Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial

Lim, Kil-Byung; Lee, Hong-Jae; Lim, Sung-Shick; Choi, Yoo-Im

doi:10.2340/16501977-0317

Cited by 137 publications

(128 citation statements)

References 7 publications

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“…While some studies 1,3,[8][9][10][11][12][13][14][15][16] show benefits in the pathophysiology of swallowing in patients with oropharyngeal dysphagia submitted to NMES, others [5][6][7] report the absence of physiological and functional changes resulting from these stimuli. It must be said that even the publications that demonstrate positive results present questionable methodological designs in scientific relevance.…”

Section: Discussionmentioning

confidence: 99%

“…The scientific literature about the therapeutic effectiveness of NMES in dysphagia is still controversial, lying since studies [5][6][7] that does not correlate improvement of biomechanic of swallowing as a result of its use, as well as studies that verified this biomechanic optimization and, consequently of dysphagia 1,3,[8][9][10][11][12][13][14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

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O efeito da eletroestimulação neuromuscular na contração da musculatura supra-hióidea durante a deglutição de indivíduos com disfagia

et al. 2016

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Purpose: the purpose of this study is to verify the effect of Neuromuscular Electrical Stimulation on the suprahyoid muscle activity during swallowing, in post stroke subjects, with oropharyngeal dysphagia. Methods: participated eight post-stroke subjects with dysphagia, male and female, referred to speech--language therapy to early swallowing rehabilitation. Before the first rehabilitation session, the patient´s muscular electrical activity of suprahyoid muscle was measured using Surface Electromyography Biofeedback. Patients were randomly divided into two groups: Experimental Group (n=4): patients who received both traditional speech-language therapy and the application of Neuromuscular Electrical Stimulation. Control Group (n=4): patients submitted to traditional speech-language therapy. After eight sessions, all patients measured the suprahyoid activity with the Surface Electromyography Biofeedback. The pre and post treatment results were compared in both groups. Results: comparing the two groups average of time and amplitude of the muscle contraction during swallowing of saliva and two swallows of paste, no statistically significant differences were observed in the pre and post treatment values. Conclusion: the use of Neuromuscular Electrical Stimulation on the parameters and methodology used did not prove efficient in promoting greater contraction of the suprahyoid muscles during the swallowing, in post-stroke individuals with oropharyngeal dysphagia. The data obtained may be due to the methodology used in this study relative to the protocol application and the way to measure the results. Keywords: Transcutaneous Electric Nerve Stimulation; Deglutition Disorders; Stroke; Speech Therapy; Electromyography RESUMO Objetivo: verificar o efeito da Eletroestimulação Neuromuscular na contração da musculatura supra--hióidea durante a deglutição em indivíduos pós-Acidente Vascular Cerebral com disfagia orofarín-gea. Métodos: participaram da pesquisa oito indivíduos pós-Acidente Vascular Cerebral com disfagia, de ambos os sexos, encaminhados para terapia fonoaudiológica com objetivo de trabalhar a função da deglutição, em início de processo terapêutico. Anteriormente ao início da primeira sessão, foi realizada a mensuração do tempo e amplitude da atividade elétrica muscular através da Eletromiografia de Superfície de Biofeedback. Os pacientes foram divididos aleatoriamente em dois grupos: Grupo Experimental (n=4): pacientes que receberam a fonoterapia tradicional e aplicação da Eletroestimulação Neuromuscular; Grupo Controle (n=4): pacientes que receberam a fonoterapia tradicional. Após oito sessões, todos os pacientes passaram novamente pela Eletromiografia de Superfície de Biofeedback para verificar a atividade elétrica da musculatura supra-hióidea. Os registros dos exames pré e pós intervenção foram comparados nos dois grupos. Resultados: comparando-se as médias das variáveis de amplitude e tempo da atividade elétrica muscular durante a deglutição de saliva e nas duas deglutições de pastoso, não foram obse...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

O efeito da eletroestimulação neuromuscular na contração da musculatura supra-hióidea durante a deglutição de indivíduos com disfagia

et al. 2016

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“…Both therapies have brought gains in the biomechanics of swallowing, but the associated NMES therapy showed better results when compared to traditional therapy in two studies 25,26 . In one study 27 , the two groups subjected to treatment showed benefits to participants, but there was no statistically significant difference between the two.…”

Section: Electrostimulation Of the Effect On Swallowing Biomechanics mentioning

confidence: 99%

“…Three researches with evidence levels 2B [25][26][27] with post stroke dysphagia patients compared the NMES therapy effect associated with traditional therapy in the treatment of oropharyngeal dysphagia with traditional therapy. Both therapies have brought gains in the biomechanics of swallowing, but the associated NMES therapy showed better results when compared to traditional therapy in two studies 25,26 .…”

Section: Electrostimulation Of the Effect On Swallowing Biomechanics mentioning

confidence: 99%

Uso da eletroestimulação na clínica fonoaudiológica: uma revisão integrativa da literatura

et al. 2015

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Resumo: Este trabalho tem como objetivo apresentar revisão integrativa de literatura sobre a aplicabilidade e o resultado do uso da eletroestimulação na prática clínica fonoaudiológica. Foram seguidos os preceitos do Cochrane Handbook, que envolveu a formulação da questão a ser investigada, localização e seleção dos estudos e avaliação crítica dos artigos. Foram utilizadas as bases de dados Medical Literature Analysis and Retrieval Sistem on-line (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), PubMed e Web of Science/ISI. Os descritores utilizados foram: "estimulação elétrica nervosa transcutânea", "estimulação elétrica", "disfagia", "transtornos de deglutição", "disfonia", "distúrbios da voz", "treinamento da voz" e "terapia por estimulação elétrica" em inglês, português e espanhol e suas combinações, no período entre 2003 e 2013. Os estudos analisados demonstraram que a eletroestimulação traz benefícios na reabilitação de pacientes na clínica fonoaudiológica, mas a metodologia utilizada nos estudos foi divergente e a população estudada muito heterogênea o que dificulta sua utilização clínica pelos profissionais da área. A eletroestimulação traz benefícios na reabilitação fonoaudiológica, porém novos estudos devem ser realizados utilizando uma amostra mais homogênea e descrevendo metodologia e técnicas fonoaudiológicas utilizadas nos procedimentos, a fim de comprovar seus resultados e viabilizar seu uso pelos profissionais da área.

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“…Aspiration can then lead to aspiration pneumonia, which accounts for approximately 34% of stroke related deaths, as well as cause complications such as choking, bronchospasm, increased infection rate, dehydration and nutritional compromise [6].…”

Section: Doi: 107243/2054-1945-5-1mentioning

confidence: 99%

Role of modified Barium Swallow Pre and Post VitalStim therapy In the rehabilitation of the swallowing mechanism

Darwish¹,

Kamel²,

Jeady³

et al. 2017

Med Imaging Radiol

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Aim: Of our study is to evaluate the efficacy of transcutaneous electrical stimulation (Vitalstim therapy) to treat patients with dysphagia and to determine the impact of the modified barium swallow study (MBSS) on patient management. Material and methods: From June 2014 to April 2016, seventy three patients with dysphagia were included. All the patients underwent pre vitalstim-therapy evaluation by speech-language pathologists, including clinical evaluation of swallowing and modified barium swallow study (MBSS). In MBSS we evaluate the following, delay in oropharyngeal swallowing phase, closure of epiglottis, laryngeal elevation, passage of contrast behind the epiglottis that denoting penetration, presence of aspiration and presence residual barium after swallowing. After VitalStim therapy, all patients underwent MBSS assessments and also underwent a follow up survey months (range, 1 to 6 months) after their therapy to assess whether the improvement was worthwhile and sustained. Results: In our study our 73 patients showing radiological findings denoting neurological swallowing disorders, 65 patients (89%) showing delay in oropharyngeal swallowing phase, weak laryngeal elevation found in 58 patients (79%) , 68 patients (93%) showing aspiration and 70 cases (96%) showing penetration and incomplete closure of the epiglottis. Presence of residual barium after swallowing within the vallecula was seen in 68 patients (93%). 52 of the 73 patients (71%) showing complete improvement at first follow up study after VitalStim therapy. 21 of the 73 patients (29%) showing some improvement and need another therapy sessions and in the next follow up study 15 cases showing complete improvement. However, 7 cases of the 21 patients having severe dysphagia before therapy, only 2 of 7 showed any improvement, and these patients still required a feeding tube for adequate nutrition, however, the 5 of 7 showing complete improvement after another session of therapy. Conclusion: We conclude that the modified barium swallow is valuable in the rehabilitation of patient with swallowing disorders helps speech pathologist to identify and modify swallowing abnormalities as well as management program. We also conclude that VitalStim therapy is effective and safe in the treatment of patients suffering with the swallowing difficulties.

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Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial

Abstract: The results suggest that neuromuscular electrical stimulation combined with thermal-tactile stimulation is a better treatment for patients with swallowing disorders after stroke than thermal-tactile stimulation alone.

Cited by 137 publications

References 7 publications

O efeito da eletroestimulação neuromuscular na contração da musculatura supra-hióidea durante a deglutição de indivíduos com disfagia

O efeito da eletroestimulação neuromuscular na contração da musculatura supra-hióidea durante a deglutição de indivíduos com disfagia

Uso da eletroestimulação na clínica fonoaudiológica: uma revisão integrativa da literatura

Role of modified Barium Swallow Pre and Post VitalStim therapy In the rehabilitation of the swallowing mechanism

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