Swallowing disorders are commonly observed in multiple sclerosis (MS) patients. The complications of dysphagia are common causes of morbidity and death in late stages of MS. However, dysphagia in MS usually receives limited attention. The purpose of this study was to determine the prevalence of different kinds of swallowing disorders in MS patients with mild to moderate disability; and to identify possible associations between clinical and demographic features of patients and the presence of dysphagia. The swallowing functions of 101 consecutive MS patients were screened by the Northwestern Dysphagia Patient Check Sheet. This is a screening test which identifies patients with pharyngeal stage disorders, aspiration, oral stage disorders and/or pharyngeal delay. 'Dysphagia' was defined as having at least one of the above mentioned four disorders. Among 101 MS patients, 32 (31.7%) were classified as having dysphagia. Pharyngeal stage disorders were the most common observed impairment (28.7%) and aspiration, oral stage disorders, and pharyngeal delay were observed in 6.9%, 5%, and 1% of patients, respectively. Dysphagic patients had a significantly longer disease duration (p = 0.031) and more neurological impairment in cerebellar functional system (p = 0.04) when compared with non-dysphagic patients. Moreover, dysphagia was significantly more prevalent in patients with more neurological disability as measured by Expanded Disability Status Scale (EDSS) scores (p = 0.04). These results emphasize the importance of assessment and management of swallowing function in MS patients, particularly in patients with a high EDSS score; more severe cerebellar dysfunction, and long disease duration.

Neuromuscular electrical stimulation (NMES) for treating dysphagia is a relatively new therapeutic method. There is a paucity of evidence about the use of NMES in patients with dysphagia caused by stroke. The present review aimed to introduce and discuss studies that have evaluated the efficacy of this method amongst dysphagic patients following stroke with emphasis on the intensity of stimulation (sensory or motor level) and the method of electrode placement on the neck. The majority of the reviewed studies describe some positive effects of the NMES on the neck musculature in the swallowing performance of poststroke dysphagic patients, especially when the intensity of the stimulus is adjusted at the sensory level or when the motor electrical stimulation is applied on the infrahyoid muscles during swallowing.

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Purpose Swallowing physiology exhibits several changes in advanced ages. The present study aimed to investigate and compare effects of a period of the head lift exercise (HLE) and neuromuscular electrical stimulation (NMES) on swallowing muscles activity in healthy elderly. Patients and methods A total of 23 older adults were randomized to either the HLE or NMES group for ten therapy sessions. They received pre- and post-therapy surface electromyography (sEMG) during water swallowing. Results For the HLE group, duration of suprahyoid muscles activity was significantly reduced at post-intervention compared to pre-intervention ( p =0.036). Moreover after treatments, duration and latency between onset and peak amplitude of suprahyoid muscles activity was significantly shorter in the HLE group compare to the NMES group (respectively, p =0.007 and p =0.003). Conclusion Our findings suggest that the HLE, against the NMES, may be effective in reducing some aging effects on the suprahyoid muscles activity, especially in elders who demonstrate prolonged duration and latency between onset and peak of the suprahyoid muscles activity during swallowing.

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