Treatment of oropharyngeal dysphagia with neuromuscular electrostimulaiton

Background and objective: Oropharyngeal dysphagia is highly prevalent in stroke patients, with a high mortality and morbidity. Neuromuscular electrostimulation (NMES) is a new and potentially useful therapy. We assessed the therapeutic effectiveness and safety of NMES in the treatment of oropharyngeal dysphagia in patients with stroke. Patients and method: Prospective study of stroke patients, with tracheal aspiration revealed by videofluoroscopy (VDF), who underwent conventional therapy of oropharyngeal dysphagia as well as NMES. We did a follow-up at the end of the treatment and 3 months later. Results: Patients underwent 18 courses of treatment (15-20) with a mean stimulation intensity of 12.45 mA (range: 6.6-16.7 mA). Before starting therapy, 8 patients were fed exclusively by means of a gastrostomy tube; after the treatment, only one patient needed it. No patient had complications. VDF parameters before treatment: oral transition time, swallowing reflex shooting (SRS) and pharyngeal transition time were longer and the hyoid elevation was reduced. After the treatment, the number of patients with tracheal aspiration decreased to 6, but only in 6 it persisted for the three analyzed viscosities (liquid, nectar and pudding), with an overall improvement of the VDF parameters. The only predictive factor of therapeutic effectiveness was the delay in the SRS. Conclusion: NMES is an effective and safe treatment for stroke patients with oropharyngeal dysphagia. (C) 2012 Elsevier Espana, S.L. All rights reserved.