6 Things To Know About Electrical Stimulation And Dysphagia
Electrical stimulation as a treatment option for dysphagia has received much attention recently from patients who are experiencing swallowing difficulties and seeking the best possible dysphagic-related therapies.1 Is electrical stimulation safe? And is it effective? Here are commonly asked questions regarding this therapy option.
1. What is electrical stimulation?
Neuromuscular electrical stimulation (NMES), as used in the treatment of dysphagia, involves the administration of small electrical impulses to swallowing muscles in the throat through electrodes attached to the skin.2 Typically, the therapist determines which muscles will benefit most from this treatment process to help encourage and enhance the swallowing process.3
2. What happens during the NMES process?
Once a safe and effective current electrical intensity has been determined by a therapist, NMES is applied in conjunction with traditional exercise therapy. The patient exercises the swallowing muscles for periods of up to one hour while receiving concurrent electrical stimulation. The electrical stimulation when applied in this manner accelerates muscle strengthening, accelerates cortical reorganization (especially after stroke), and increases the effectiveness of the exercise therapy.4
3. Who offers NMES treatments?
While Speech Language Pathology (SLP) professionals receive a graduate-level education focused on dysphagia treatments, they are typically not trained in the use of electrotherapy. Most commonly, Physical Therapy (PT) professionals perform this type of treatment, in which it is primarily used to decrease pain and increase muscle strength but also has other applications such as facilitating tissue healing.5
4. Will insurance cover NMES treatments?
The evidence base for the use of electrotherapy as practiced by PT’s is well documented and insurance generally covers its use. However, every plan is different and you should consult with your insurance company directly regarding your particular plan and its coverage.
5. Are NMES treatments safe?
While virtually no medical treatment has proven to be 100% safe in all instances, research indicates that NMES treatments typically have few to no side effects. One recent study specifically tracked for changes in pulse oxymetry readings and cardiac function (reflective of changes in heart rate and blood pressure). They reported data on 892 patients and reported no reports of laryngospasm, no reports of bradycardia and no reports of electromagnetic interference with cardiac pacemakers.7
6. Are NMES treatments right for me?
Research and input from practicing SLP’s confirms that the majority of users are reporting positive outcomes, high therapist and patient satisfaction, and few adverse effects.8 However, it is important to consult closely with your own health care professionals who are familiar with your complete health history before making any treatment decisions.9
When it comes to finding the best possible treatments for dysphagia, knowledge is power. Ask your health care professionals detailed questions regarding your specific dysphagic situation. And be sure to do your own homework, learning and understanding as much about your situation as possible. Becoming a self-advocate for your health, or the health of a loved one, helps to ensure you will have access to the best possible treatment options.
- Park JW, Oh JC, Lee HJ, Park SJ, Yoon TS, Kwon BS. Effortful swallowing training coupled with electrical stimulation leads to an increase in hyoid elevation during swallowing. Dysphagia. Sep 2009;24(3):296-301.
- Mitchell K, Ramirez K, Robles M, et al. The Effectiveness of NMES (VitalStim) Therapy in the Neonatal Population: Children’s Hospital of Orange County; 2010.
- Humbert IA, Poletto CJ, Saxon KG, et al. The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing. J Appl Physiol. Dec 2006;101(6):1657-1663.
- Bogaardt H, van Dam D, Wever NM, Bruggeman CE, Koops J, Fokkens WJ. Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis. Ann Otol Rhinol Laryngol. Apr 2009;118(4):241-246.
- Oh BM, Kim DY, Paik NJ. Recovery of swallowing function is accompanied by the expansion of the cortical map. Int J Neurosci. Sep 2007;117(9):1215-1227.
- Ludlow CL, Humbert I, Saxon K, Poletto C, Sonies B, Crujido L. Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal Dysphagia. Dysphagia. Jan 2007;22(1):1-10.
- McDuffie C, Morgan M, Armstrong C, Nathan C. Electrical stimulation of post irradiated head and neck SCCA. AAO-HNS. Los Angeles; 2005.
- Permsirivanich W, Tipchatyotin S, Wongchai M, et al. Comparing the effects of rehabilitation swallowing therapy vs. neuromuscular electrical stimulation therapy among stroke patients with persistent pharyngeal dysphagia: a randomized controlled study. J Med Assoc Thai. Feb 2009;92(2):259-265.
- Carnaby-Mann GD, Crary MA. Examining the evidence on neuromuscular electrical stimulation for swallowing: a meta-analysis. Arch Otolaryngol Head Neck Surg. Jun 2007;133(6):564-571.