Combined NMES,FEES and Traditional Swallowing Rehabilitation in the Treatment of Stroke-related Dysphagia

Combined Neuromuscular Electrical Stimulation (NMES) With Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Traditional Swallowing Rehabilitation in the Treatment of Stroke-related Dysphagia

The investigators aimed to evaluate effects of combined NMES, FEES and traditional swallowing rehabilitation in stroke patients with moderate-to-severe dysphagia.

Neuromuscular electrical stimulation (NMES)and Fiberoptic endoscopic evaluation of swallowing (FEES) are both promising approaches to enhance swallowing recovery for dysphagic patients. However, there is no literature on the effectiveness of combined application of these modalities in the treatment of patients with poststroke dysphagia. The purpose of this study was to prospectively investigate whether combined NMES, FEES and traditional swallowing rehabilitation can improve swallowing functions in patients with moderate-to-severe dysphagia after stroke.

Inclusion Criteria:

• age between 20-85 years old
• first-time stroke confirmed by computed tomography or magnetic resonance image
• dysphagia > 3 weeks, with preservation of the swallowing reflex
• currently on a restricted diet, with a Functional Oral Intake Scale (FOIS) score of 5 or less
• Mini-Mental State Examination (MMSE)> 21
• no obvious mental depression, receptive aphasia or cognitive impairment

Exclusion Criteria:

• progressive cerebrovascular disease or other neurologic diseases
• unstable cardiopulmonary status, serious psychologic disorder or epilepsy;
• tumors, extensive surgery or radiotherapy of the head and neck region
• cardiac pacemakers
• swallowing therapy within 2 months before participation