Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study.
OBJECTIVE
To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI).


METHODS
Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated.


RESULTS
There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks.


CONCLUSIONS
The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.
Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.
Kyung Rok
0000-0003-3798-4878
KR
Ko
Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.
Hee Jung
0000-0002-8389-1480
HJ
Park
Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.; Department of Nanobiomedical Science & BK21 Plus NBM Research Center for Regenerative Medicine, Dankook University, Cheonan, Korea.; Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Korea.
Jung Keun
0000-0001-9254-4424
JK
Hyun
Voice & Speech Clinic, Department of Otorhinolaryngology-Head & Neck Surgery, Dankook University College of Medicine, Cheonan, Korea.
In-Hyo
0000-0002-2665-661X
IH
Seo
Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.
Tae Uk
0000-0001-9904-8781
TU
Kim
Brain injuries; Deglutition disorders; Dysphonia; Electrical stimulation therapy; Stroke