title: The effects of surface neuromuscular electrical stimulation on post-stroke dysphagia: a systemic review and meta-analysis.
abstract: OBJECTIVE
  In this study, we intended to evaluate whether swallow treatment with neuromuscular electrical stimulation is superior to that without neuromuscular electrical stimulation, and whether neuromuscular electrical stimulation alone is superior to swallow therapy.
  
  
  METHODS
  We searched the PubMed and Scopus databases from their earliest record to 31 December 2014 for randomized and quasi-randomized controlled trials that used neuromuscular electrical stimulation to treat post-stroke dysphagia. The Jadad scale was used to assess the quality of the included studies. We extracted the mean differences and standard deviation (SD) between baseline and posttreatment or posttreatment mean and SD for selected outcomes measured in the experimental and control groups for subsequent meta-analyses.
  
  
  RESULTS
  Eight studies were identified. For the comparison "swallow treatment with neuromuscular electrical stimulation vs. swallow treatment without neuromuscular electrical stimulation," we found a significant standardized mean difference (SMD) of 1.27 (95% confidence interval (CI) = 0.51-2.02, P = 0.001) with significant heterogeneity (I(2) = 85%). The meta-analysis for the comparison of neuromuscular electrical stimulation alone and swallow therapy demonstrated a non-significant SMD of 0.25 (95% CI = -0.16-0.65, P = 0.23) without significant heterogeneity (I(2) = 16%).
  
  
  CONCLUSIONS
  Swallow treatment with neuromuscular electrical stimulation seems to be more effective than that without neuromuscular electrical stimulation for post-stroke dysphagia in the short term considering the limited number of studies available. Evidence was insufficient to indicate that neuromuscular electrical stimulation alone was superior to swallow therapy.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipai, Taiwan.
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipai, Taiwan Institute of Injury Prevention and Control, Taipei Medical University, Taipai, Taiwan.
authors.forename: Kwang-Hwa
authors.initials: KH
authors.lastname: Chang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Hung-Chou
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Biostatistics Center, China Medical University, Taichung, Taiwan.
authors.forename: Wen-Miin
authors.initials: WM
authors.lastname: Liang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipai, Taiwan.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipai, Taiwan Institute of Injury Prevention and Control, Taipei Medical University, Taipai, Taiwan semitune@gmail.com.
authors.forename: Yen-Nung
authors.initials: YN
authors.lastname: Lin
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D004599:Electric Stimulation Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000175:diagnosis; D013624:Taiwan; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Stroke; dysphagia; electrical stimulation; neuromuscular