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Effect of Neuromuscular Electrical Stimulation (NMES) on the Measures of Hyolaryngeal Elevation during Swallow in Individuals with Parkinson’s Disease
Abstract
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.
Keywords
References
Marino BL, de Souza LR, Sousa K, et.al Parkinson’s disease: a review from pathophysiology to treatment. Mini reviews in medicinal chemistry. 2020; 20(9): 754-67.
Kendall KA, Leonard RJ. Bolus transit and airway protection coordination in older dysphagic patients. Laryngoscope. 2001; 111(11 Pt 1): 2017-21
Pearson Jr WG, Hindson DF, Langmore SE, Zumwalt AC. Evaluating swallowing muscles essential for hyolaryngeal elevation by using muscle functional magnetic resonance imaging. International Journal of Radiation Oncology* Biology* Physics. 2013; 85(3): 735-40.
Kahrilas PJ, Logemann JA, Krugler C, et al. Volitional augmentation of upper esophageal sphincter opening during swallowing. American Journal of Physiology-Gastrointestinal and Liver Physiology. 1991; 260(3): G450-6.
Troche MS, Okun MS, Rosenbek JC et al. Sapienza CM. Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial. Neurology. 2010; 75(21): 1912-9.
Wheeler-Hegland KM, Rosenbek JC, Sapienza CM. Submental sEMG and hyoid movement during Mendelsohn maneuver, effortful swallow, and expiratory muscle strength training.
Lee HY, Hong JS, Lee KC, et al. Changes in hyolaryngeal movement and swallowing function after neuromuscular electrical stimulation in patients with Dysphagia. Ann Rehabil Med. 2015; 39(2):199-209.
Xia W, Zheng C, Lei Q, et al. Treatment of post-stroke dysphagia by vitalstim therapy coupled with conventional swallowing training. Journal of Huazhong University of Science and Technology [Medical Sciences]. 2011; 31(1): 73-6.
Beom J, Kim SJ, Han TR. Electrical Stimulation of the Suprahyoid Muscles in Brain-injured Patients with Dysphagia: A Pilot Study. Ann Rehabil Med. 2011; 35(3): 322-7.
Lim KB, Lee HJ, Lim SS, Choi YI. Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial. Journal of rehabilitation medicine. 2009; 41(3): 174-8.
Lee Y, Nicholls B, Sup Lee D, Chen Y, Chun Y, Siang Ang C, Yeo WH. Soft electronics enabled ergonomic human-computer interaction for swallowing training. Scientific Reports. 2017; 7(1): 1-2.
Oh DH, Park JS, Kim WJ. Effect of neuromuscular electrical stimulation on lip strength and closure function in patients with dysphagia after stroke. Journal of Physical Therapy Science. 2017; 29(11): 1974-5.
Umay EK, Yaylaci A, Saylam G, et al. The effect of sensory level electrical stimulation of the masseter muscle in early stroke patients with dysphagia: A randomized controlled study. Neurology India. 2017; 65(4):734.
Frost J, Robinson HF, Hibberd J. A comparison of neuromuscular electrical stimulation and traditional therapy, versus traditional therapy in patients with longstanding dysphagia. Curr Opin Otolaryngol Head Neck Surg. 2018; 26(3): 167-173.
Curtis JA, Huber JE, Dakin AE, Troche MS. Effects of Bolus Holding on Respiratory-Swallow Coordination in Parkinson's Disease. Am J Speech Lang Pathol. 2022; 31(2): 705-721.
Heijnen BJ, Speyer R, Baijens LW, et.al Neuromuscular electrical stimulation versus traditional therapy in patients with Parkinson's disease and oropharyngeal dysphagia: effects on quality of life. Dysphagia. 2012; 27(3): 336-45.
Lin CW, Chang YC, Chen WS, et al. Prolonged swallowing time in dysphagic Parkinsonism patients with aspiration pneumonia. Archives of physical medicine and rehabilitation. 2012; 93(11): 2080-4.
Lin PH, Hsiao TY, Chang YC, et al. Effects of functional electrical stimulation on dysphagia caused by radiation therapy in patients with nasopharyngeal carcinoma. Supportive Care in Cancer. 2011; 19(1): 91-9.
Long YB, Wu XP. A randomized controlled trail of combination therapy of neuromuscular electrical stimulation and balloon dilatation in the treatment of radiation-induced dysphagia in nasopharyngeal carcinoma patients. Disability and rehabilitation. 2013; 35(6):450-4.
Ludlow CL, Humbert I, Saxon K, et al. Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal dysphagia. Dysphagia. 2007; 22(1): 1-0.
Nam HS, Beom J, Oh BM, Han TR. Kinematic effects of hyolaryngeal electrical stimulation therapy on hyoid excursion and laryngeal elevation. Dysphagia. 2013; 28(4):548-56.
Schultz JL, Perlman AL, VanDaele DJ. Laryngeal movement, oropharyngeal pressure, and submental muscle contraction during swallowing. Archives of physical medicine and rehabilitation. 1994; 75(2): 183-8.
Suttrup I, Warnecke T. Dysphagia in Parkinson’s disease. Dysphagia. 2016; 31(1): 24-32.
Tan C, Liu Y, Li W, et al. Transcutaneous neuromuscular electrical stimulation can improve swallowing function in patients with dysphagia caused by non‐stroke diseases: a meta‐analysis. Journal of oral rehabilitation. 2013; 40(6): 472-80.
Terré R, Mearin F. A randomized controlled study of neuromuscular electrical stimulation in oropharyngeal dysphagia secondary to acquired brain injury. European journal of neurology. 2015; 22(4): 687-e44.
J.A. Logemann., (1998) Evaluation and Treatment of Swallowing Disorder, 2nd ed., Pro-Ed,
Jayasekeran V, Singh S, Tyrrell P, et al. Adjunctive functional pharyngeal electrical stimulation reverses swallowing disability after brain lesions. Gastroenterology. 2010; 138(5):1737-46.
Park JS, Jung YJ, Kim HH, Lee G. A novel method using kinesiology taping for the activation of suprahyoid muscles in healthy adults: A preliminary research. Dysphagia. 2020; 35(4): 636-42.
Park JS, Oh DH, Hwang NK, Lee JH. Effects of neuromuscular electrical stimulation in patients with Parkinson’s disease and dysphagia: a randomized, single-blind, placebo-controlled trial. NeuroRehabilitation. 2018; 42(4):457-63.
Carnaby-Mann GD, Crary MA. Examining the evidence on neuromuscular electrical stimulation for swallowing: a meta-analysis. Arch Otolaryngol Head Neck Surg. 2007; 133(6): 564-71.
Alamer A, Melese H, Nigussie F. Effectiveness of neuromuscular electrical stimulation on post-stroke dysphagia: a systematic review of randomized controlled trials. Clinical interventions in aging. 2020; 15: 1521.
Lim KB, Lee HJ, Yoo J, Kwon YG. Effect of low-frequency rTMS and NMES on subacute unilateral hemispheric stroke with dysphagia. Annals of Rehabilitation Medicine. 2014; 38(5): 592-602.
Carnaby GD, LaGorio L, Silliman S, Crary M. Exercise-based swallowing intervention (McNeill Dysphagia Therapy) with adjunctive NMES to treat dysphagia post-stroke: A double-blind placebo-controlled trial. J Oral Rehabil. 2020; 47(4): 501-510.
Ryu JS, Kang JY, Park JY, et al. The effect of electrical stimulation therapy on dysphagia following treatment for head and neck cancer. Oral Oncology. 2009; 45(8): 665-8.
Kim, H. S, Kwon, J. B., Lim, et al. 10 Yea Epidemiologic data of Parkinson’s Disease: A Nationwide Population-based Retrospective Cohort of South Korea. bioRxiv,2018; 253682.
Kim, J. The Effect of Bolus Volume on Hyolaryngeal Muscle Activity in Parkinson's Disease (Doctoral dissertation, Texas Christian University). 2018
Li L, Li Y, Huang R, et al. The value of adding transcutaneous neuromuscular electrical stimulation (VitalStim) to traditional therapy for post-stroke dysphagia: a randomized controlled trial. Eur J Phys Rehabil Med. 2015; 51(1):71-8.
Dafiah PM, Swapna N. Variations in the amplitude and duration of hyolaryngeal elevation during swallow: Effect of sour and carbonated liquid bolus. Physiol Behav. 2020; 224: 113028.
Rofes L, Arreola V, Almirall J, et al. Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterology research and practice. 2010; 2011.
Park JM, Yong SY, Kim JH, et al. Cutoff value of pharyngeal residue in prognosis prediction after neuromuscular electrical stimulation therapy for Dysphagia in subacute stroke patients. Annals of Rehabilitation Medicine. 2014; 38(5): 612-9.
Costa DR, Santos PSDS, Fischer Rubira CM, B. et al. Immediate effect of neuromuscular electrical stimulation on swallowing function in individuals after oral and oropharyngeal cancer therapy. SAGE Open Med. 2020; 8: 2050312120974152.
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 (1985). 2006; 101(6): 1657-63.
Baijens LW, Speyer R, Passos VL, et al. Surface electrical stimulation in dysphagic Parkinson patients: a randomized clinical trial. Laryngoscope. 2013; 123(11): E38-44.
Carnaby-Mann GD, Crary MA. Adjunctive neuromuscular electrical stimulation for treatment-refractory dysphagia. Ann Otol Rhinol Laryngol. 2008; 117(4): 279-87.
Zeng Y, Yip J, Cui H, et al. Efficacy of neuromuscular electrical stimulation in improving the negative psychological state in patients with cerebral infarction and dysphagia. Neurological research. 2018; 40(6): 473-9.
Zhang M, Tao T, Zhang ZB, et al. Effectiveness of neuromuscular electrical stimulation on patients with dysphagia with medullary infarction. Archives of physical medicine and rehabilitation. 2016; 97(3):355-62.
Zoratto DC, Chau T, Steele CM. Hyolaryngeal excursion as the physiological source of swallowing accelerometry signals. Physiological measurement. 2010; 31(6):843.
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