4.6 Article

Neuromuscular electrical stimulation improves swallowing initiation in patients with post-stroke dysphagia

Journal

FRONTIERS IN NEUROSCIENCE
Volume 16, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fnins.2022.1011824

Keywords

neuromuscular electrical stimulation (NMES); delayed swallowing initiation; stroke; rehabilitation; VFSS

Categories

Funding

  1. National Natural Science Foundation of China
  2. Medical Scientific Research Foundation of Guangdong Province
  3. [81401872]
  4. [A2022240]

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This study aimed to investigate the immediate effect of neuromuscular electrical stimulation (NMES) on swallowing initiation in post-stroke patients. The results showed that the Modified Barium Swallow Impairment Profile-6 (MBSImp-6) and Penetration-Aspiration Scale (PAS) scores were significantly lower in the real NMES condition. Oral transit time (OTT) was also significantly shorter during real NMES. This suggests that NMES may be a supplementary approach for promoting early feeding training in post-stroke patients with dysphagia.
Objective: More than half of post-stroke patients develop dysphagia, which manifests as delayed swallowing and is associated with a high risk of aspiration. In this study, we aimed to investigate the immediate effect of neuromuscular electrical stimulation (NMES) on swallowing initiation in post-stroke patients using videofluoroscopic swallowing study (VFSS) data.Materials and methods: This randomized, self-controlled crossover study included 35 patients with post-stroke dysphagia. All selected patients received real and sham NMES while swallowing 5 ml of thin liquid. Participants completed the conditions in random order, with a 10-min interval between conditions. The primary evaluation indicators included the Modified Barium Swallow Impairment Profile-6 (MBSImp-6) and Penetration-Aspiration Scale (PAS). Secondary indicators included oral transit time (OTT), pharyngeal transit time (PTT), and laryngeal closure duration (LCD).Results: Modified Barium Swallow Impairment Profile-6 (P = 0.008) and PAS (P < 0.001) scores were significantly lower in the Real-NMES condition than in the Sham-NMES condition. OTT (P < 0.001) was also significantly shorter during Real-NMES than during Sham-NMES. However, LCD (P = 0.225) and PTT (P = 0.161) did not significantly differ between the two conditions.Conclusion: Neuromuscular electrical stimulation may represent a supplementary approach for promoting early feeding training in patients with post-stroke dysphagia.

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