Immediate effects of transcutaneous electrical stimulation on physiological swallowing effort in older versus young adults.
OBJECTIVE
This study compared the immediate impact of different transcutaneous electrical stimulation (TES) amplitudes on physiological swallowing effort in healthy older adults versus young adults.


BACKGROUND
Swallowing physiology changes with age. Reduced physiological swallowing effort in older adults including lower lingua-palatal and pharyngeal pressures may increase risk for swallowing dysfunction (i.e. dysphagia). Transcutaneous electrical stimulation (TES) has been advocated as an adjunctive modality to enhance outcomes in exercise-based therapy for individuals with dysphagia. However, significant variation in how TES is applied during therapy remains and the physiological swallowing response to TES is poorly studied, especially in older adults.


METHODS
Physiological change in swallowing associated with no stimulation, sensory stimulation and motor stimulation was compared in 20 young adults versus 14 older adults. Lingua-palatal and pharyngeal manometric pressures assessed physiological swallowing effort.


RESULTS
Multivariate analyses identified interactions between age and stimulation amplitude on lingual and pharyngeal functions. Motor stimulation reduced anterior tongue pressure in both age groups but selectively reduced posterior lingua-palatal pressures in young adults only. Sensory stimulation increased base of tongue (BOT) pressures in older adults but decreased BOT pressures in young adults. Motor stimulation increased hypopharyngeal pressures in both groups.


CONCLUSIONS
Age and TES level interact in determining immediate physiological responses on swallow performance. A one-size-fit-all approach to TES in dysphagia rehabilitation may be misdirected.
Speech Pathology/Audiology Department, Bauru Dental School, University of São Paulo, São Paulo, Brazil.
Giédre
G
Berretin-Felix
Swallow Research Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
Isaac
I
Sia
Swallow Research Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
Ali
A
Barikroo
Swallow Research Laboratory, Department of Behavioral Science and Community Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
Giselle D
GD
Carnaby
Swallow Research Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
Michael A
MA
Crary
D000328:Adult; D000367:Age Factors; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders; D006801:Humans; D015999:Multivariate Analysis; D014059:Tongue; D004561:Transcutaneous Electric Nerve Stimulation; D055815:Young Adult
age effects; deglutition; dysphagia; transcutaneous electrical stimulation