Neuromuscular electrical stimulation combined with swallowing training for dysphagia after stroke

Abstract

Objective To investigate the effects of neuromuscular electrical stimulation (NMES) combined with swallowing training for relieving dysphagia in stroke patients.Methods A total of 150 chronic stroke patients at least 3 months post-stroke who were afflicted with dysphagia were randomly and evenly divided into a conventional swallowing training group,an NMES group,and an NMES combined with conventional swallowing training group.Prior to and after treatment,surface electromyography (sEMG) signals from the swallowing muscles were detected,swallowing function was evaluated using the standardized swallowing assessment (SSA),their swallowing was studied videofluoroscopically (VFSS),and a swallowing-related quality of life questionnaire (SWAL-QOL) was administered.Results There were significant differences in the maximum amplitude of sEMG signals,and the scores on the SSA,VFSS and SWAL-QOL in both groups between prior to and after treatment.After 4 weeks of treatment,the maximum amplitude of the sEMG signals and all three assessment scores were significantly higher where NMES had been combined with conventional swallowing training group compared with the other two groups.Indeed,there was no significant difference between the group which had received conventional swallowing training and the NMES groups.The analysis of coefficients revealed correlation between sEMG maximum amplitude and the SSA,VFSS and SWALQOL results.Conclusions NMES combined with conventional swallowing training is helpful for improving swallowing function in chronic stroke patients with dysphagia. Key words: Dysphagia; Neuromuscular electrical stimulation; Swallowing; Stroke