The Impact of Diaphragm Training on Dysphagia in Bulbar Palsy After Ischemic Stroke

Before each feeding, inside and outside of the tube was cleaned with water. During feeding, the patient should maintain a semi-reclining or sitting position with mouth opened, and the tube was inserted slowly and smoothly into the upper part of the esophagus by medical staffs while the appropriate depth of intubation was checked with the calibration markings on the tube wall. The distance from the incisors to the head part of the tube should be between 22-25 cm. However, the specific depth should be evaluated based on patients' feedback and adjusted accordingly. After insertion, the tail part of the tube should be put into a container full of water and the absence of continuous bubbles indicated a successful intubation. Then, the feeding was to be conducted three times per day with 50 ml per minute and 400-600ml for each feeding.

Diaphragm training includes both active and passive methods. Passive training involves placing weights on the participant's abdomen to provide resistance during breathing. Active training involves instructing participants to practice diaphragmatic breathing techniques.

"Including： Basic treatment, including corresponding control of risk factors and education on healthy lifestyles.~Swallowing training, including lemon ice stimulation, mendelson maneuver, empty swallowing training, and pronunciation training.~Pulmonary function training, including standing training, cough training, and diaphragm muscle training."