Emerging modalities in dysphagia rehabilitation: neuromuscular electrical stimulation.
OBJECTIVE
The aim of this review article is to advise the New Zealand medical community about the application of neuromuscular electrical stimulation (NMES) as a treatment for pharyngeal swallowing impairment (dysphagia). NMES in this field of rehabilitation medicine has quickly emerged as a widely used method overseas but has been accompanied by significant controversy.


METHODS
Basic information is provided about the physiologic background of electrical stimulation. The literature reviewed in this manuscript was derived through a computer-assisted search using the biomedical database Medline to identify all relevant articles published until from the initiation of the databases up to January 2007. The reviewers used the following search strategy: [(deglutition disorders OR dysphagia) AND (neuromuscular electrical stimulation OR NMES)]. In addition, the technique of reference tracing was used and very recently published studies known to the authors but not yet included in the database systems were included.


CONCLUSIONS
This review elucidates not only the substantive potential benefit of this treatment, but also potential key concerns for patient safety and long term outcome. The discussion within the clinical and research communities, especially around the commercially available VitalStim stimulator, is objectively explained.
Huckabee
Maggie-Lee
ML
Department of Communication Disorders at University of Canterbury and the Van der Veer Institute for Parkinson's and Brain Research, Christchurch. maggie-lee.huckabee@canterbury.ac.nz
Doeltgen
Sebastian
S
D000075202:Contraindications; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D006801:Humans; D017933:Peripheral Nervous System / Q000502:physiology