Hoo Young Lee1, Ji Seong Hong2, Kil Chan Lee3, Yoon-Kyum Shin4, Sung-Rae Cho5. 1. Department of Rehabilitation Medicine, Gangnam Severance Hospital, Seoul, Korea. ; Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea. 2. Department of Rehabilitation Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea. 3. Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea. 4. Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea. 5. Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea. ; Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea. ; Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, Korea.
Abstract
OBJECTIVE: To investigate immediate changes in hyolaryngeal movement and swallowing function after a cycle of neuromuscular electrical stimulation (NMES) on both submental and throat regions and submental placement alone in patients with dysphagia. METHODS: Fifteen patients with dysphagia were recruited. First, videofluoroscopic swallowing study (VFSS) was performed before NMES. All patients thereafter received a cycle of NMES by 2 methods of electrode placement: 1) both submental and throat regions and 2) submental placement alone concomitant with VFSS. The Penetration-Aspiration Score (PAS) and the NIH-Swallowing Safety Scale (NIH-SSS) were measured for swallowing function. RESULTS: During swallowing, hyolaryngeal descent significantly occurred by NMES on both submental and throat regions, and anterior displacement of hyolaryngeal complex was significant on submental placement alone. NMES on submental placement alone did not change the PAS and NIH-SSS. However, NMES on both submental and throat regions significantly reduced the NIH-SSS, although it did not change the PAS. Patients with no brainstem lesion and with dysphagia duration of <3 months showed significantly improved the NIH-SSS. CONCLUSION: Immediate hyolaryngeal movement was paradoxically depressed after NMES on both submental and throat regions with significant reductions in the NIH-SSS but not the PAS, suggesting improvement in pharyngeal peristalsis and cricopharyngeal functions at the esophageal entry rather than decreased aspiration and penetration. The results also suggested that patients with dysphagia should be carefully screened when determining motor-level NMES.
OBJECTIVE: To investigate immediate changes in hyolaryngeal movement and swallowing function after a cycle of neuromuscular electrical stimulation (NMES) on both submental and throat regions and submental placement alone in patients with dysphagia. METHODS: Fifteen patients with dysphagia were recruited. First, videofluoroscopic swallowing study (VFSS) was performed before NMES. All patients thereafter received a cycle of NMES by 2 methods of electrode placement: 1) both submental and throat regions and 2) submental placement alone concomitant with VFSS. The Penetration-Aspiration Score (PAS) and the NIH-Swallowing Safety Scale (NIH-SSS) were measured for swallowing function. RESULTS: During swallowing, hyolaryngeal descent significantly occurred by NMES on both submental and throat regions, and anterior displacement of hyolaryngeal complex was significant on submental placement alone. NMES on submental placement alone did not change the PAS and NIH-SSS. However, NMES on both submental and throat regions significantly reduced the NIH-SSS, although it did not change the PAS. Patients with no brainstem lesion and with dysphagia duration of <3 months showed significantly improved the NIH-SSS. CONCLUSION: Immediate hyolaryngeal movement was paradoxically depressed after NMES on both submental and throat regions with significant reductions in the NIH-SSS but not the PAS, suggesting improvement in pharyngeal peristalsis and cricopharyngeal functions at the esophageal entry rather than decreased aspiration and penetration. The results also suggested that patients with dysphagia should be carefully screened when determining motor-level NMES.
Entities:
Keywords:
Deglutition; Electric stimulation; Hyoid bone; Larynx
Authors: Gary Y Shaw; Phillip R Sechtem; Jeff Searl; Kristina Keller; Taib A Rawi; Emily Dowdy Journal: Ann Otol Rhinol Laryngol Date: 2007-01 Impact factor: 1.547
Authors: Christy L Ludlow; Ianessa Humbert; Keith Saxon; Christopher Poletto; Barbara Sonies; Lisa Crujido Journal: Dysphagia Date: 2007-01 Impact factor: 3.438