Electrical stimulation of hyoid muscles in post-stroke dysphagia

Abstract

Aims. The purpose of this study was to evaluate swallowing changes in post-stroke patients with dysphagia after four weeks of suprahyoid muscles electrical stimulation. Methods. This was a prospective randomized study of early stage stroke patients with dysphagia. Electrical stimulation of suprahyoid muscles was given to a group of 54 patients (26 men, average age 70 years) for 20 minutes a day, 5 days a week. Standard orofacial rehabilitation without electrical stimulation was carried out on a control group of 54 patients (31 men, average age 69 years). Swallowing was evaluated at the beginning of the study and at the end, by videofluoroscopy -measuring the time for oral and pharyngeal phases. Results. The difference in duration of oral transit time (OTT) after the therapy between the study group (average: 0.55 ± 0.01) and the control group (average: 0.29 ± 0.03) was statistically significant (P=0.01). Difference in duration of the pharyngeal transit time (PTT) after the therapy between the study group (average: 0.37 ± 0.02) and control group (average: 0.15 ± 0.02) was also statistically significant (P=0.009). Conclusion. Electrical stimulation of suprahyoid muscles significantly reduced the duration of the oral and pharyngeal phases: in the post-stroke patients with dysphagia used in this study. The result is improved swallowing. This is a recently recommended approach and your study confirms its efficacy.

<p>Effectiveness of Neuromuscular Electrical Stimulation on Post-Stroke Dysphagia: A Systematic Review of Randomized Controlled Trials</p>

“… Both IEMT and NMES were associated with improvement in pharyngeal swallowing security signs at the end of the intervention, but the effect did not persist at 3-month follow-up and no differences in respiratory complications were detected between treatment groups and controls. Konecny et al (2018) 40 A total 108 post-stroke patients: EG = 54; CG = 54 Mean age (years): EG = 70 (7.3); CG = 69 (8.2) Time since onset (days): not stated EG = received NMES of the suprahyoid muscles with a frequency of 60 Hz for 20 min a day, five days a week. CG = received standard OFR without ES VFSS OTT PTT The difference in duration of OTT after the therapy between the EG and CG was statistically significant (P=0.01).…”

“…This might be explained by the reversibility of the training effect and/or the natural evolution of dysphagia. 43,44 A study done by Konecny et al (2018) 40 showed that improvement of swallowing times (OTT and PTT) was significantly better in intervention group (NMES) compared to control groups. Despite this fact, the oral and PTTs improvement was observed in both groups after 4 weeks of therapy.…”

“…Out of 11 studies, 10 of them (n=748) confirmed that NMES had increased swallowing function of post-stroke dysphagia patients compared to the control groups in all outcome measures. 30,[33][34][35][37][38][39][40] However, one study (n=36) indicated that the NMES had no observed differences between the experimental and control groups. 36…”

“…Of all included studies, 6 studies evaluated swallowing function by using PAS. 30,[34][35][36]38,39 Four studies evaluated swallowing function by using VFDS, 30,32,38,40 and only three studies used FDS. 34,35,38…”

“…32,34,36,39 Five studies had lost to adequate follow up, 30,[32][33][34][35] and six studies were assessed using intention to treat analysis. 30,31,34,39,40 For all included studies the potential source of bias was blinding the participant, therapist, and assessor.…”