Effects of Short Term Interferential Current Stimulation on Swallowing Reflex in Dysphagic Patients
DOI:
https://doi.org/10.12970/2311-1917.2015.03.01.1Keywords:
Deglutition, deglutition disorders, surface electrical stimulation, interferential current, videofluoroscopic measurements.Abstract
We have previously shown that surface interferential current (IFC) stimulation at the sensory threshold significantly increases the number of swallows. In the present study, we evaluated the effects of IFC stimulation at the sensory threshold on the swallowing reflex of dysphagic patients (7 male and 5 female, Age, 75.8 ± 5.3 years) by videofluoroscopic (VFS) measurements. Each subject underwent three series of VFS examination, before, during, and after the IFC stimulation. We tested three food types, juice, jelly, and biscuits, however, only juice consistency resulted in significant changes in temporal measurements of VFS parameters before, during and after IFC stimulation. For juice consistency, IFC stimulation shortened the pharyngeal response duration (the duration from the hyoid bone beginning maximum elevation to its return to the resting position, before IFC: 1.37 ± 0.31(SD) s vs. during IFC: 1.17 ± 0.29 s, p<0.001) without changing the amount of anterior and vertical displacements of the hyoid bone. The duration from the onset of elevation of the soft palate to return to the resting position was also significantly shortened by the IFC stimulation (before IFC: 0.72 ± 0.16 s vs. during IFC: 0.64 ± 0.19 s, p=0.035), suggesting that pharyngeal motor activation sequence as a whole was shortened by the IFC stimulation. No painful and/or uncomfortable sensations were reported. We conclude that surface interferential current stimulation has a potential to be an alternative mode of therapeutic electrical stimulation for dysphagic patients.
References
Rofes L, Arreola V, Almirall J, et al. Diagnosis and management of oropharyngeal Dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res and Prac 2011; 2011: 13.
Bulow M, Speyer R, Baijens L, Woisard V, Ekberg O. Neuromuscular electrical stimulation (NMES) in stroke patients with oral and pharyngeal dysfunction. Dysphagia 2008; 23(3): 302-9. http://dx.doi.org/10.1007/s00455-007-9145-9
Freed ML, Freed L, Chatburn RL, Christian M. Electrical stimulation for swallowing disorders caused by stroke. Respirat Care 2001; 46(5): 466-74.
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 2007; 22(1): 1-10. http://dx.doi.org/10.1007/s00455-006-9029-4
Baijens LW, Speyer R, Passos VL, Pilz W, Roodenburg N, Clave P. The effect of surface electrical stimulation on swallowing in dysphagic Parkinson patients. Dysphagia 2012; 27(4): 528-37. http://dx.doi.org/10.1007/s00455-011-9387-4
Carnaby-Mann GD, Crary MA. Examining the evidence on neuromuscular electrical stimulation for swallowing: a meta analysis. Archives of Otolaryngology--Head & Nec Surge 2007; 133(6): 564-71. http://dx.doi.org/10.1001/archotol.133.6.564
Clark H, Lazarus C, Arvedson J, Schooling T, Frymark T. Evidence-based systematic review: effects of neuromuscular electrical stimulation on swallowing and neural activation. Amer Jr of Speech-lang path / Amer Speech-Langge-Hearing Assoc 2009; 18(4): 361-75. http://dx.doi.org/10.1044/1058-0360(2009/08-0088)
Hamdy S, Rothwell JC, Aziz Q, Singh KD, Thompson DG. Long-term reorganization of human motor cortex driven by short-term sensory stimulation. Nat Neurosci 1998; 1(1): 64- 8. http://dx.doi.org/10.1038/264
Jayasekeran V, Singh S, Tyrrell P, et al. Adjunctive functional pharyngeal electrical stimulation reverses swallowing disability after brain lesions. Gastroenterol 2010; 138(5): 1737-46. http://dx.doi.org/10.1053/j.gastro.2010.01.052
Furuta T, Takemura M, Tsujita J, Oku Y. Interferential electric stimulation applied to the neck increases swallowing frequency. Dysphagia 2012; 27(1): 94-100. http://dx.doi.org/10.1007/s00455-011-9344-2
Waxman MJ, Durfee D, Moore M, Morantz RA, Koller W. Nutritional aspects and swallowing function of patients with Parkinson's disease. Nutrition in clinical practice: official publication of the American Society for Parenteral and Enteral Nutrition 1990; 5(5): 196-9. http://dx.doi.org/10.1177/0115426590005005196
Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Jr of Psych Res 1975; 12(3): 189-98. http://dx.doi.org/10.1016/0022-3956(75)90026-6
Lof GL, Robbins J. Test-retest variability in normal swallowing. Dysphagia 1990; 4(4): 236-42. http://dx.doi.org/10.1007/BF02407271
Kim Y, McCullough GH. Maximum hyoid displacement in normal swallowing. Dysphagia 2008; 23(3): 274-9. http://dx.doi.org/10.1007/s00455-007-9135-y
Palmer JB. Bolus aggregation in the oropharynx does not depend on gravity. Arch Phys Med Rehabil 1998; 79(6): 691- 6. http://dx.doi.org/10.1016/S0003-9993(98)90046-6
Miller AJ. The neurobiology of swallowing and dysphagia. Devel Disabi Res Rev 2008; 14(2): 77-86. http://dx.doi.org/10.1002/ddrr.12
Jean A. Brain stem control of swallowing: Neuronal network and cellular mechanisms. Physiol Rev 2001; 81(2): 929-69.
Hrycyshyn AW, Basmajian JV. Electromyography of the oral stage of swallowing in man. The Amer Jr of Anat 1972; 133(3): 333-40. http://dx.doi.org/10.1002/aja.1001330307
Ezure K, Oku Y, Tanaka I. Location and axonal projection of one type of swallowing interneurons in cat medulla. Brain Res 1993; 632(1-2): 216-24. http://dx.doi.org/10.1016/0006-8993(93)91156-M
Sumi T. Reticular ascending activation of frontal cortical neurons in rabbits, with special reference to the regulation of deglutition. Brain Res 1972; 46: 43-54. http://dx.doi.org/10.1016/0006-8993(72)90004-2
