| 【Objective】The purpose of this study was to investigate the effects of picture visual stimulation-assisted motor imagery training on swallowing function,appetite level,and quality of life in patients with swallowing disorders in acute ischemic stroke.【Methods】In this study,a class experimental research method was used to select 100 patients with acute ischemic stroke swallowing disorder from the wards of the Department of Neurology,Second Affiliated Hospital of Hainan Medical College,according to strict nadir criteria from December 1,2019 to December 31,2020,and they were divided into intervention and control groups according to the odd or even number of ward numbers.Patients in both groups received conventional treatment and care for acute ischemic stroke in the Department of Neurology.Patients in the control group received 14 days of swallowing organ movement combined with pharyngeal icteric sensory stimulation training,and patients in the intervention group received 14 days of picture visual stimulation-assisted motor imagery combined with pharyngeal icteric sensory stimulation training.Patients in both groups were evaluated by SSA scale and WST rating before,on day 7 and 14 of the intervention,appetite level by SNAQ and quality of life by SWAL-QOL before and on day 14 of the intervention.To investigate the effects of visual stimulation-assisted motor imagery training on swallowing function,appetite and quality of life in patients with swallowing disorders in acute ischemic stroke.【Results】1.Comparison of swallowing function before and after intervention: the results of repeated measures ANOVA showed that the intervention effect of SSA score was statistically different between the intervention group and the control group(F=12.704,P=0.001),and the time trend graph showed that the SSA score of both groups decreased with the increase of intervention time,but the decreasing trend was more significant in the intervention group than in the control group;indicating that by SSA scale evaluation,picture visual stimulation-assisted motor imagery combined with pharyngeal icteric sensory stimulation training was more effective in improving the patients’ swallowing function,and the longer the intervention time,the lower the SSA score and the more obvious the improvement of swallowing function.The results using generalized estimating equations showed no statistically significant difference in WST ratings between the two groups before and after the intervention(Wald χ2 =1.972,P > 0.05,OR = 0.612,95% CI = 0.308 ～ 1.215),indicating that picture visual stimulation-assisted motor imagery combined with pharyngeal ice-acid sensory stimulation training did not have a significant effect on patients’ WST rating outcomes.The non-parametric Wilcoxon signed rank sum test was used to compare the WST rating results of the two groups of patients on day 7 and day 14 of the intervention,and the results showed that on day 7 of the intervention,there was no statistical difference in the WST rating of the intervention group compared to the control group(Z=-1.693,P >0.05);on day 14 of the intervention,there was a statistical difference in the WST rating of the intervention group compared to the control group,and the results of the intervention group were better than those of the control group(Z=-2.027,P <0.05);indicating that the picture visual stimulation-assisted motor imagery combined with pharyngeal icteric sensory stimulation training was not significant in improving the swallowing function of the patients by WST evaluation at day 7 of the intervention,and the swallowing function improvement at day 14 of the intervention was significant.2.Comparison of appetite level after the intervention: the simplified appetite questionnaire score of the intervention group was better than that of the control group(t=1.498,P<0.05),indicating that picture visual stimulation-assisted motor imagery combined with pharyngeal ice-acid sensory stimulation training could better improve the appetite level of the patients.3.Comparison of post-intervention dysphagia-specific quality of life scores: the total dysphagia-specific quality of life score was better in the intervention group than in the control group(Z=7.889,P<0.01),as evidenced by improved appetite(t=17.663,P<0.01),time to eat(Z=-2.708,P=0.007),social interaction(t=7.836,P<0.01),psychological burden(t=13.180,P<0.01),fear(t=8.959,P<0.01),mental health(t=5.776,P<0.01),sleep(t=2.125,P=0.036),and fatigue(Z=-5.7,P<0.01)dimensions of quality of life were better than the control group(P<0.05);while in symptom frequency(t=1.709,P=0.091),food choice(Z=-1.304,P=0.192),and verbal communication(t=1.620,P=0.109)dimensions,there was no statistical difference between the two groups.It indicates that picture visual stimulation assisted motor imagery combined with pharyngeal icteric sensory stimulation training can better improve the overall quality of life level of patients,with more significant effects in the dimensions of appetite,eating time,social interaction,psychological burden,fear,mental health,sleep,and fatigue.4.Comparison of patient satisfaction: After the end of the intervention,the satisfaction scores of patients in both groups were compared,and the intervention group was higher than the control group(t=2.871,P<0.05).This indicates that the patients were more satisfied with the picture visual stimulation-assisted motor imagery combined with pharyngeal icteric sensory stimulation training method.【Conclusions】1.Picture visual stimulation-assisted motor imagery combined with pharyngeal ice-acid sensory stimulation improves swallowing function in patients with acute ischemic stroke swallowing disorder.2.Picture visual stimulation-assisted motor imagery combined with pharyngeal icteric sensory stimulation improved appetite levels in patients with acute ischemic stroke swallowing disorder.3.Picture visual stimulation-assisted motor imagery combined with pharyngeal icteric sensory stimulation improved the quality of life of patients with acute ischemic stroke swallowing disorder,with more significant improvements in the dimensions of appetite,eating time,social interaction,psychological burden,fear,mental health,sleep,and fatigue.4.Patients were more satisfied with picture visual stimulation assisted motor imagery combined with pharyngeal icteric sensory stimulation training. |
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