Study of transcutaneous neuromuscular electrical stimulation (vitalstim) therapy for post-stroke dysphagia

Li L, Li Y, Huang R, Yin J, Shen Y, Shi J.

Eur J Phys Rehabil Med. 2014 Jul 23.

Abstract

BACKGROUND:

Dysphagia is not uncommon after stroke. Dysphagia may delay the functional recovery and substantially affects the quality of life after stroke, mainly if lest untreated. To detect and treat dysphagia as early as possible is critical for patients’ recovery after stroke. Electrical stimulation has been reported as a treatment for pharyngeal dysphagia in recent studies, but the therapeutic effects of neuromuscular electrical stimulation(VitalStim) therapy lacks convincing supporting evidence, needs further clinical investigation.

AIM:

To investigate the effects of neuromuscular electrical stimulation (VitalStim) and traditional swallowing therapy on recovery of swallowing difficulties after stroke.

DESIGN:

Randomized controlled trial.

SETTING:

University hospital.

POPULATION:

135 stroke patients who had a diagnosis of dysphagia at the age between 50–80.

METHODS:

135 subjects were randomly divided into three groups: traditional swallowing therapy(n=45), VitalStim therapy (n=45), and VitalStimtherapy plus traditional swallowing therapy (n=45). The traditional swallowing therapy included basic training and direct food intake training. Electrical stimulation was applied by an occupational therapist, using a modified hand–held battery–powered electrical stimulator (VitalStim® Dual Channel Unit and electrodes, Chattanooga Group, Hixson, TN, USA). Surface electromyography (sEMG), the Standardized Swallowing Assessment (SSA), Videofluoroscopic Swallowing Study (VFSS) and visual analog scale (VAS) were used to assess swallowing function before and 4 weeks after the treatment.

RESULTS:

118 subjects with dysphagia completed the study, 40 in the traditional swallowing therapy group and VitalStim therapy group, 38 in the VitalStim and traditional swallowing therapy group. There were significant differences in sEMG value, SSA and VFSS scores in each group after the treatment (P<.001). After 4–week treatment, sEMG value (917.1±91.2), SSA value (21.8 ± 3.5), Oral transit time (0.4 ± 0.1) and Pharyngeal transit time (0.8±0.1) were significantly improved in the VitalStim and traditional swallowing therapy group than the other two groups (P<.001).

CONCLUSION:

Data suggest that VitalStim therapy coupled with taditional swallowing therapy may be beneficial for post–stroke dysphagia.

CLINICAL REHABILITATION IMPACT:

VitalStim therapy coupled with taditional swallowing therapy can improve functional recovery for post–strokedysphagia.

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