Acupuncture plus cold stimulation and neuromuscular electrical stimulation for the treatment of swallowing disorders after infantile viral encephalitis

Abstract

Objective To explore the effect of acupuncture plus neuromuscular electrical stimulation and cold stimulation on children with swallowing disorders caused by viral encephalitis. Methods A total of 322 children with dysphagia subsequent to viral encephalitis were randomly divided into an acupuncture + cold stimulation group (group A, n=107), an electrical stimulation + cold stimulation group (group E, n=107) and an acupuncture + electric stimulation + cold stimulation group (group C, n=108) using a random number table. The treatments were applied in two courses each of 14 days with an interval of two days between the courses. Before and after the treatment, the total effectiveness rates and the incidence of aspiration pneumonia and malnutrition were analyzed. The children′s swallowing function was evaluated using a standardized swallowing assessment (SSA), while the severity of dysphagia was assessed using dysphagia outcome and severity scale (DOSS) based on videofluorescopic imaging. Results There were no significant differences in any of the outcome measures before the treatment. Afterward the total effectiveness rate in group A was 76%, significantly higher than in group E (62%) but significantly lower than in group C (91%). There was significant improvement in the average SSA and DOSS scores of all 3 groups. Compared with group A, the average SSA score of group E was higher while the average DOSS score was lower. For group C the relationship was the opposite, with the average SSA score significantly higher and the average DOSS score significantly lower. After the treatment there were no significant differences between groups A and E in the incidence of aspiration pneumonia or malnutrition, but the incidence of both in group C was significantly lower than in groups A and E. Conclusion Acupuncture administered together with electrical and cold stimulation can significantly improve dysphagia and lower the incidence of aspiration pneumonia and malnutrition for children with viral encephalitis. Key words: Encephalitis; Swallowing disorders; Acupuncture; Electrical stimulation; Cold stimulation