Transcutaneous Neuromuscular Electrical Stimulation (VitalStim) Curative Therapy for Severe Dysphagia: Myth or Reality?

Shaw, Gary Y.; Sechtem, Phillip R.; Searl, Jeff; Keller, K.; Rawi, Taib A.; Dowdy, Emily

doi:10.1177/000348940711600107

Cited by 104 publications

(84 citation statements)

References 18 publications

(19 reference statements)

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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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“…Unlike the routine barium swallow in which only the esophageal stage of swallowing is studied, using the modified barium swallow all four stages of swallowing are studied with particular emphasis on the oral and pharyngeal stages [9]. It is a fluoroscopic procedure designed to determine whether food or liquid is entering a person's lungs, also known as aspiration.…”

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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“…Demonstrate the beneficial effects of NMES on the biomechanics and the physiology of swallowing and oral intake and rehabilitation of dysphagic individuals by different etiologies was the object of five studies, with respective levels of evidence 2B, 2B, 3A, 4, 2B [29][30][31][32][33] that used heterogeneous samples, involving subjects following stroke, Parkinson's disease, cranial trauma, cerebral atrophy, head and neck tumors, among others. All studies have demonstrated satisfactory results, and in one of them 29 61% of patients had improvement in swallowing, 33% had no more use of the feed tube being 6% (severe dysphagia) improved but still required to continue feeding by the feed tube.…”

Section: Effect Of Electrical Stimulation In Subjects Without Vocal Dmentioning

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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Transcutaneous Neuromuscular Electrical Stimulation (VitalStim) Curative Therapy for Severe Dysphagia: Myth or Reality?

Cited by 104 publications

References 18 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

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

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

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