Combined Effects of NMES and Mendelsohn Maneuver on the Swallowing Function and Swallowing-Quality of Life of Patients with Stroke-Induced Sub-Acute Swallowing Disorders.

Haewon Byeon

doi:10.3390/biomedicines8010012

Abstract

It is necessary to identify how to improve the swallowing-related quality of life, as well as the swallowing function, in order to evaluate the effect of treatments on swallowing disorders. This study aimed to prove the effects of a compound swallowing intervention (Mendelsohn maneuver + neuromuscular electrical stimulation (NMES)) on the swallowing function and the quality of life by applying the compound swallowing intervention to patients with sub-acute swallowing disorders due to cerebral infarction for eight weeks. This study analyzed 43 subjects who were diagnosed with swallowing disorders due to cerebral infarction. The experiment consisted of the Mendelsohn maneuver treatment group (n = 15), the NMES treatment group (n = 13), the compound intervention group (Mendelsohn maneuver + NMES; n = 15). The results of ANCOVA showed that the changes in Functional Dysphagia Scale (FDS) scores and Swallowing–Quality of Life (SWAL–QOL) score were different among groups. The compound intervention group had the highest FDS scores and SWAL–QOL score followed by Mendelsohn, and the NMES group had the lowest. The result of this study suggests that NMES can be more effective when it is combined with a traditional swallowing rehabilitation therapy rather than a single intervention method.

Highlights

Stroke is very like to have sequelae, even if surgical treatment is successfully conducted and the patient survives
Special attention should be given to patients with acute cerebral infarction, because they are highly likely to experience aspiration, which means that food passes through the airway
Functional Dysphagia Scale (FDS) (Table 2) and SWAL–QOL (Table 3) of the Mendelsohn intervention group, the neuromuscular electrical stimulation (NMES) group, and the compound intervention group were compared by using one-way ANOVA for analyzing pre-homogeneity

Summary

Introduction

Stroke is very like to have sequelae, even if surgical treatment is successfully conducted and the patient survives. The onset rate of swallowing disorders is the highest. Previous studies have reported that the onset rate of swallowing disorders in patients with acute cerebral infarction varies greatly, ranging from 37% to 65% [1,2]. Special attention should be given to patients with acute cerebral infarction, because they are highly likely to experience aspiration, which means that food passes through the airway. 20% of patients with cerebral infarction die from aspiration pneumonia within a year from the onset; it was reported that one in three patients with sub-acute cerebral infarction and aspiration had silent aspiration, which showed no observable symptom [3]. Active swallowing rehabilitation is needed from the onset of a swallowing disorder, to maintain the life of the patient

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