Novel Neuromuscular Electrical Stimulation System for Treatment of Dysphagia after Brain Injury

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  • TOYAMA Keiichi
    Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital
  • MATSUMOTO Shuji
    Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
  • KURASAWA Miho
    Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital
  • SETOGUCHI Haruka
    Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital
  • NOMA Tomokazu
    Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital
  • TAKENAKA Keita
    Department of Rehabilitation, Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital
  • SOEDA Akina
    Department of Rehabilitation, Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital
  • SHIMODOZONO Megumi
    Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
  • KAWAHIRA Kazumi
    Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University

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The purpose of this study was to compare the effects of a novel neuromuscular electrical stimulation (NMES) to the effects of conventional treatment in patients with dysphagia after brain injury. In total, 26 patients were non-randomly divided into an experimental group (n = 12) and a control group (n = 14). The experimental group received NMES intervention followed by conventional treatment, including thermaltactile stimulation with intensive repetition of a dry-swallow task. The control group received conventional treatment without NMES. NMES at a fixed pulse duration of 50 μs and a frequency of 50 Hz was delivered over the skin areas above the motor point of the target muscles, i.e., the bilateral geniohyoid, mylohyoid/anterior belly of the digastric, and thyrohyoid muscles, using a high-voltage pulsed-current device. The two groups received 40-min treatments once a day, 5 days per week, for 8 weeks. Outcome, assessed before and 8 weeks after treatment, was evaluated with regard to the videofluoroscopic dysphagia scale (VDS), the anterior and superior displacement of the hyoid bone and larynx, and the functional oral intake scale. Both groups exhibited improvement, but the experimental group exhibited more significant improvement in the displacement of the hyoid bone and larynx, VDS-total score, and VDS-pharyngeal score than the control group did. The results suggest that NMES combined with conventional treatment is superior to conventional treatment alone in patients with dysphagia following treatment for brain injury. Further investigations are necessary to examine the effects of NMES in patients with more varied types of diseases.

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