{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:05:36Z","timestamp":1780031136332,"version":"3.53.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To observe the clinical efficacy of electromyography (EMG)-guided targeted mecobalamin injections for treating dysphagia resulting from medullary paralysis and to investigate effective dysphagia management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study was a prospective randomized controlled trial. A total of 110 patients with dysphagia due to post-stroke bulbar palsy were enrolled at Baoding No.1 Central Hospital from February 2017 to December 2020. Patients were randomly assigned using a random number table to either a control group (\n                      <jats:italic>n<\/jats:italic>\n                      = 55) receiving conventional pharmacotherapy combined with rehabilitation training, or a treatment group (\n                      <jats:italic>n<\/jats:italic>\n                      = 55) receiving the same conventional therapy plus additional EMG-guided targeted injections of mecobalamin into the swallowing muscles. Swallowing function was assessed using the Wada water swallowing test (WST) and videofluoroscopic swallowing study (VFSS) after 2 weeks of treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The treatment group showed a significantly higher overall response rate on the WST than the control group (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Based on VFSS, the marked and overall effectiveness rates were 50.9% and 96.4% in the treatment group, respectively, significantly higher than the corresponding rates of 18.2% and 83.6% in the control group (both\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). The incidence of aspiration decreased significantly in both groups post-treatment (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05), with a more pronounced reduction observed in the treatment group (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EMG-guided targeted injection of mecobalamin into swallowing muscles is an effective adjunctive strategy for enhancing swallowing function in patients with dysphagia due to post-stroke medullary paralysis.<\/jats:p>\n                  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