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Effect of Low-Frequency rTMS and NMES on Subacute Unilateral Hemispheric Stroke With Dysphagia.

Lim KB, Lee HJ, Yoo J, Kwon YG - Ann Rehabil Med (2014)

Bottom Line: In rTMS group, rTMS was performed at 100% resting motor threshold with 1 Hz frequency for 20 minutes per session (5 days per week for 2 weeks).We evaluated the functional dysphagia scale (FDS), pharyngeal transit time (PTT), the penetration-aspiration scale (PAS), and the American Speech-Language Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale at baseline, after 2 weeks, and after 4 weeks.No significant difference in mean changes of FDS and PAS for semi-solid, PTT, and ASHA NOMS was observed among the three groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Inje University Ilsan Paik Hospital, Goyang, Korea.

ABSTRACT

Objective: To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on post-stroke dysphagia.

Methods: Subacute (<3 months), unilateral hemispheric stroke patients with dysphagia were randomly assigned to the conventional dysphagia therapy (CDT), rTMS, or NMES groups. In rTMS group, rTMS was performed at 100% resting motor threshold with 1 Hz frequency for 20 minutes per session (5 days per week for 2 weeks). In NMES group, electrical stimulation was applied to the anterior neck for 30 minutes per session (5 days per week for 2 weeks). All three groups were given conventional dysphagia therapy for 4 weeks. We evaluated the functional dysphagia scale (FDS), pharyngeal transit time (PTT), the penetration-aspiration scale (PAS), and the American Speech-Language Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale at baseline, after 2 weeks, and after 4 weeks.

Results: Forty-seven patients completed the study; 15 in the CDT group, 14 in the rTMS group, and 18 in the NMES group. Mean changes in FDS and PAS for liquid during first 2 weeks in the rTMS and NMES groups were significantly higher than those in the CDT group, but no significant differences were found between the rTMS and NMES group. No significant difference in mean changes of FDS and PAS for semi-solid, PTT, and ASHA NOMS was observed among the three groups.

Conclusion: These results indicated that both low-frequency rTMS and NMES could induce early recovery from dysphagia; therefore, they both could be useful therapeutic options for dysphagic stroke patients.

No MeSH data available.


Related in: MedlinePlus

Intervention design. In rTMS group, rTMS is performed for 20 minutes per session, 5 days per week during the first 2 weeks. In NMES group, electrical stimulation is applied for 30 minutes per session, 5 days per week during the first 2 weeks. All three groups are given CDT for 4 weeks. CDT, conventional dysphagia therapy; rTMS, repetitive transcranial magnetic stimulation; NMES, neuromuscular electrical stimulation.
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Figure 1: Intervention design. In rTMS group, rTMS is performed for 20 minutes per session, 5 days per week during the first 2 weeks. In NMES group, electrical stimulation is applied for 30 minutes per session, 5 days per week during the first 2 weeks. All three groups are given CDT for 4 weeks. CDT, conventional dysphagia therapy; rTMS, repetitive transcranial magnetic stimulation; NMES, neuromuscular electrical stimulation.

Mentions: Eligible patients with confirmed dysphagia based on the result of the VFSS were randomly allocated to the conventional dysphagia treatment (CDT) group, the rTMS group, or the NMES group using a randomization table. All patients in the three groups received the conventional dysphagia treatment including oropharyngeal muscle-strengthening, exercise for range of motion of the neck and tongue, thermal tactile stimulation, Mendelson maneuver, and food intake training for 4 weeks. The two groups other than the CDT group underwent either rTMS or NMES for two weeks (Fig. 1).


Effect of Low-Frequency rTMS and NMES on Subacute Unilateral Hemispheric Stroke With Dysphagia.

Lim KB, Lee HJ, Yoo J, Kwon YG - Ann Rehabil Med (2014)

Intervention design. In rTMS group, rTMS is performed for 20 minutes per session, 5 days per week during the first 2 weeks. In NMES group, electrical stimulation is applied for 30 minutes per session, 5 days per week during the first 2 weeks. All three groups are given CDT for 4 weeks. CDT, conventional dysphagia therapy; rTMS, repetitive transcranial magnetic stimulation; NMES, neuromuscular electrical stimulation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4221387&req=5

Figure 1: Intervention design. In rTMS group, rTMS is performed for 20 minutes per session, 5 days per week during the first 2 weeks. In NMES group, electrical stimulation is applied for 30 minutes per session, 5 days per week during the first 2 weeks. All three groups are given CDT for 4 weeks. CDT, conventional dysphagia therapy; rTMS, repetitive transcranial magnetic stimulation; NMES, neuromuscular electrical stimulation.
Mentions: Eligible patients with confirmed dysphagia based on the result of the VFSS were randomly allocated to the conventional dysphagia treatment (CDT) group, the rTMS group, or the NMES group using a randomization table. All patients in the three groups received the conventional dysphagia treatment including oropharyngeal muscle-strengthening, exercise for range of motion of the neck and tongue, thermal tactile stimulation, Mendelson maneuver, and food intake training for 4 weeks. The two groups other than the CDT group underwent either rTMS or NMES for two weeks (Fig. 1).

Bottom Line: In rTMS group, rTMS was performed at 100% resting motor threshold with 1 Hz frequency for 20 minutes per session (5 days per week for 2 weeks).We evaluated the functional dysphagia scale (FDS), pharyngeal transit time (PTT), the penetration-aspiration scale (PAS), and the American Speech-Language Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale at baseline, after 2 weeks, and after 4 weeks.No significant difference in mean changes of FDS and PAS for semi-solid, PTT, and ASHA NOMS was observed among the three groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Inje University Ilsan Paik Hospital, Goyang, Korea.

ABSTRACT

Objective: To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on post-stroke dysphagia.

Methods: Subacute (<3 months), unilateral hemispheric stroke patients with dysphagia were randomly assigned to the conventional dysphagia therapy (CDT), rTMS, or NMES groups. In rTMS group, rTMS was performed at 100% resting motor threshold with 1 Hz frequency for 20 minutes per session (5 days per week for 2 weeks). In NMES group, electrical stimulation was applied to the anterior neck for 30 minutes per session (5 days per week for 2 weeks). All three groups were given conventional dysphagia therapy for 4 weeks. We evaluated the functional dysphagia scale (FDS), pharyngeal transit time (PTT), the penetration-aspiration scale (PAS), and the American Speech-Language Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale at baseline, after 2 weeks, and after 4 weeks.

Results: Forty-seven patients completed the study; 15 in the CDT group, 14 in the rTMS group, and 18 in the NMES group. Mean changes in FDS and PAS for liquid during first 2 weeks in the rTMS and NMES groups were significantly higher than those in the CDT group, but no significant differences were found between the rTMS and NMES group. No significant difference in mean changes of FDS and PAS for semi-solid, PTT, and ASHA NOMS was observed among the three groups.

Conclusion: These results indicated that both low-frequency rTMS and NMES could induce early recovery from dysphagia; therefore, they both could be useful therapeutic options for dysphagic stroke patients.

No MeSH data available.


Related in: MedlinePlus