AUTHOR=Zhang Yao-Wen , Dou Zu-Lin , Zhao Fei , Xie Chun-Qing , Shi Jing , Yang Chen , Wan Gui-Fang , Wen Hong-Mei , Chen Pei-Rong , Tang Zhi-Ming 

TITLE=Neuromuscular electrical stimulation improves swallowing initiation in patients with post-stroke dysphagia

JOURNAL=Frontiers in Neuroscience

VOLUME=Volume 16 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2022.1011824

DOI=10.3389/fnins.2022.1011824

ISSN=1662-453X

ABSTRACT=Objective: More than half of post-stroke patients develop dysphagia, which manifests as delayed swallowing initiation and is associated with a high risk of aspiration. In this study, we aimed to investigate the immediate effect of neuromuscular electrical stimulation (NMES) on swallowing initiation in post-stroke patients using videofluoroscopic swallowing study (VFSS) data.
Methods: This study used randomised, self-controlled crossover design. Total of 35 patients with post-stroke dysphagia involved in this study. All selected patients received real and sham NMES while swallowing 5 ml of thin liquid. Participants completed the conditions in random order, with a 10-min interval between conditions. The primary evaluation indicators included the Modified Barium Swallow Impairment Profile-6 (MBSImp-6) and Penetration-Aspiration Scale (PAS). Secondary indicators included oral transit time (OTT), pharyngeal transit time (PTT), and laryngeal closure duration (LCD). 
Results: MBSImP-6 (P=0.008) and PAS (P<0.001) scores were significantly lower in the Real-NMES condition than in the Sham-NMES condition. OTT (P<0.001) was also significantly shorter during Real-NMES than during Sham-NMES. However, LCD (P=0.225) and PTT (P=0.161) did not significantly differ between the two conditions. 
Conclusion: NMES can immediately improve swallowing initiation in post-stroke patients and reduce the risk of penetration/aspiration. Thus it can be uesd as a supplementary approach for promoting early feeding training in patients with post-stroke dysphagia.