Effect of Transcutaneous Electrical Stimulation in Chronic Poststroke Patients with Oropharyngeal Dysphagia: 1-Year Results of a Randomized Controlled Trial
| Autor: | Viridiana Arreola, Christopher Cabib, Elisabet Palomera, Desiree Muriana, Daniel Álvarez-Berdugo, Omar Ortega, Noemí Tomsen, Pere Clavé, Laia Rofes |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Sensory system Motor function law.invention 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Randomized controlled trial law medicine Humans Electric stimulation therapy 030212 general & internal medicine Stroke Aged Aged 80 and over business.industry Swallowing Disorders Stroke Rehabilitation Transcutaneous Electrical Stimulation General Medicine Middle Aged medicine.disease Deglutition Treatment Outcome Transcutaneous Electric Nerve Stimulation Female medicine.symptom business Deglutition Disorders 030217 neurology & neurosurgery Oropharyngeal dysphagia |
| Zdroj: | Neurorehabilitation and neural repair. 35(9) |
| ISSN: | 1552-6844 |
| Popis: | Background. Chronic poststroke oropharyngeal dysphagia (CPSOD) is associated with impaired oropharyngeal sensory/motor function. We aimed to assess effect of sensory (SES) and motor (NMES) transcutaneous electrical stimulation (TES) on safety of swallow and clinical outcomes in patients with CPSOD in a one-year follow-up randomized controlled trial. Methods. Ninety patients (74.1 ± 11.5 y, modified Rankin score 2.6 ± 1.7) with CPSOD and impaired safety of swallow were randomized to (a) compensatory treatment (CT), (b) CT + SES, and (c) CT + NMES. Patients were treated with up to two cycles (6 months apart) of 15 × 1 hour TES sessions over two weeks and followed up with 4-5 clinical and videofluoroscopic assessments during one year. Key results. Baseline penetration–aspiration scale (PAS) was 4.61 ± 1.75, delayed time to laryngeal vestibule closure (LVC) 396.4 ± 108.7 ms, and impaired efficacy signs 94.25%. Swallowing parameters significantly improved between baseline and 1-year follow-up in SES and NMES groups for prevalence of patients with a safe swallow ( P < .001), mean PAS ( P < .001), time to LVC ( P < .01), and need for thickening agents ( P < .001). Patients in the CT presented a less intense improvement of signs of impaired safety of swallow without significant changes in time to LVC. No differences between groups were observed for 1-year mortality (6.1%), respiratory infections (9.6%), nutritional and functional status, QoL, and hospital readmission rates (27.6%). No significant adverse events related to TES were observed. Conclusions and inferences. Transcutaneous electrical stimulation is a safe and effective therapy for older patients with CPSOD. After 1-year follow-up, TES greatly improved the safety of swallow and reduced the need for fluid thickening in these patients. |
| Databáze: | OpenAIRE |
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