and pharyngeal phase items in videofluoroscopic swallowing study.

Conclusions: Patients with stroke demonstrated contralesional oral sensory deficits, which were associated with impaired mastication and swallowing. Oral proprioception was correlated with mastication and swallowing, whereas tactile sensation correlated with the pharyngeal phase.

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来源期刊
CiteScore
4.60
自引率
6.70%
发文量
423
审稿时长
1 months
期刊介绍: American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).
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