Efficacy of a speaking valve combined with transcranial direct current stimulation for post-stroke dysphagia in tracheostomized patients
10.3760/cma.j.cn115330-20250422-00244
- VernacularTitle:语音阀联合tDCS对卒中气管切开术后吞咽障碍患者的康复效果临床研究
- Author:
Junqiu DU
1
;
Jing SU
;
Xingnan ZHOU
;
Tiantian DAI
;
Hong LIU
;
De HUAI
Author Information
1. 徐州医科大学附属淮安医院（江苏省淮安市第二人民医院）康复医学科，淮安 223022
- Publication Type:Journal Article
- Keywords:
Stroke;
Tracheostomy;
Dysphagia;
Transcranial direct current stimulation (tDCS);
Speaking valve
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(11):1377-1382
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the therapeutic efficacy of combined therapy with a speaking valve and transcranial direct current stimulation (tDCS) for dysphagia in stroke patients post-tracheostomy.Methods:This retrospective case-control study enrolled 120 stroke patients with post-stroke tracheostomy-associated dysphagia, admitted to the Department of Rehabilitation Medicine at Huai′an Second People′s Hospital. Participants were randomly allocated to either a control group [45 males and 15 females, aged from 46 to 78 (65.78±8.68) years]receiving tDCS and conventional rehabilitation or an intervention group [41 males and 19 females, aged from 46 to 79 (66.32±9.18) years]receiving tDCS plus speaking valve therapy, with 60 patients per group. Swallowing function was assessed before and after a 3-week intervention using the Standardized Swallowing Assessment (SSA), Water Swallowing Test (WST) grading, Functional Oral Intake Scale (FOIS), and Swallowing-quality of life score (SWAL-QOL).The SPSS 22.0 was used for statistical analysis.Results:The intervention group demonstrated a significantly higher overall treatment response rate than the control group [95.0%(57/60) vs 78.3%(44/56), χ2=-6.056, P<0.001]. Post-treatment, the intervention group showed significantly greater improvements, as evidenced by a lower SSA score (21.50±1.82 vs 24.92±1.42, t=-11.480, P<0.001) and superior WST grades (observation group: 45 cases at grade 1, 12 cases at grade 2, 5 cases at grade 3; control group: 33 cases at grade 1, 11 cases at grade 2, 16 cases at grade 3, Z=5.484, P<0.001). Furthermore, the intervention group achieved significantly higher FOIS scores (observation group: 1 case at grade 1, 1 case at grade 2, 1 case at grade 4, 8 cases at grade 5, 7 cases at grade 6, 45 cases at grade 7; control group: 2 cases at grade 1, 7 cases at grade 2, 3 cases at grade 3, 4 cases at grade 4, 5 cases at grade 5, 6 cases at grade 6, 33 cases at grade 7, Z=-3.559, P<0.001) and greater improvements in SWAL-QOL scores ( P<0.001), indicating enhanced oral intake and quality of life. Conclusion:The combination of a speaking valve and tDCS effectively promotes the swallowing recovery and improves quality of life in stroke patients with post-tracheostomy dysphagia. This combined modality represents a promising and effective therapeutic strategy for this patient population.
