Objective To explore the effect of oral sensorimotor therapy (OSMT), acupuncture, and low frequency electrical stimulation on salivation in patients with cerebral palsy.Methods From September, 2014 to October, 2015, 80 cerebral palsy patients with salivation were recruited. They were randomly divided into four treatment groups: group A was treated with OSMT, group B was treated with acupuncture, group C was treated with frequency electrical stimulation, and group D was treated with acupuncture and low frequency electrical stimulation, for eight weeks. Meanwhile, 20 cerebral palsy patients with salivation from outpatients were chosen as control group.Results There was no improvement in the root mean square (RMS) value of surface electromyography (sEMG) after treatment in both the control group and group A (t<1.668, P>0.05), and the RMS value significantly improved in the groups B, C and D (t>8.983, P<0.001). There was no significant difference in the salivation score and RMS value between the control group and group A (W=389.5, t=2.041, P>0.05), and they was better in the groups B, C and D than in the control group and group A (W>226.0, t>8.534, P<0.01), as well as in group D than in groups B and C (W>306.0, t>3.663, P<0.05).Conclusion Acupuncture and low frequency electrical stimulation could effectively improve salivation in children with cerebral palsy, and their combination was superior to either ones, while OSMT did not show obvious benefit.
WANG Li-jiang
,
LIU Qiu-yan
,
LIU Bin
,
HOU Mei
. Effect of Acupuncture Combined with Low Frequency Electrical Stimulation on Cerebral Palsy Salivation [J]. Chinese Journal of Rehabilitation Theory and Practice, 2016
, 22(12)
: 1442
-1441
.
DOI: 10.3969/j.issn.1006-9771.2016.12.017
[1] Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006 [J]. Dev Med Child Neurol Suppl, 2007, 109: 8-14.
[2] 中国康复医学会儿童康复专业委员会, 中国残疾人康复协会小儿脑性瘫痪康复专业委员会,《中国脑性瘫痪康复指南》编委会. 中国脑性瘫痪康复指南(2015)：第一部分[J] 中国康复医学杂志, 2015, 30(7): 747-754.
[3] Chang SC, Lin CK, Tung LC, et al. The association of drooling and health-related quality of life in children with cerebral palsy [J]. Neuropsychiatr Dis Treat, 2012, 8: 599-604.
[4] Reid SM, McCutcheon J, Reddihough DS, et al. Prevalence and predictors of drooling in 7- to 14-year-old children with cerebral palsy: a population study [J]. Dev Med Child Neurol, 2012, 54(11): 1032-1036.
[5] Alrefai AH, Aburahma SK, Khader YS. Treatment of sialorrhea in children with cerebral palsy: a double-blind placebo controlled trial [J]. Clin Neurol Neurosurg, 2009, 111(1): 79-82.
[6] Hegde AM, Pani SC. Drooling of saliva in children with cerebral palsy-etiology, prevalence, and relationship to salivary flow rate in an Indian population [J]. Spec Care Dentist, 2009, 29(4): 163-168.
[7] Hustad KC, Gorton K, Lee J. Classification of speech and language profiles in 4-year-old children with cerebral palsy: a prospective preliminary study [J]. J Speech Lang Hear Res, 2010, 53(6): 1496-1513.
[8] Santos MT, Ferreira MC, Leite MF, et al. Salivary parameters in Brazilian individuals with cerebral palsy who drool [J]. Child Care Health Dev, 2011, 37(3): 404-409.
[9] 李晓捷,唐久来,马丙祥,等. 脑性瘫痪的定义、诊断标准及临床分型[J]. 中华实用儿科临床杂志, 2014, 29(19): 1520.
[10] Ciftci T, Akinci D, Yurttutan N, et al. US-guided botulinum toxin injection for excessive drooling in children [J]. Diagn Interv Radiol, 2013, 19(1): 56-60.
[11] Thomas-Stonell N, Greenberg J. Three treatment approaches and clinical factors in the reduction of drooling [J]. Dysphagia, 1988, 3(2): 73-78.
[12] Lee ZI, Cho DH, Choi WD, et al. Effect of botulinum toxin type a on morphology of salivary glands in patients with cerebral palsy [J]. Ann Rehabil Med, 2011, 35(5): 636-640.
[13] Moller E, Pedersen SA, Vinicoff PG, et al. Onabotulinumtoxin A Treatment of Drooling in Children with Cerebral Palsy: A Prospective, Longitudinal Open-Label Study [J]. Toxins (Basel), 2015, 7(7): 2481-2493.
[14] 李林. 小儿脑性瘫痪流涎症康复治疗研究进展[J]. 中国康复理论与实践, 2009, 15(9): 804-806.
[15] 侯梅,姜艳平,杨会娟. 脑瘫患儿吞咽障碍和口运动特点及其临床评定[J]. 中华物理医学与康复杂志, 2011, 33(12): 953-955.
[16] 侯梅,傅平,张红,等. 脑瘫患儿口运动障碍的治疗方法与疗效评价[J]. 中国康复理论与实践, 2004, 10(1): 57-58.
[17] Arvedson J, Clark H, Lazarus C, et al. The effects of oral-motor exercises on swallowing in children: an evidence-based systematic review [J]. Dev Med Child Neurol, 2010, 52(11): 1000-1013.
[18] Li L, Li Y, Huang R, et al. The value of adding transcutaneous neuromuscular electrical stimulation (VitalStim) to traditional therapy for post-stroke dysphagia: a randomized controlled trial [J]. Eur J Phys Rehabil Med, 2015, 51(1): 71-78.
[19] 徐燕忠. 康复训练治疗吞咽困难63例[J]. 中华物理医学与康复杂志, 2003, 25(1): 60-60.
[20] 段华林,张惠佳,颜华,等. 神经肌肉电刺激治疗脑瘫患儿流涎症的临床观察[J]. 中国康复理论与实践, 2010, 16(5): 453-454.
[21] Hu X, Rymer WZ, Suresh NL. Assessment of validity of a high-yield surface electromyogram decomposition [J]. J Neuroeng Rehabil, 2013, 10: 99.
[22] Supuk TG, Skelin AK, Cic M. Design, development and testing of a low-cost sEMG system and its use in recording muscle activity in human gait [J]. Sensors (Basel), 2014, 14(5): 8235-8258.
[23] 肖灵君,薛晶晶,燕铁斌,等. 表面肌电图在吞咽功能评估中的信度研究[J]. 中国康复医学杂志, 2014, 29(12): 1155-1158.
[24] Disselhorst-Klug C, Schmitz-Rode T, Rau G. Surface electromyography and muscle force: limits in sEMG-force relationship and new approaches for applications [J]. Clin Biomech (Bristol, Avon), 2009, 24(3): 225-235.
[25] Walshe M, Smith M, Pennington L. Interventions for drooling in children with cerebral palsy [J]. Cochrane Database Syst Rev, 2012, 11: CD008624.
