Is non-invasive neuromuscular electrical stimulation effective in severe chronic neurogenic dysphagia? Reporton a post-traumatic brain injury patient
| Autor: | Valeria Conti Nibali, Carlo Salviera, María C. Pizzimenti, Placido Bramanti, Daniela Floridia, Antonino Naro, Lucia Salmeri, Rocco Salvatore Calabrò |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Traumatic brain injury medicine.medical_treatment Electric Stimulation Therapy Physical Therapy Sports Therapy and Rehabilitation Stimulation Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Swallowing Nervous system disease Metaplasticity Neuroplasticity otorhinolaryngologic diseases medicine Humans 030223 otorhinolaryngology Rehabilitation business.industry digestive oral and skin physiology Recovery of Function medicine.disease Dysphagia Treatment Outcome Brain Injuries Chronic Disease Physical therapy Neurology (clinical) medicine.symptom Deglutition Disorders business 030217 neurology & neurosurgery |
| Zdroj: | NeuroRehabilitation. 38:53-57 |
| ISSN: | 1878-6448 1053-8135 |
| DOI: | 10.3233/nre-151295 |
| Popis: | Background Neurogenic dysphagia is a difficulty in swallowing induced by nervous system disease. It often causes serious complications, which are preventable if dysphagia is properly managed. There is growing debate concerning the usefulness of non-invasive neuromuscular electrical stimulation (NMES) in treating swallowing dysfunction. Objective Aim of this study was to assess the effectiveness of Vitalstim© device, and to investigate the neurophysiological mechanisms underlying functional recovery. Methods A 34-year-old man, affected by severe chronic dysphagia following traumatic brain injury, underwent two different intensive rehabilitation trainings, including either conventional rehabilitation alone or coupled to Vitalstim training. We evaluated patient swallowing function in two separate sessions (i.e. before and after the two trainings) by means of ad hoc swallowing function scales and electrophysiological parameters (rapid paired associative stimulation). The overall Vitalstim program was articulated in 6 weekly sessions for 6 weeks. Results The patient did not report any side-effect either during or following both the intensive rehabilitation trainings. We observed an important improvement in swallowing function only after Vitalstim training. In fact, the patient was eventually able to safely eat even solid food. Conclusions This is the first report objectively suggesting (by means of rPAS) a correlation between the brain neuroplastic changes induced by Vitalstim and the swallowing function improvement. It is hypothesizable that Vitalstim may have targeted cortical (and maybe subcortical) brain areas that are recruited during the highly coordinated function of swallowing, and it may have thus potentiated the well-known neuroplastic changes induced by repetitive and intensive swallowing exercises, probably thanks to metaplasticity phenomena. |
| Databáze: | OpenAIRE |
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