Skip to main content

Advertisement

SpringerLink
Log in

Electrical, taste, and temperature stimulation in patients with chronic dysphagia after stroke: a randomized controlled pilot trial

  • Original article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

Abstract

The objective of present study was compare a traditional swallowing therapy program with a new combined swallowing therapy program including neuromuscular electrical stimulation in patients with oropharyngeal dysphagia after stroke. This pilot study included eight patients with chronic oropharyngeal dysphagia after stroke. These patients underwent traditional therapy with gustative-thermic-tactile stimulation (group A), or a new combined program adding neuromuscular electrical stimulation (group B). Study participants were evaluated before and after the intervention using fiberoptic endoscopic evaluation of swallowing with temporal measures of posterior oral spillage and whiteout time, functional oral intake scale and a visual analog scale classifies an individual’s swallowing ability. The two groups did not differ in terms of posterior oral spillage time, whiteout time and functional oral intake scale. Subjects in group B exhibited significant increases in visual analog scale scores. However, both groups demonstrated improvement with decreases in posterior oral spillage time, increased whiteout time, and increased functional oral intake scale and visual analog scale scores. There was no difference in the parameters studied in both therapeutic programs in individuals with chronic oropharyngeal dysphagia after stroke.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data and code that support the findings of this study are available from the corresponding author, upon reasonable request.

References

  1. Schelp AO, Cola PC, Gatto AR, Silva RG, Carvalho LR (2004) Incidência de disfagia orofaríngea após acidente vascular encefálico em hospital público de referência. Arq Neuropsiquiatr 62:503–506

    Article  PubMed  Google Scholar 

  2. Clavé P, Shaker R (2015) Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol 12:259–270

    Article  PubMed  Google Scholar 

  3. Bath PM, Lee HS, Everton LF (2018) Swallowing therapy for dysphagia in acute and subacute stroke. Cochrane Database Syst Rev 10:CD000323

    PubMed  Google Scholar 

  4. Cola PC, Gatto AR, Silva RG, Spadotto AA, Schelp AO, Henry MACA (2010) The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke. Arq Gastroenterol 47:18–21

    Article  PubMed  Google Scholar 

  5. Hamdy S, Jilani S, Price V, Parker C, Hall N, Power M (2003) Modulation of human swallowing behavior by thermal and chemical stimulation in health and after brain injury. Neurogastroenterol Motil 15:69–77

    Article  CAS  PubMed  Google Scholar 

  6. Rofes L, Cola PC, Clavé P (2014) The effects of sensory stimulation on neurogenic oropharyngeal dysphagia. J Gastroenterol Hepatol Res 3:937–938

    Google Scholar 

  7. Miura Y, Morita Y, Koizumi H, Shingai T (2009) Effects of taste solutions, carbonation, and cold stimulus on the power frequency content of swallowing submental surface electromyography. Chem Senses 34:325–331

    Article  PubMed  Google Scholar 

  8. Bove M, Mansson I, Eliasson I (1998) Thermal oral-pharyngeal stimulation of swallowing. Acta Otolaryngol (Stockh) 118:728–731

    Article  CAS  Google Scholar 

  9. Bülow M, Speyer R, Baijens L, Woisard V, Ekberg O (2008) Neuromuscular electrical stimulation (NMES) in stroke patients with oral and pharyngeal dysfunction. Dysphagia 23:302–309

    Article  PubMed  Google Scholar 

  10. Diéguez-Pérez I, Leirós-Rodríguez R (2020) Effectiveness of different application parameters of neuromuscular electrical stimulation for the treatment of dysphagia after stroke: a systematic review. J Clin Med 9:2618

    Article  PubMed Central  CAS  Google Scholar 

  11. Permsirivanich W, Tipchatyotin S, Wongchai M, Leelamanit V, Setthawatcharawanich S, Sathirapanya P, Phabphal K, Juntawises U, Boonmeeprakob A (2009) Comparing the effects of rehabilitation swallowing therapy vs neuromuscular electrical stimulation therapy among stroke patients with persistent pharyngeal dysphagia: a randomized controlled study. J Med Assoc Thai 92:259–265

    PubMed  Google Scholar 

  12. Lim KB, Lee HJ, Lim SS, Choi YI (2009) Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial. J Rehabil Med 41:174–178

    Article  PubMed  Google Scholar 

  13. Heijnem BJ, Speyer R, Baijens LW, Bogaardt HC (2012) Neuromuscular electrical stimulation versus traditional therapy in patients with Parkinson’s disease and oropharyngeal dysphagia: effects on quality of life. Dysphagia 27:335–345

    Google Scholar 

  14. Lam P, Stanschus S, Zaman R, Cichero JAY (2017) The international dysphagia diet standardisation initiative (IDDSI) framework: the Kempen pilot. BJNN/Stroke Assoc Suppl 1:S18–S26

    Google Scholar 

  15. Dua KS, Ren J, Bardan E, Xie P, Shaker R (1997) Coordination of deglutitive glottal function and pharyngeal bolus transit during normal eating. Gatroenterology 112:73–83

    Article  CAS  Google Scholar 

  16. Logemann JA, Rademaker AW, Pauloski BR, Ohmae Y, Kahrilas PJ (1998) Normal swallowing physiology as viewed by videofluoroscopy and videoendoscopy. Folia Phoniatr Logop 50:311–319

    Article  CAS  PubMed  Google Scholar 

  17. Van Daele DJ, McCulloch TM, Palmer PM, Langmore SE (2005) Timing of glottic closure during swallowing: a combined electromyographic and endoscopic analysis. Ann Otol Rhinol Laringol 114:478–487

    Article  Google Scholar 

  18. Mozzanica F, Lorusso R, Robotti C, Zambon T, Corti P, Pizzorni N, Vanderwegen J, Schindler A (2019) Effect of age, sex, bolus volume, and bolus consistency on whiteout duration in health subjects during FEES. Dysphagia 34:192–200

    Article  PubMed  Google Scholar 

  19. Spadotto AA, Gatto AR, Cola PC, Montagnoli AN, Schelp AO, Silva RG et al (2008) Software para análise quantitativa da deglutição. Radiol Bras 41:25–28

    Article  Google Scholar 

  20. Crary MA, Carnaby-Mann GD, Groher ME (2005) Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil 86:1516–1520

    Article  PubMed  Google Scholar 

  21. Sun S, Hsu C, Lin H, Sun H, Chang P, Hsieh W, Wang J (2013) Combined neuromuscular electrical stimulation (NMES) with fiberoptic endoscopic evaluation of swallowing (FEES) and traditional swallowing rehabilitation in the treatment of stroke-related dysphagia. Dysphagia 28:557–566

    Article  CAS  PubMed  Google Scholar 

  22. Lazarus C, Logemann JA, Gibbons P (1993) Effects of maneuvers on swallowing function in a dysphagic oral cancer patient. Head Neck 15:419–424

    Article  CAS  PubMed  Google Scholar 

  23. Bülow M, Olsson R, Ekberg O (1999) Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers. Dysphagia 14:67–72

    Article  PubMed  Google Scholar 

  24. Meng P, Zhang S, Wang Q, Wang P, Han C, Gao J, Yue S (2018) The effect of surface neuromuscular electrical stimulation on patients with post-stroke dysphagia. J Back Musculoskelet Rehabil 31:363–370

    Article  PubMed  Google Scholar 

  25. Frost J, Robinson F, Hibberd J (2018) A comparison of neuromuscular electrical stimulation and traditional therapy, versus traditional therapy in patients with longstanding dysphagia. Curr Opin Otolaryngol Head Neck Surg 26:167–173

    Article  PubMed  Google Scholar 

  26. Carnaby G, Lagorio L, Crary M, Miller D (2012) A randomized double blind trial of neuromuscular electrical stimulation + McNeill dysphagia therapy (MDTP) after stroke (ANSRS). Presentation to the Dysphagia Research Society Annual Meeting. Toronto, Canada. Dysphagia 27:569–620

    Article  Google Scholar 

  27. Baijens LW, Speyer R, Passos VL, Pilz W, Van Der Kruis J, Haamans S, Desjardins-Roumbouts C (2013) Surface electrical stimulation in dysphagic Parkinson patients: a randomized clinical trial. Laryngoscope 123:E38–E44

    Article  PubMed  Google Scholar 

  28. Butler SG, Maslan J, Stuart A, Leng X, Wilhelm E, Lintzenich CR, Williamson J, Kritchevsky SB (2011) Factors influencing bolus dwell times in health older adults assessed endoscopically. Laryngoscope 121:2526–2534

    Article  PubMed  PubMed Central  Google Scholar 

  29. Scheel R, Pisegna JM, McNally E, Noordzij JP, Langmore SE (2016) Endoscopic assessment of swallowing after prolonged intubation in the ICU setting. Ann Otol Rhinol Laryngol 125:43–52

    Article  PubMed  Google Scholar 

  30. Tejima C, Kikutani T, Takahashi N, Tamura F, Yoshida M (2015) Application of simple swallowing provocation test with fiberoptic endoscopic evaluation of swallowing in a cross-sectional study. BMC Geriatrics 15:48

    Article  PubMed  PubMed Central  Google Scholar 

  31. Abe H, Tsubahara A (2011) Observation of arytenoid movement during laryngeal elevation using videoendoscopic evaluation of swallowing. Dysphagia 26:150–154

    Article  PubMed  Google Scholar 

  32. Perlman AL, Van Daele DJ (1993) Simultaneous videoendoscopic and ultrasound measures of swallowing. J Med Speech Lang Pathol 1:223–232

    Google Scholar 

  33. Terré R, Mearin F (2015) A randomized controlled study of neuromuscular electrical stimulation in oropharyngeal dysphagia secondary to acquired brain injury. Eur J Neurol 22:687–696

    Article  PubMed  Google Scholar 

  34. Suntrup-Krueger S, Ringmaier C, Muhle P, Wollbrink A, Kemmling A, Hanning U, Claus I, Warnecke T, Teisman I, Pantev C, Dziewas R (2018) Randomized trial of transcranial direct current stimulation for poststroke dysphagia. Ann Neurol 83:328–340

    Article  PubMed  Google Scholar 

  35. Simonelli M, Ruoppolo G, Iosa M, Morone G, Fusco A, Grasso MG, Gallo A, Paolucci S (2019) A stimulus for eating. The use of neuromuscular transcutaneous electrical stimulation in patients affected by severe dysphagia after subacute stroke: a pilot randomized controlled trial. NeuroRehabilitation 44:103–110

    Article  PubMed  Google Scholar 

  36. Barikroo A, Carnaby G, Crary M (2017) Electrical stimulation therapy for dysphagia: a follow-up survey of USA dysphagia practitioners. Int J Rehabil Res 40:360–365

    Article  PubMed  Google Scholar 

  37. Chen YW, Chang KH, Chen HC, Liang WM, Wang YH, Lin YN (2016) The effects of surface neuromuscular electrical stimulation on post-stroke dysphagia: a systemic review and meta-analysis. Clin Rehabil 30:24–35

    Article  PubMed  Google Scholar 

  38. Winstein C, Lewthwaite R, Blanton SR, Wolf LB, Wishart L (2014) Infusing motor learning research into neurorehabilitation practice: a historical perspective with case exemplar from the accelerated skill acquisition program. Neurol Phys Ther 38:190–200

    Article  Google Scholar 

  39. Bastian AJ (2008) Understanding sensorimotor adaptation and learning for rehabilitation. Curr Opin Neurol 21:628–633

    Article  PubMed  PubMed Central  Google Scholar 

  40. Carnaby-Mann GD, Crary MA (2010) McNeill Dysphagia therapy program: a case-control study. Arch Phys Med Rehabil 91:743–749

    Article  PubMed  Google Scholar 

  41. Arslan SS, Azola A, Sunday K, Vose A, Plowman E, Tabor L, Singer M, Robison R, Humbert IA (2018) Effects of submental surface electrical stimulation on swallowing kinematics in healthy adults: an error-based learning paradigm. Am J Speech-Lang Pathol 27:1375–1384

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank our patients and their family for collaboration. We also thank all the members of the dysphagia team of Hospital Mataró for have share the knowledge.

Funding

This work was support by São Paulo Research Foundation—Fapesp. Process number: 2013/03583-7.

Author information

Authors and Affiliations

  1. Medicine Department, Marília University-UNIMAR, Av. Hygino Muzzi Filho, 1001, Mirante, Cep: 17.525-902, Marília,, São Paulo, Brazil

    Paula Cristina Cola & Claudio José Rubira

  2. Dysphagia Research Rehabilitation Center, Paulista State University-UNESP, Marília, São Paulo, Brazil

    Paula Cristina Cola & Claudio José Rubira

  3. Dysphagia Research Rehabilitation Center, Graduate of Speech, Language and Hearing Sciences Department, Paulista State University-UNESP, Marília, São Paulo, Brazil

    Suely Mayumi Motonaga Onofri & Roberta Gonçalves da Silva

  4. Graduate of Physiotherapy Department, Paulista State University-UNESP, Marília, São Paulo, Brazil

    Cristiane Rodrigues Pedroni

  5. Gastrointestinal Physiology Laboratory, Hospital de Mataró, Mataró, Barcelona, Spain

    Pere Clavé

Authors
  1. Paula Cristina Cola
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suely Mayumi Motonaga Onofri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claudio José Rubira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cristiane Rodrigues Pedroni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pere Clavé
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Roberta Gonçalves da Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

We declare that all authors participated sufficiently in the work to make public their responsibility for its content. PCC principal researcher and research preparation; SMMO data collection and analysis and article writing; CJR statistical design and assistance in writing the article; CRP research preparation and article writing; PC research preparation and article writing; RGS supervisor, research preparation and article writing.

Corresponding author

Correspondence to Paula Cristina Cola.

Ethics declarations

Conflict of interest

All of the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The protocol number is: 1.905.696 from Universidade Estadual Paulista “Júlio de Mesquita Filho”—UNESP—Marília (SP), Brazil.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Study carried out at the Dysphagia Research Rehabilitation Center; Graduate of Speech, Language and Hearing Sciences Department, Paulista State University-UNESP, Marília (SP), Brazil.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 3933 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cola, P.C., Onofri, S.M.M., Rubira, C.J. et al. Electrical, taste, and temperature stimulation in patients with chronic dysphagia after stroke: a randomized controlled pilot trial. Acta Neurol Belg 121, 1157–1164 (2021). https://doi.org/10.1007/s13760-021-01624-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-021-01624-2

Keywords

Search

Navigation