Electrical neuromuscular stimulation in dysphagia: current status

Purpose of review To assess current information regarding the physiological effects of transcutaneous electrical stimulation (TES) on the neck and current evidence regarding the clinical effects of adding TES to dysphagia rehabilitation. Recent findings Physiological studies have demonstrated that when electrical stimulation is applied on the throat it will lower the hyo-laryngeal complex and resist elevation needed for airway protection during swallowing. Submental TES has not been found to effectively elevate the hyo-laryngeal complex. Recent controlled clinical trials have had mixed results. Most indicate that TES is beneficial in the treatment of dysphagia; however, studies differ on whether these effects are greater than, equal to, or less than traditional therapy alone for the rehabilitation of swallowing. Summary Currently TES for dysphagia is one of several tools available to the clinician for the rehabilitation of dysphagia. The two controlled clinical trials demonstrate that use of TES in dysphagia therapy is equivalent to traditional dysphagia therapy and of greater benefit only on one of several measures in one study. TES should be used only in patients who can overcome the resistive lowering of the hyo-laryngeal complex induced by TES which could place severely affected patients at greater risk of penetration.