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The Effects of Electrical Stimulation Pulse Duration on Lingual Palatal Pressure Measures During Swallowing in Healthy Older Adults

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Abstract

Limited research in swallowing physiology has suggested that the most common existing transcutaneous electrical stimulation (TES) protocol (VitalStim) may not penetrate to layers of tissue to affect deep swallowing muscles. TES amplitude is the primary parameter that determines the depth of electrical current penetration (DECP). Preliminary work suggests that replacing a long-pulse duration with a short-pulse duration can increase maximum amplitude tolerance (MAT) within subjects’ comfort level. Increasing MAT may indicate a higher DECP. The current study evaluates this premise in reference to the effects of varying pulse duration on lingual-palatal pressure during swallowing. Thirty healthy older adults (60–70 years of age) participated in this study. Each subject swallowed three trials of 10 mL pudding under three TES conditions: no stimulation, short-pulse duration, and long-pulse duration. TES was delivered using two pairs of surface electrodes on the submental muscles. MAT and perceived discomfort levels were identified separately for short and long-pulse TES conditions. Lingual-palatal peak pressure, pressure integral, and pressure duration were measured under each condition. Two-way repeated measures ANOVAs were conducted to identify within subject effects of TES condition and tongue bulb location. Lingual-palatal pressure and pressure integral were significantly reduced in the short-pulse duration condition. MAT was significantly higher in the short-pulse duration versus the long-pulse duration condition. Furthermore, MAT was significantly correlated with lingual-palatal pressure. Changing pulse duration had no significant impact on tongue pressure duration. Results suggest that a short-pulse duration may penetrate deeper into muscles involved in swallowing. The specific impact is reflected in a reduced upward pressure of the tongue on the palate during swallowing. This ‘restrictive’ effect of TES on tongue pressure may have the potential to be used during a resistive exercise paradigm for tongue elevation during swallowing.

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Funding

This study was partially supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR001427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Speech Pathology and Audiology Program, Swallowing Physiology & Rehabilitation Research Laboratory, School of Health Sciences, Kent State University, PO Box 5190, Kent, OH, 44242-0001, USA

    Ali Barikroo

  2. Department of Speech, Language, and Hearing Sciences, Upper Airway Dysfunction Lab, Gainesville, FL, USA

    Karen Hegland

  3. Department of Communication Sciences and Disorders, Swallowing Research Laboratory, University of Central Florida, Orlando, USA

    Giselle Carnaby & Michael Crary

  4. Department of Physiological Sciences, University of Florida, Gainesville, USA

    Donald Bolser

  5. Institute on Aging and the Department of Aging and Geriatric Research, University of Florida, Gainesville, USA

    Todd Manini

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  1. Ali Barikroo
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Correspondence to Ali Barikroo.

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Barikroo, A., Hegland, K., Carnaby, G. et al. The Effects of Electrical Stimulation Pulse Duration on Lingual Palatal Pressure Measures During Swallowing in Healthy Older Adults. Dysphagia 34, 529–539 (2019). https://doi.org/10.1007/s00455-019-09991-y

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