Skip to main content

Electrical Stimulation for the Treatment of Dysphagia

  • Chapter
  • First Online:
Electroceuticals

Abstract

Dysphagia is the term used to describe swallowing disorders usually resulting from a neurological or physical impairment of the oral, pharyngeal or oesophageal mechanisms. Difficulty with swallowing may have life threatening consequences and can lead to an impaired quality of life. Electrical stimulation has recently become of interest to clinicians working with people presenting with dysphagia due to its rehabilitation potential especially for pharyngeal stage swallowing disorders. The electro-therapies for dysphagia can be divided into two main groups; those that are peripherally delivered and those where the stimulation is delivered cortically. This chapter outlines a number of electro-therapies as treatment approaches for dysphagia. The rationale for the use of each technique in the treatment of dysphagia is explained and an overview of the current published literature reported.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Logemann J. Evaluation and treatment of swallowing disorders. San Diego: College-Hill Press Inc; 1983.

    Google Scholar 

  2. Katzan IL, Dawson NV, Thomas ME, Votruba ME, Cebul RD. The cost of pneumonia after acute stroke. Neurology. 2007;68:1938–43.

    Article  CAS  PubMed  Google Scholar 

  3. Heuschmann PU, Kolominsky-Rabas PL, Roether J, Misselwitz B, Lowitzsch K, Heidrich J, et al. Predictors of in-hospital mortality in patients with acute ischemic stroke treated with thrombolytic therapy. JAMA. 2004;292(15):1831–8.

    Article  CAS  PubMed  Google Scholar 

  4. Hassan A, Khealani BA, Shafgat S, Aslam M, Salahuddin N, Syed NA, et al. Stroke-associated pneumonia: microbiological data and outcome. Singapore Med J. 2006;47(3):204–7.

    CAS  PubMed  Google Scholar 

  5. Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756–63.

    Article  PubMed  Google Scholar 

  6. Mann G, Hankey GJ, Cameron D. Swallowing function after stroke. Prognosis and prognostic factors at six months. Stroke. 1999;30(4):744–8.

    Article  CAS  PubMed  Google Scholar 

  7. Hartelius L, Svensson P. Speech and swallowing symptoms associated with Parkinson’s disease and multiple sclerosis: a survey. Folia Phoniatr. 1994;46(1):9–17.

    Article  CAS  Google Scholar 

  8. Steele C, Greenwood C, Ens I, Robertson C, Seidman-Carlson C. Mealtime difficulties in a home for the aged: not just dysphagia. Dysphagia. 1997;12:43–50.

    Article  CAS  PubMed  Google Scholar 

  9. Reilly S, Skuse D, Poblete X. Prevalence of feeding problems and oral motor dysfunction in children with cerebral palsy: a community survey. J Pediatr. 1996;129(6):877–82.

    Article  CAS  PubMed  Google Scholar 

  10. McKinstry M, Tranter M, Sweeney J. Outcomes of dysphagia intervention in a pulmonary rehabilitation program. Dysphagia. 2010;25(2):104–11.

    Article  PubMed  Google Scholar 

  11. McCabe D, Ashford J, Wheeler-Hegland K, Frymark T, Mullen R, Musson N, et al. Evidence- based systematic review: Oropharyngeal dysphagia behavioral treatments. Part IV- Impact of dysphagia treatment on individuals’ postcancer treatments. 2 J Rehabil Res Dev. 2009;46(2):205–14.

    Google Scholar 

  12. Ward E, Uriate M, Conroy A. Duration of dysphagic symptoms and swallowing outcomes after thermal burn injury. J Burn Care Rehabil. 2001;22(6):441–53.

    Article  CAS  PubMed  Google Scholar 

  13. Ward E, Green K, Morton A. Patterns and predictors of swallowing resolution following adult traumatic brain injury. J Head Trauma Rehabil. 2007;22(3):184–91.

    Article  PubMed  Google Scholar 

  14. Frempong-Boadu A, Houton JK, Osborn B, Opulencia J, Kells L, Guida DG, Roux P. Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and post-operative assessment. J Spinal Disord Tech. 2002;15(5):362–8.

    Article  PubMed  Google Scholar 

  15. Logemann J. Evaluation and treatment of swallowing disorders. (rev. ed). Austin: PRO-ED and St. Tammany Parish Schools Dysphagia Team; 1998.

    Google Scholar 

  16. Crary M, Groher M. Introduction to adult swallowing disorders. Philadelphia: Butterworth-Heinemann; 2003.

    Google Scholar 

  17. Costa Bandeira A, Azevedo E, Vartanian JG, Nishimoto I, Kowalski L, Carrara-de AE. Quality of life related to swallowing after tongue cancer treatment. Anna Karinne Dysphagia. 2008;23(2):183.

    Article  Google Scholar 

  18. Rosenvinge S, Starke I. Improving care for patients with dysphagia. Age Ageing. 2005;34(6):587–93.

    Article  PubMed  Google Scholar 

  19. Robbins SM, Houghton PE, Woodbury MG, Brown JL. The therapeutic effect of functional and transcutaneous electric stimulation on improving gait speed in stroke patients: a meta-analysis. Arch Phys Med Rehabil. 2006;87:853–9.

    Article  PubMed  Google Scholar 

  20. Huckabee ML, Doeltgen S. Emerging modalities in dysphagia rehabilitation: neuromuscular electrical stimulation. N Z Med J. 2007;120:U2744.

    PubMed  Google Scholar 

  21. Clark H, Lazarus C, Arvedson J, Schooling T, Frymark T. Evidence-based sustematic review: effects of neuromuscular electrical stimulation on swallowing and neural activation. Am J Speech Lang Pathol. 2009;18:361–75.

    Article  PubMed  Google Scholar 

  22. Freed ML, Freed L, Chatburn RL, Christian M. Electrical stimulation for swallowing disorders caused by stroke. Respir Care. 2001;46(5):466–74.

    CAS  PubMed  Google Scholar 

  23. Blumenfeld L, Hahn Y, LePage A, Leonard R, Belafsky PC. Transcutaneous electrical stimulation versus traditional dysphagia therapy: a nonconcurrent cohort study. Otolaryngol Head Neck Surg. 2006;135(5):754–7.

    Article  PubMed  Google Scholar 

  24. Clark HM. Neuromuscular treatments for speech and swallowing: a tutorial. Am J Speech Lang Pathol. 2003;12(4):400–15.

    Article  PubMed  Google Scholar 

  25. Mysiw WJ, Jackson RD. Electrical stimulation. In: Braddom RL, editor. Physical medicine and rehabilitation. Philadelphia: Saunders; 1996. p. 464–87.

    Google Scholar 

  26. Lim KB, Lee HJ, Lim SS, Choi YI. Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial. J Rehabil Med. 2009;41:174–8.

    Article  PubMed  Google Scholar 

  27. Park JW, Kim Y, Oh JC, Lee HJ. Effortful swallowing training combined with electrical stimulation in post stroke dysphagia: a randomized controlled study. Dysphagia. 2012;27:521–7.

    Article  PubMed  Google Scholar 

  28. Kushner DS, Peters K, Eroglu S, Perless-Carroll M, Johnson-Greene D. Neuromuscular electrical stimulation in acute stoke feeding tube-dependent dysphagia during inpatient rehabilitation. Am J Phys Med Rehabil. 2013;92(6):486–95.

    Article  PubMed  Google Scholar 

  29. Lee KW, Kim SB, Lee JH, Lee SJ, Ri JW, Park JG. The effect of early neuromuscular electrical stimulation therapy in acute/subacute ischaemic stroke patients with dysphagia. Ann Rehabil Med. 2014;38(2):153–9.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Ludlow C, Humbert I, Saxon K, Poletto C, Sonies B, Crujido L. Effects of surface electrical stimulation in chronic pharyngeal dysphagia. Dysphagia. 2007;22:1–10.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Humbert IA, Poletto CJ, Saxon KG, Kearney PR, Crujido L, Wright-Harp W, et al. The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing. J Appl Physiol. 2006;101:1657–63.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Baijens LW, Speyer R, Passos VL, Pilz W, Van der Kruis J, Haarmans S, Desjardins-Rombouts C. Surface electrical stimulation in dysphagic Parkinson patients: a randomized clinical trial. Laryngoscope. 2013;123(11):38–44.

    Article  Google Scholar 

  33. Ryu JS, Kang JK, Park JY, Nam SY, Choi SH, Roh JL, et al. The effect of electrical stimulation therapy on dysphagia following treatment for head and neck cancer. Oral Oncol. 2009;45:665–8.

    Article  PubMed  Google Scholar 

  34. Gallas S, Marie JP, Leroi AM. Sensory transcutaneous electrical stimulation improves post-stroke dysphagic patients. Dysphagia. 2010;25:291–7.

    Article  PubMed  Google Scholar 

  35. Ayala KJ, Cruz KJ. Transcutaneous electrical stimulation in dysphagia treatment: is there sufficient evidence? Tex J Audiol Speech Lang Pathol. 2008;31:37–54.

    Google Scholar 

  36. Carnaby-Mann G, Crary M. Examining the evidence on neuromuscular electrical stimulation for swallowing, a meta-analysis. Arch Otolaryngol Head Neck Surg. 2007;133:564–71.

    Article  PubMed  Google Scholar 

  37. Tan C, Liu Y, Li W, Liu J, Chen L. Transcutaneous neuromuscular electrical stimulation can improve swallowing function in patients with dysphagia caused by non-stroke diseases: a meta-analysis. J Oral Rehabil. 2013;40:472–80.

    Article  CAS  PubMed  Google Scholar 

  38. Chen YW, Chang KH, Chen HC, Liang WM, Wang YH, Lin YN. The effects of surface neuromuscular electrical stimulation on post-stroke dysphagia: a systematic review and meta-analysis. Clin Rehabil. 2015. doi:10.1177/0269215515571681

  39. Geeganage C, Beavan J, Ellender S, Bath PM. Interventions for dysphagia and nutritional support in acute and subacute stroke. Cochrane Database Syst Rev. 2012;10:CD000323.

    PubMed  Google Scholar 

  40. Park CL, O’Neill PA, Martin DF. A pilot exploratory study of oral electrical stimulation on swallow function after stroke: an innovative technique. Dysphagia. 1997;12(3):161–6.

    Article  CAS  PubMed  Google Scholar 

  41. Power M, Fraser CH, Hobson A, Singh S, Tyrell P, Nicholson D, Turnbull I, Thompson DG, Hamdy S. Evaluating oral stimulation as a treatment for dysphagia after stroke. Dysphagia. 2006;21:49–55.

    Article  PubMed  Google Scholar 

  42. Hamdy S, Rothwell JC, Aziz Q, Singh KD, Thompson DG. Long term re-organization of human motor cortex driven by short term sensory stimulation. Nat Neurosci. 1998;1(1):64–8.

    Article  CAS  PubMed  Google Scholar 

  43. Hamdy S, Aziz Q, Rothwell JC. Recovery of swallowing after dysphagic stroke realtes to functional reorganization in the intact motor cortex. Gastroenterology. 1998;115(5):1104–12.

    Article  CAS  PubMed  Google Scholar 

  44. Hamdy S, Rothwell JC, Aziz Q, Thompson DG. Organization and reorganization of human swallowing motor cortex: implications for recovery after stroke. Clin Sci. 2000;99(2):151–7.

    Article  CAS  PubMed  Google Scholar 

  45. Mistry S, Michou E, Vasant D, Ghannouchi I, Verin E, Hamdy S. New techniques – future. J Gastroenterol Hepatol. 2014;3(5):1080–7.

    Google Scholar 

  46. Jayasekeran V, Singh S, Tyrrell P, Michou E, Jefferson S, Mistry S, et al. Adjunctive functional pharyngeal electrical stimulation reverses swallowing disability following brain lesions. Gastroenterology. 2010;138(5):1737–46.

    Article  PubMed  Google Scholar 

  47. Vasant DH, Michou E, Tyrrell P, Mistry S, Jayasekeran V, Hamdy S. Pharyngeal electrical stimulation (PES) expedites swallowing recovery in dysphagia post-acute stroke: a phase II double-blinded randomised controlled trial. Gastroenterology. 2014;146(5):S-77.

    Google Scholar 

  48. Momosaki R, Abo M, Watanabe S, Kakuda W, Yamada N, Mochio K. Functional magnetic stimulation using a parabolic coil for dysphagia after stroke. Neuromodulation. 2014;17(7):637–41.

    Article  PubMed  Google Scholar 

  49. Momosaki R, Abo M, Watanabe S, Kakuda W, Yamada N. Functional magnetic stimulation over suprahyoid muscle can induce plastic change in swallowing motor cortex. Arch Phys Med Rehabil. 2014;95 10(e91–e92):0003–9993.

    Google Scholar 

  50. Shigematsu T, Fujishima I, Ohno K. Transcranial direct current stimulation improves swallowing function in stroke patients. Neurorehabil Neural Repair. 2013;27(4):363–9.

    Article  PubMed  Google Scholar 

  51. Hummel F, Celnik P, Giraux P, Floel A, Wu WH, Gerloff C, et al. Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain. 2005;128(pt3):490–9.

    Article  PubMed  Google Scholar 

  52. Hummel FC, Cohen LG. Non-invasive brain stimulation: a new strategy to improve neurorehabilitation after stroke? Lancet Neurol. 2006;5:708–12.

    Article  PubMed  Google Scholar 

  53. Stefan K, Kunesch E, Cohen LG, Benecke R, Classen J. Induction of plasticity in the human motor cortex by paired associative stimulation. Brain. 2000;123:572–84.

    Article  PubMed  Google Scholar 

  54. Huang YZ, Edwards MJ, Rounis E, Bhatia KP, Rothwell JC. Theta burst stimulation of the human motor cortex. Neuron. 2005;45:201–6.

    Article  CAS  PubMed  Google Scholar 

  55. Verin E, Leroi AM. Poststroke dysphagia rehabilitation by repetitive transcranial magnetic stimulation: a non-controlled pilot study. Dysphagia. 2009;24(2):204–10.

    Article  CAS  PubMed  Google Scholar 

  56. Khedr EM, Abo-Elfetoh N. Therapeutic role of rTMS on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction. J Neurol Neurosurg Psychiatry. 2010;81(5):495–9.

    Article  PubMed  Google Scholar 

  57. Kim L, Chun MH, Kim BR, Lee SJ. Effect of repetitive transcranial magnetic stimulation on patients with brain injury and dysphagia. Ann Rehabil Med. 2011;35:765–71.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Cheng IK, Chan KM, Wong CS, Cheung RT. Preliminary evidence of the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on swallowing functions in post-stroke individuals with chronic dysphagia. Int J Lang Commun Disord. 2015;50(3):389–96. doi:10.1111/1460-6984.12144.

    Article  PubMed  Google Scholar 

  59. Momosaki R, Abo M, Kakuda W. Bilateral repetitive transcranial magnetic stimulation combined with intensive swallowing rehabilitation for chronic stroke dysphagia: a case series study. Case Rep Neurol. 2014;6(1):60–7.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Jefferson S, Mistry S, Michou E, Singh S, Rothwell JC, Hamdy S. Reversal of a virtual lesion in human pharyngeal motor cortex by high frequency contralesional brain stimulation. Gastroenterology. 2009;137:841–9.

    Article  PubMed  Google Scholar 

  61. Lefaucheur JP, Obadia NA, Antal A, Ayache SS, Baeken C, Benninger D, et al. Evidence based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation. Clin Neurophysiol. 2014;125(11):2150–206.

    Article  PubMed  Google Scholar 

  62. Kumar S, Wagner CW, Frayne C, Zhu L, Selim M, Feng W, et al. Noninvasive brain stimulation may improve stroke-related dysphagia: a pilot study. Stroke. 2011;42:1035–40.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Doeltgen S, Huckabee ML. Swallowing rehabilitation: from the research laboratory to routine clinical application. Arch Phys Med Rehabil. 2012;93:207–13.

    Article  PubMed  Google Scholar 

  64. Restivo DA, Casabona A, Marchese-Ragona R. Transcranial direct current stimulation (TDCS) for dysphagia associated to multiple sclerosis. Clin Neurophysiol. 2014;125:1–205.

    Article  Google Scholar 

  65. Yang EJ, Baek SR, Shin J, Lim JY, Jang HJ, Kim YK, Paik NJ. Effects of transcranial direct current stimulation (tDCS) on post-stroke dysphagia. Restor Neurol Neurosci. 2012;30(4):303–11.

    CAS  PubMed  Google Scholar 

  66. Michou E, Mistry S, Jefferson S, Singh S, Rothwell J, Hamdy S. Targeting unlesioned pharyngeal motor cortex improves swallowing in healthy individuals and after dysphagic stroke. Gastroenterology. 2012;142:29–38.

    Article  PubMed  Google Scholar 

  67. Crary MA, Carnaby-Mann GD, Groher M. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86(8):1516–20.

    Article  PubMed  Google Scholar 

  68. Poorjavad M, Moghadam ST, Ansari NN, Daemi M. Surface electrical stimulation for treating swallowing disorders after stroke: a review of the stimulation intensity levels and the electrode placements. Stroke Res Treat. 2014;24:918057. HTTP://DXDOI.ORG/10.1155/2014/918057.

  69. Permsirivanich W, Tipchatyotin S, Wongchai M, Leelanmit V, Setthawacharawanich S, Sathirapanya P, et al. Comparing the effects of rehabilitation swallowing therapy vs. neuromuscular electrical stimulation therapy among stroke patients with persistent pharyngeal dysphagia: a randomized controlled study. J Med Assoc Thia. 2009;92(2):259–65.

    Google Scholar 

  70. Bulow M, Speyer R, Baijens L, Woisard V, Ekberg O. Neuromuscular electrical stimulation (NMES) in stroke patients with oral and pharyngeal dysfunction. Dysphagia. 2008;23:302–9.

    Article  PubMed  Google Scholar 

  71. Langdon C, Backer D. Dysphagia in stroke: a new solution. Stroke Res Treat. 2010:570403. doi:10.4061/2010/570403.

  72. National Institute for Health and Care Excellence. Transcutaneous neuromuscular electrical stimulation for oropharyngeal dysphagia. NICE interventional procedure guidance (IPG490). 2014. ISBN 978-1-4731-0529-4.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sue Pownall PhD, BSc (Hons), FRCSLT .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Pownall, S., Enderby, P., Sproson, L. (2017). Electrical Stimulation for the Treatment of Dysphagia. In: Majid, A. (eds) Electroceuticals. Springer, Cham. https://doi.org/10.1007/978-3-319-28612-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-28612-9_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28610-5

  • Online ISBN: 978-3-319-28612-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics