Neuromuscular electrical stimulation is no more effective than usual care for the treatment of primary dysphagia in children

Christiaanse, Mary E.; Mabe, Betty; Russell, Greg; Simeone, Tanya Long; Fortunato, John E.; Rubin, Bruce

doi:10.1002/ppul.21400

Cited by 53 publications

(44 citation statements)

References 19 publications

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“…33 Neuromuscular electrical stimulation (NMES) Systematic review of evidence showed promising but insufficient evidence with need for high-quality controlled trials; 34 NMES of anterior neck muscles did not improve swallow function more than patients receiving usual oral motor training and dietary manipulations without NMES 35 …”

Section: Oral Appliances or Feeding Devicesmentioning

confidence: 99%

Feeding children with cerebral palsy and swallowing difficulties

2013

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Children with cerebral palsy (CP) are at risk for aspiration with oral feeding with potential pulmonary consequences, and commonly have reduced nutrition/hydration status and prolonged stressful meal times. There is considerable variability in the nature and severity of swallowing problems in these children whose needs change over time. Children with generalized severe motor impairment (for example, spastic quadriplegia) are likely to experience greater swallowing deficits than those with diplegia, but oropharyngeal dysphagia is prevalent even in children with mild CP. This review is focused on dysphagia in children with CP: types of deficits, clinical and instrumental evaluation, management decision making and evidence of effectiveness of interventions.European Journal of Clinical Nutrition (2013) 67, S9-S12; doi:10.1038/ejcn.2013.224Keywords: cerebral palsy; dysphagia; pediatrics; feeding; swallowing INTRODUCTIONChildren with cerebral palsy (CP) commonly have feeding disorders and swallowing problems (dysphagia) that in many instances place them at risk for aspiration with oral feeding, with potential pulmonary consequences. They also commonly have reduced nutrition/hydration status and prolonged stressful meal times. The specific nature and severity of the swallowing problems may differ, at least to some degree, in relation to sensorimotor impairment, gross and fine motor limitations, and cognitive/ communication deficits. Children with generalized severe motor impairment (for example, spastic quadriplegia) are likely to experience greater swallowing deficits 1,2 than those with diplegia, but oropharyngeal dysphagia is prevalent even in children with mild CP. 3 Concerns are multifactorial and include issues of reduced volume of food and liquid consumed orally, nutrition deficits, inadequate hydration and limited range of textures with slow advance of oral skills.Children with moderate-to-severe dysphagia usually are managed most effectively with an interdisciplinary team that allows for multiple factors to be addressed in a coordinated way. These factors include, but are not limited to, gastrointestinal issues, pulmonary status, nutrition/hydration, oral sensorimotor skills, behavioral issues and family interactions. The importance of a structured approach is stressed to handle these multiple problems. 4 It is critical that all decisions for the management of feeding and swallowing problems are made in consideration of the primary needs of the child that is, a stable airway with adequate nutrition and hydration. In addition, any feeding/ swallowing intervention should be pleasurable and non-stressful for patients and care givers. In some instances, tube feeding may be needed either temporarily or long term. [5][6][7][8] It is expected, with rare exceptions, that these children can cope with at least minimal tastes for pleasure, a practice that may have a positive impact on management of saliva/secretions while maintaining oral function and swallowing.This review paper is focused on dysphagia: types of deficit...

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Section: Oral Appliances or Feeding Devicesmentioning

confidence: 99%

Feeding children with cerebral palsy and swallowing difficulties

2013

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“…One recent study evaluated the use of neuro-motor electrical stimulation (NMES) of anterior neck muscles in a heterogeneous group of children with dysphagia [56]. The authors reported that, overall, NMES treatment did not improve the swallow function more than a control intervention.…”

Section: Management Of Pediatric Swallowing Disordersmentioning

confidence: 99%

Pediatric Dysphagia: Physiology, Assessment, and Management

2015

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Infancy and childhood represent a time of unparalleled physical growth and cognitive development. In order for infants and children to reach their linear and neurological growth potential, they must be able to reliably and safely consume sufficient energy and nutrients. Swallowing difficulties (dysphagia) in pediatric populations can have a detrimental effect on dietary intake and, thus, growth and development. As a result, it is imperative to accurately identify and appropriately manage dysphagia in pediatric populations. This article provides an overview of dysphagia in children, as well as common causes of childhood swallowing difficulties, populations at risk for pediatric dysphagia, techniques used to assess swallowing in pediatric patients, and the current treatment options available for infants and children with dysphagia.

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“…[39,40,41,42,43,44]). Others [36,45] suggested a negative effect of electric stimulation on hyolaryngeal elevation [46,47] or found no significant differences between traditional therapeutic methods and NMES [48,49,50,51,52,53]. …”

Section: Dysphagiamentioning

confidence: 99%

Electrical Stimulation in Treatment of Pharyngolaryngeal Dysfunctions

Miller

Jungheim

Kühn

et al. 2013

Folia Phoniatr Logop

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Objective: Neuromuscular electrical stimulation (NMES) has been proposed in the treatment of laryngopharyngeal dysfunctions (dysphonia, dyspnoea, dysphagia) for more than 40 years. Several studies have investigated possible therapeutic effects. Some researchers described favourable results, whereas others did not find relevant benefits. This article aims to review available studies to give an overview regarding the current state of knowledge. Methods: We conducted a selective literature search using PubMed. Results: In total, 356 papers were identified: 6 case reports, 11 reviews, 43 prospective clinical trials and 3 retrospective trials were found. Conclusion: Due to different stimulation protocols, electrode positioning and various underlying pathological conditions, summarizing the present studies appears to be difficult. However, there is evidence that NMES is a valuable adjunct in patients with dysphagia and in patients with vocal fold paresis. Nevertheless, more empirical data is needed to fully understand the benefits provided by NMES. Further research suggestions are put forward.

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Neuromuscular electrical stimulation is no more effective than usual care for the treatment of primary dysphagia in children

Abstract: NMES treatment of anterior neck muscles in a heterogeneous group of pediatric patients with dysphagia did not improve the swallow function more than that seen in patients who did not receive NMES treatment. However, there may be subgroups of children that will improve with NMES treatment.

Cited by 53 publications

References 19 publications

Feeding children with cerebral palsy and swallowing difficulties

Feeding children with cerebral palsy and swallowing difficulties

Pediatric Dysphagia: Physiology, Assessment, and Management

Electrical Stimulation in Treatment of Pharyngolaryngeal Dysfunctions

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