Preliminary outcomes in transcutaneous neuromuscular electrical stimulation use in patients with dysphagia

Abstract

Dysphagia is a common disorder associated with a large number of etiologies like aging, stroke, traumatic brain injury, head and neck cancer, neurodegenerative disorders, structural changes or congenital abnormalities. The type of the treatment and its results depend on the type, severity and the cause of dysphagia. The primary goal of dysphagia treatment is to improve the swallowing process and decrease the risk of aspiration. Along with the existing rehabilitation swallowing treatments, new adjunctive therapy options developed, one of them being the neuromuscular electrical stimulation (NMES). The authors present the principles of NMES, a small literature review about the results of this therapy and their experience in using transcutaneous NMES in dysphagia patients.

Effectiveness of Different Application Parameters of Neuromuscular Electrical Stimulation for the Treatment of Dysphagia after a Stroke: A Systematic Review

“…Most of the analysed investigations applied NMES with short impulses (700 µs) [ 28 , 29 , 30 , 31 , 32 , 33 , 35 , 40 , 41 ]. However, some studies used longer impulses (between 300 [ 27 ] and 800 ms [ 44 ]), which also obtained benefits; this could be due to the daily application of the treatment or to what has been suggested by Sarafoleanu [ 59 ], who stated that, with low-intensity and long impulses, it is possible to increase the recruitment of the motor units.…”

“…It is important to take into account that this is a controversial aspect of the application of NMES, since its administration, combined with simultaneous voluntary contraction, has been previously tested by Vanderthommen and Duchateau [ 53 ], who concluded that these two methods should not be used together due to the high metabolic demand caused by such a combination and to the possible fatigue that it could cause in the muscle fibres. On the other hand, Sarafoleanu and Enache [ 59 ] concluded that the combination of these two treatments induced greater muscular adaptations. The results obtained in this review are in line with the conclusions of the latter authors.…”