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Effect of Neuromuscular Electrical Stimulation (NMES) on the Measures of Hyolaryngeal Elevation during Swallow in Individuals with Parkinson’s Disease

M. Sonam Belliappa, S.P. Goswami


Inadequate hyolaryngeal elevation is one among the leading cause of aspiration and dysphagia in individuals with Parkinson’s disease. Treatment protocols specific in strengthening the hyolaryngeal elevation are seldom studied in this population. Neuromuscular Electrical Stimulation (NMES) for swallow is a recent technical advancement in the arena of dysphagia rehabilitation that targets on stimulating the laryngeal extrinsic and the suprahyoid muscles, responsible for adequate movements of the hyolaryngeal complex. The literature published on the efficacy of using NMES in persons with post stroke, post head and neck cancer dysphagia has evidenced a positive outcome. There are seldom research evidences that addressed the effect of NMES on the hyolaryngeal mechanism in individuals with PD. The current study aimed to investigate the effect of NMES on the hyolaryngeal measures (duration and amplitude) across three swallowing conditions (dry swallow, liquid swallow and semisolid swallow) in individuals with PD with mild Dysphagia. Eight individuals with PD with mild Dysphagia in the age range of 56–78 years, within 6 months of onset of the disease participated in the study. For ten days, the subjects underwent NMES therapy in ten sessions, each lasting 45 minutes. The measures of the hyolaryngeal elevation (amplitude and duration) were obtained using Digital Accelerometry for Swallow Imaging (DASI) at three time points (pre therapy, post therapy and follow up for three swallow conditions (dry swallow, 5 ml liquid, 5 ml semisolid). Results of the analyzed data showed significant higher amplitude and a longer duration of hyolaryngeal elevation in the post therapy time points of the liquid and semisolid condition. The increase in the amplitude and durational measures indicated a positive effect on the hyolaryngeal physiology. NMES exercise shows a significant improvement in the post therapy values, which indicates the benefit of its usage in dysphagia intervention in individuals with PD.


NMES, Neuromuscular Electrical stimulation, Dysphagia, Parkinson’s disease, PD, Hyolaryngeal elevations

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