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The Effect of Four-Channel Neuromuscular Electrical Stimulation on Swallowing Kinematics and Pressures

A Pilot Study

Park, Donghwi MD; Suh, Jee Hyun MD; Kim, Hayoung BS; Ryu, Ju Seok MD, PhD

American Journal of Physical Medicine & Rehabilitation: December 2019 - Volume 98 - Issue 12 - p 1051–1059
doi: 10.1097/PHM.0000000000001241
Original Research Articles
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Objective The purpose of this study was to evaluate the effectiveness of the sequential four-channel neuromuscular electrical stimulation system.

Design As a prospective case-control study, ten healthy subjects and ten patients with dysphagia were prospectively enrolled. Swallowing with and without sequential four-channel neuromuscular electrical stimulation (suprahyoid, infrahyoid muscles) was evaluated via videofluoroscopic swallowing study and high-resolution manometry.

Results Results showed that the sequential four-channel neuromuscular electrical stimulation significantly improved the videofluoroscopic dysphagia scale during thick-fluid swallowing in patients with dysphagia. Furthermore, the kinematic analysis of videofluoroscopic swallowing study showed a tendency that neuromuscular electrical stimulation reduced duration of hyoid bone movement during thin- or thick-fluid swallowing. The high-resolution manometry parameters—maximal pressure of velopharynx, tongue base, cricopharyngeal pressure, minimal upper esophageal sphincter pressure, area of velopharynx, upper esophageal sphincter activity time, and duration of nadir upper esophageal sphincter—during thin-fluid swallowing were significantly improve in both groups compared with the high-resolution manometry parameters without neuromuscular electrical stimulation.

Conclusion The sequential four-channel neuromuscular electrical stimulation may help improve the parameters of videofluoroscopic swallowing study, kinematic analysis of the hyoid bone movement, and high-resolution manometry during swallowing. Further investigations are needed to better examine the effects of neuromuscular electrical stimulation in patients with dysphagia.

From the Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea (DP); and Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea (JHS, HYK, JSR).

All correspondence should be addressed to: Ju Seok Ryu, MD, PhD, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea, 463-707.

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2016R1D1A1B03935130).

DP and JHS contributed equally to this article and should therefore be regarded as equivalent first authors.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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Online date: June 10, 2019

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