呼气肌力量训练对帕金森病吞咽功能的影响：来自高分辨率视频测压的见解。
Impact of expiratory muscle strength training on swallowing function in Parkinson's disease: insights from high-resolution videomanometry.
文献信息
| PMID | 42800081 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Fernanda Cristina de Oliveira Rocha |
| 作者单位 | Medical College of Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Digestive Motility Laboratory, Gastroenterology Division of Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Electronic address: fernandarocha@medicina.ufrj.br. |
| 期刊 | Clinics (Sao Paulo, Brazil) |
| SCI 分区 | Q2 |
| IF | 2.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
引言： 呼气肌力量训练（EMST）用于帕金森病（PD）患者口咽性吞咽困难的康复。
材料与方法： 20名PD患者（16名男性）在训练前、训练期间和训练后接受了高分辨率视频测压（HRVM）。
结果： 参与者的平均年龄为68.2 ± 8.5岁，PD分期对应于Hoehn和Yahr 2期（1.0-3.6）。最大呼气压力（MEP）为79.2 ± 24 cmH2O。训练后，喉部抬高和总位移增加（10 mL花蜜；分别为r = 0.46，95% CI [0.8, 8.8]，p = 0.044和r = 0.53，95% CI [1.5, 5.9]，p = 0.018）。此外，在非控制性吞咽期间（花蜜；r = 0.56，95% CI [4.9, 18.6]，p = 0.017），食团内压力（IBP）增加。观察到中度直接和反向相关性。发现上食管括约肌（UES）开放大小与年龄之间存在直接相关性（10 mL花蜜；p = 0.037），以及喉部前移与分期之间存在直接相关性（10 mL花蜜；p = 0.012）。观察到UES开放大小与MEP之间存在反向相关性（10 mL布丁；p = 0.020）。观察到UES松弛时间与分期之间存在直接相关性（10 mL花蜜；p = 0.051），以及非控制性吞咽期间的IBP与分期之间存在直接相关性（p = 0.008）。非控制性吞咽期间UES松弛的最低点与MEP呈直接相关（p = 0.031），与分期呈反向相关（p = 0.005）。
结论： EMST影响喉部位移。疾病分期、年龄和MEP是PD康复期间应分析的相关参数。HRVM是评估EMST在执行期间的影响以及对PD患者吞咽功能影响的综合工具。
英文摘要
INTRODUCTION: Expiratory Muscle Strength Training (EMST) is used for the rehabilitation of oropharyngeal dysphagia in patients with Parkinson's Disease (PD).
MATERIALS & METHODS: Twenty individuals (16-men) with PD underwent High-Resolution Videomanometry (HRVM) before, during, and after training.
RESULTS: Participants' mean age was 68.2 ± 8.5 years, with PD staging corresponding to Hoehn and Yahr stage 2 (1.0-3.6). Maximum Expiratory Pressure (MEP) was 79.2 ± 24 cmH2O. After training, there was an increase in laryngeal elevation and total displacement (10 mL nectar; r = 0.46, 95% CI [0.8, 8.8], p = 0.044 and r = 0.53, 95% CI [1.5, 5.9], p = 0.018, respectively). In addition, Intrabolus Pressure (IBP) increased during uncontrolled swallowing (nectar; r = 0.56, 95% CI [4.9, 18.6], p = 0.017). Moderate direct and inverse correlations were observed. A direct correlation was found between the Upper Esophageal Sphincter (UES) opening size and age (10 mL nectar; p = 0.037), and between laryngeal anteriorization and stage (10 mL nectar; p = 0.012). An inverse correlation was observed between UES opening size and MEP (10 mL pudding; p = 0.020). A direct correlation was observed between UES relaxation time and stage (10 mL nectar; p = 0.051), and between IBP during uncontrolled swallowing and stage (p = 0.008). The nadir of UES relaxation during uncontrolled swallowing showed a direct correlation with MEP (p = 0.031) and an inverse correlation with stage (p = 0.005).
CONCLUSION: EMST influences laryngeal displacement. Disease stage, age, and MEP are relevant parameters that should be analyzed during PD rehabilitation. HRVM is a comprehensive tool for evaluating the impacts of EMST both during execution and on swallowing function in patients with PD.