Treatment of dysphagia with neuromuscular electrical stimulation

The treatment of dysphagia is very important for people who suffer from this condition after a stroke, traumatic brain injury (TBI) or other causes. Neurogenic dysphagia is a disorder that appears within the context of a nervous system injury and is characterised by a difficulty in the preparation of the food bolus in the mouth or in the movement of food from the mouth to the stomach with the risk that it passes into the airway.

The origin of the dysphagia is usually neurological, although it can also be mechanical or due to the patient using a tracheotomy cannula or taking certain drugs.

This therapeutic programme of neuromuscular electrical stimulation for the treatment of dysphagia is aimed at patients suffering from neurogenic dysphagia with video-fluoroscopic diagnosis of tracheal aspiration (the passage of food content into the respiratory tract) that presents any of these anomalies:

• Alteration in the retraction of the base of the tongue
• Dysfunction in raising the soft palate
• Reduced laryngeal ascent
• Alteration in pharyngeal contraction
• Dysfunction in the opening of the upper oesophageal sphincter

 TECHNIQUES USED

Neuromuscular electrical stimulation techniques used to treat dysphagia are applied to the floor of the mouth or the pharynx. They allow certain muscle groups involved in the swallowing process to be enhanced, increasing laryngeal ascent and favouring glottal closure, or increasing sensory input in the central nervous system facilitating the swallowing response.

TYPES OF INTERVENTION

• Clinical and functional assessment of swallowing
• Video-fluoroscopic exploration
• Oesophageal manometry, only in the case of dysfunction in the opening of the oesophageal sphincter
• The treatment consists of twenty 60-minute sessions, in which neuromuscular electrical stimulation is combined with therapeutic dysphagia exercises with the speech therapist
• Video-fluoroscopy and final assessment of the treatment to verify the changes brought about in swallowing functioning, indicating the therapeutic routine to be followed
• The patient will be given a complete final report with the assessments, the treatment carried out and the final recommendations