Abstract
Objective To observe the effect of neuromuscular electrical stimulation (NMES) at different intensities on functional swallowing and the velocity of hyolaryngeal excursion in post-stroke dysphagia. Methods Thirty stroke survivors with dysphagia were randomly divided into a control group, an NMES group and an intensive NMES group, each of 10. All 3 groups received conventional swallowing training, while the patients in the NMES group also received NMES at 30~80 Hz in an intensity of ≤25 mA once a day and those in the intensive NMES group received it twice a day. Before, as well as 2 and 4 weeks after the treatment, video fluoroscopy when swallowing pap was used to determine the superior and anterior excursion distances of the hyoid and larynx and the excursion′s duration and the corresponding velocity. A water drinking test (WDT) was also administered, and dysphagia severity scale (DSS) and penetration-aspiration scale (PAS) ratings were assessed. Results After the treatment, significant improvement was observed in the average WDT, DSS and PAS scores of all three groups compared to before the treatment. The average WDT score of the intensive NMES group was significantly better than that of the control group after 2 weeks of treatment. After 2 and 4 weeks of treatment, the average DSS of the intensive NMES group was significantly better than that of the control group, while the intensive NMES group′s average PAS score was significantly better than those of both of the other groups. The average anterior hyoid excursion velocity of the intensive NMES group was significantly faster than those of the other two groups after both 2 and 4 weeks of treatment. Pearson correlation analysis indicated that the PAS score was significantly correlated with the anterior hyoid excursion velocity. Conclusion Two NMES sessions a day are superior to only one session in improving functional swallowing after stroke. It better promotes quick movement of the body parts involved. Key words: Neuromuscular electrical stimulation; Dysphagia; Penetration-aspiration scale; Videofluoroscopy; Stroke
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