Mendelsohnmaneuver 门德尔松法 Hans Bogaardt MSc, speech-pathologist Department Otolaryngology Academic Medical Center University AmsterdamAmsterdam dysphagia在治疗吞咽困难的时候采用生物反馈和电刺激 How Mendelsohn…如何采用门德尔松… Goal目的: Patient has increased control over suprahyoidal muscles 加强患者对舌骨上肌的控制能力 Verbal explenation 口头解释 Normalswallowing 正常的吞咽 Laryngealexcursion 喉移动 Patient feels (normal) swallowing 病人体会(正常的)吞咽 Patientsown laryngeal movement 病人具有正常的喉移动 therapist:normal swallow 治疗师:正常吞咽 therapist:Mendelsohn maneuver 治疗师:门德尔松法 Step Connectpatient equipment让病人和医生都与仪器连接 channelEMG 1或2频道EMG Demonstratesurface-EMG 示范表面EMG musclesarm biofeedback做生物反馈 Armmuscles, stick out tongue 臂肌,吐舌 tongueagainst palate 按压舌头使其顶往上颚 explainexplicitly 明确解释 negativepractice 相反练习Step patientmake high-pitchvoice /iiii/让病人发高音 ‘pharyngealsqueeze’ “咽挤压” FEESST-protocolFEESST方法 (Aviv, 2001) Letpatient feel changes neck让病人感觉到颈部肌肉的变化 Watchdifferences EMGmonitor 观察EMG检测器的信号变化 Repeatseveral times 重复几次 Step ‘Laryngeallift’ Liftlarynx wihtout making sound... 提拉喉同时不发出声音 Tactilefeedback, visual feedback 触觉反馈,视觉反馈 Rapidrepetitions 快速重复 rapidversion Shaker-HeadTilt 振动器头倾斜的快速视像 Step Showpatient what happens swallowing让病人看看在吞咽的时候会发生什么 Tactilefeedback 触觉反馈 Visualfeedback 视觉反馈 Auditoryfeedback 听觉反馈 patientswallow directlyafter let him contract muscles neck让病人吞咽,动作完成之后即刻让他收缩颈部肌肉 Mendelsohn-manoeuvre