Effects of Transcutaneous Neuromuscular Electrical Stimulation on Post-Stroke Dysphagia: A Systematic Review and Meta-Analysis
Frontiers in Neurology
Wang, Y., Xu, L., et al. (2023).
Frontiers in Neurology, 14, 1163045.
<div>This systematic review with meta-analysis investigates the effects of neuromuscular electrical stimulation (NMES) combined with swallowing therapy in individuals with post-stroke dysphagia.</div>
Sichuan Provincial Department of Education Central Guided Local Science and Technology Development Fund Project (China)
From database inception to June 9, 2022
<div>Randomized controlled trials</div>
46
<div>A combination of NMES and swallowing therapy demonstrated significant benefits in individuals with post-stroke dysphagia including:</div>
<div>
<ul>
<li>increased forward (Mean Difference [MD]= 4.28) and upward (MD=2.84) movement distance of the hyoid bone;</li>
<li>improved quality of life (MD=11.9); and</li>
<li>reduced complication rates (Odds Ratio=0.37).</li>
</ul>
<div>Swallowing function showed significant improvements on the following dysphagia measures:</div>
<div>
<ul>
<li>Penetration-Aspiration Scale (MD=-0.63);</li>
<li>Functional Oral Intake Scale (MD=1.32);</li>
<li>Functional Dysphagia Scale (MD=-8.81);</li>
<li>Standardized Swallowing Assessment (MD=-6.39);</li>
<li>Videofluoroscopic Swallow Study (MD = 1.42); and</li>
<li>Water swallow test (MD=-0.78).</li>
</ul>
<div>Limitations of this review include the small number of low-quality studies. Additional, high-quality research with large sample sizes is needed to further investigate the effects and safety of NMES and swallowing therapy in individuals with post-stroke dysphagia.</div>
</div>
</div>
<div>For individuals with post-stroke dysphagia, NMES combined with swallowing therapy demonstrated better effects using a frequency of 25 Hertz and an intensity of 0–15 milliampere during a treatment course of 4 weeks or less. Patient characteristics that improved outcomes include an older age (i.e., more than 60 years) with an onset of fewer than 20 days.</div>
<div> </div>
<div>Limitations of this review include the small number of low-quality studies. Additional, high-quality research with large sample sizes is needed to further investigate the effects and safety of NMES and swallowing therapy in individuals with post-stroke dysphagia.</div>
