Ann Rehabil Med.  2016 Aug;40(4):600-610. 10.5535/arm.2016.40.4.600.

Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study

• Ko KR
• Park HJ
• Hyun JK
• Seo IH
• Kim TU

• KMID: 2356645
• DOI: http://doi.org/10.5535/arm.2016.40.4.600

Abstract

OBJECTIVE
To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI).
METHODS
Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated.
RESULTS
There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks.
CONCLUSION
The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.

Keyword

Dysphonia; Deglutition disorders; Electrical stimulation therapy; Stroke; Brain injuries

MeSH Terms

Acoustics
Asthenia
Brain Injuries*
Deglutition
Deglutition Disorders*
Dysphonia*
Electric Stimulation Therapy
Electric Stimulation*
Humans
Phonation
Pilot Projects*
Stroke

Figure

• 

  Fig. 1 Schematization of perceptual evaluation changes: total GRBAS score at baseline and at 2 and 4 weeks after initiation of the study in each group. GRBAS, grade, roughness, breathiness, asthenia, and strain. a)p<0.017 by Mann-Whitney U test with Bonferroni correction. b)p<0.025 by Wilcoxon signed-rank test with Bonferroni correction.

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