Adjunctive neuromuscular electrical stimulation for treatment-refractory dysphagia.
OBJECTIVE
Neuromuscular electrical stimulation (NMES) has been proposed as an adjunctive modality for the treatment of swallowing disorders. We present data from a prospective case series to define and measure effects of a systematic therapy for chronic pharyngeal dysphagia using adjunctive NMES.


METHODS
Six adult patients with pharyngeal dysphagia received 15 sessions of a standardized protocol of swallowing exercises with adjunctive NMES. The patients completed clinical and instrumental baseline, posttreatment, and 6-month follow-up evaluations. Outcome measures included the proportion of patients who improved in clinical swallowing ability, functional oral intake, and change in body weight; patient perception of swallowing ability; and changes in kinematic aspects of swallowing.


RESULTS
Significant change was demonstrated for clinical swallowing ability (p < .042), functional oral intake (p < .02), weight gain (p < .026), and patient perception of swallowing ability (p < .043). Hyoid and laryngeal elevation during swallowing demonstrated bolus-specific patterns of change. No patient experienced a treatment-related or swallowing-related complication. Patients (4 of 5) who were followed out to 6 months after treatment maintained functional gains.


CONCLUSIONS
A systematic therapy for chronic pharyngeal dysphagia using adjunctive NMES produced improvement in clinical swallowing ability and functional oral intake without significant weight loss or complications.
Carnaby-Mann
Giselle D
GD
Department of Behavioral Science and Community Health, College of Public Health and Health Professions, University of Florida, 101 S Newell Dr, PO Box 100175, Gainesville, FL 32610, USA.
Crary
Michael A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000628:therapy*; D004599:Electric Stimulation Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009469:Neuromuscular Junction / Q000502:physiology; D009752:Nutritional Status; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain