Preliminary outcomes in transcutaneous neuromuscular electrical stimulation use in patients with dysphagia

2018 ◽  
Vol 8 (31) ◽  
pp. 167-174
Author(s):  
Codrut Sarafoleanu ◽  
Raluca Enache
Keyword(s):  
Traumatic Brain Injury ◽  
Head And Neck Cancer ◽  
Electrical Stimulation ◽  
Neurodegenerative Disorders ◽  
Structural Changes ◽  
Congenital Abnormalities ◽  
Neuromuscular Electrical Stimulation ◽  
Therapy Options ◽  
Dysphagia Treatment ◽  
Risk Of Aspiration

Abstract Dysphagia is a common disorder associated with a large number of etiologies like aging, stroke, traumatic brain injury, head and neck cancer, neurodegenerative disorders, structural changes or congenital abnormalities. The type of the treatment and its results depend on the type, severity and the cause of dysphagia. The primary goal of dysphagia treatment is to improve the swallowing process and decrease the risk of aspiration. Along with the existing rehabilitation swallowing treatments, new adjunctive therapy options developed, one of them being the neuromuscular electrical stimulation (NMES). The authors present the principles of NMES, a small literature review about the results of this therapy and their experience in using transcutaneous NMES in dysphagia patients.

Does Neuromuscular Electrical Stimulation Benefit Patients With Head and Neck Cancer Treated With Radiation Therapy?

2019 ◽  
Vol 4 (3) ◽  
pp. 517-521
Author(s):  
Susan E. Langmore
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Electrical Stimulation ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Neuromuscular Electrical Stimulation ◽  
Post Radiation

Purpose This article is a review of the evidence for using neuromuscular electrical stimulation (NMES) as a treatment for dysphagia when given to head and neck cancer patients with dysphagia secondary to radiation therapy. Method The rationale for using NMES for dysphagia in this population will be summarized. Recent studies will then be reviewed for evidence of efficacy of NMES when given to patients post–radiation therapy or during radiation therapy. Conclusion Evidence to date suggests no benefit from electrical stimulation when used therapeutically postradiotherapy. There are too few studies to date that have looked at NMES during radiotherapy to make any conclusions. Further studies are warranted.

scholarly journals Feasibility of eccentric overloading and neuromuscular electrical stimulation to improve muscle strength and muscle mass after treatment for head and neck cancer

2019 ◽  
Author(s):  
Colin Lavigne ◽  
Rosemary Twomey ◽  
Harold Lau ◽  
George Francis ◽  
S. Nicole Culos-Reed ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Electrical Stimulation ◽  
Muscle Strength ◽  
Strength Training ◽  
Head And Neck ◽  
Muscle Mass ◽  
Neck Cancer ◽  
Neuromuscular Electrical Stimulation ◽  
Knee Extensors ◽  
Patient Reported

Purpose: Treatment of head and neck cancer (HNC) results in severe weight loss, mainly due to loss of lean body mass. Consequently, decreases in muscular strength and health-related quality of life (HRQL) occur. This study investigated the feasibility of a 12-week experimental (EXP) and conventional (CON) strength training intervention delivered after HNC treatment.Methods: Participants were randomized to an EXP group (n=11) involving eccentric strength training and neuromuscular electrical stimulation (NMES), or a CON group (n=11) involving dynamic strength training matched for training volume. Feasibility outcomes included recruitment, completion, adherence and evidence of progression. A neuromuscular assessment involving maximal isometric voluntary contractions (MIVCs) in the knee extensors was evaluated prior to and during incremental cycling to volitional exhaustion at baseline and after the interventions. Anthropometrics and patient-reported outcomes (PROs) were also assessed.Results: Although recruitment was challenging, completion was 82% in CON and 100% in EXP. Adherence was 81% in CON and 92% in EXP. Overall, MIVC increased by 19 ± 23%, muscle mass improved 18 ± 22%, cycling exercise time improved by 18 ± 13%, and improvements in HRQL and fatigue were clinically relevant.Conclusions: Both interventions were found to be feasible for HNC patients after treatment. Strength training significantly improved maximal muscle strength, muscle mass, and PROs after HNC treatment. Future research should include fully powered trials and consider the use of eccentric overloading and NMES during HNC treatment.Implications for Cancer Survivors: Eccentric overloading and NMES may be useful alternatives to conventional strength training after HNC treatment.

scholarly journals Neuromuscular electrical stimulation in critically ill traumatic brain injury patients attenuates muscle atrophy, neurophysiological disorders, and weakness: a randomized controlled trial

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Paulo Eugênio Silva ◽  
Rita de Cássia Marqueti ◽  
Karina Livino-de-Carvalho ◽  
Amaro Eduardo Tavares de Araujo ◽  
Joana Castro ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Electrical Stimulation ◽  
Brain Injury ◽  
Critically Ill ◽  
Neuromuscular Electrical Stimulation ◽  
Muscle Thickness ◽  
Control Group ◽  
Secondary Outcomes

Abstract Background Critically ill traumatic brain injury (TBI) patients experience extensive muscle damage during their stay in the intensive care unit. Neuromuscular electrical stimulation (NMES) has been considered a promising treatment to reduce the functional and clinical impacts of this. However, the time needed for NMES to produce effects over the muscles is still unclear. This study primarily aimed to assess the time needed and effects of an NMES protocol on muscle architecture, neuromuscular electrophysiological disorder (NED), and muscle strength, and secondarily, to evaluate the effects on plasma systemic inflammation, catabolic responses, and clinical outcomes. Methods We performed a randomized clinical trial in critically ill TBI patients. The control group received only conventional physiotherapy, while the NMES group additionally underwent daily NMES for 14 days in the lower limb muscles. Participants were assessed at baseline and on days 3, 7, and 14 of their stay in the intensive care unit. The primary outcomes were assessed with muscle ultrasound, neuromuscular electrophysiology, and evoked peak force, and the secondary outcomes with plasma cytokines, matrix metalloproteinases, and clinical outcomes. Results Sixty participants were randomized, and twenty completed the trial from each group. After 14 days, the control group presented a significant reduction in muscle thickness of tibialis anterior and rectus femoris, mean of − 0.33 mm (− 14%) and − 0.49 mm (− 21%), p < 0.0001, respectively, while muscle thickness was preserved in the NMES group. The control group presented a higher incidence of NED: 47% vs. 0% in the NMES group, p < 0.0001, risk ratio of 16, and the NMES group demonstrated an increase in the evoked peak force (2.34 kg/f, p < 0.0001), in contrast to the control group (− 1.55 kg/f, p < 0.0001). The time needed for the NMES protocol to prevent muscle architecture disorders and treat weakness was at least 7 days, and 14 days to treat NED. The secondary outcomes exhibited less precise results, with confidence intervals that spanned worthwhile or trivial effects. Conclusions NMES applied daily for fourteen consecutive days reduced muscle atrophy, the incidence of NED, and muscle weakness in critically ill TBI patients. At least 7 days of NMES were required to elicit the first significant results. Trial registration The trial was registered at ensaiosclinicos.gov.br under protocol RBR-8kdrbz on 17 January 2016.

scholarly journals Dysphagia in Stroke: A New Solution

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Claire Langdon ◽  
David Blacker
Keyword(s):  
Theoretical Basis ◽  
Neuromuscular Electrical Stimulation ◽  
Adjunctive Treatment ◽  
Respiratory Complications ◽  
Swallowing Function ◽  
Safety And Efficacy ◽  
Increased Risk ◽  
Dysphagia Treatment ◽  
Risk Of Aspiration

Dysphagia is extremely common following stroke, affecting 13%–94% of acute stroke sufferers. It is associated with respiratory complications, increased risk of aspiration pneumonia, nutritional compromise and dehydration, and detracts from quality of life. While many stroke survivors experience a rapid return to normal swallowing function, this does not always happen. Current dysphagia treatment in Australia focuses upon prevention of aspiration via diet and fluid modifications, compensatory manoeuvres and positional changes, and exercises to rehabilitate paretic muscles. This article discusses a newer adjunctive treatment modality, neuromuscular electrical stimulation (NMES), and reviews the available literature on its efficacy as a therapy for dysphagia with particular emphasis on its use as a treatment for dysphagia in stroke. There is a good theoretical basis to support the use of NMES as an adjunctive therapy in dysphagia and there would appear to be a great need for further well-designed studies to accurately determine the safety and efficacy of this technique.

Point/Counterpoint: Electrical Stimulation for Dysphagia: The Argument for Electrical Stimulation for Dysphagia

2011 ◽  
Vol 20 (4) ◽  
pp. 96-101 ◽  
Author(s):  
Jennifer Carter
Keyword(s):  
Clinical Trials ◽  
Electrical Stimulation ◽  
Neuromuscular Electrical Stimulation ◽  
Traditional Treatment ◽  
Treatment Approaches ◽  
Traditional Therapy ◽  
Positive Difference ◽  
Dysphagia Treatment

This article is one side of the debate about the use of neuromuscular electrical stimulation (NMES or “VitalStim”) in dysphagia treatment and presents the case supporting the use of this modality. I present published results of clinical trials examining the effectiveness of NMES and acknowledge some flaws in the trials. The evidence shows that, when added to traditional therapy, NMES makes a statistically significant positive difference for a variety of traditional treatment approaches to which it may be added.

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