Journal of International Academy of Physical Therapy Research (국제물리치료학회지)

International Academy of Physical Therapy Research (국제물리치료연구학회)
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Effect of Neuromuscular Electrical Stimulation Combined with Traditional Dysphagia Rehabilitation on Masseter Muscle Thickness and Bite Force in Stroke with Dysphagia Patient

  • Lee, Myunglyeol (Department of Emergency Medical Services, Kyungdong University) ;
  • Lee, Kuija (Department of Emergency Medical Services, Kyungdong University) ;
  • Kim, Jinuk (Department of Emergency Medical Services, Kyungdong University)
  • Received : 2021.04.20
  • Accepted : 2021.05.25
  • Published : 2021.06.30
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Abstract

Background: Patients with dysphagia after stroke are treated with neuromuscular electrical stimulation (NMES), but its effect on masseter muscle thickness and bite force in the oral phase is not well known. Objectives: To investigated the effect of NMES on masseter muscle thickness and occlusal force in patients with dysphagia after stroke. Design: Two group, pre-post design. Methods: In this study, 25 patients with dysphagia after stroke were recruited and allocated to either the experimental or the control groups. Patients in the experimental group were treated with NMES to the masseter muscle at the motor level for 30 minutes and were additionally treated with traditional swallowing rehabilitation for 30 minutes. In contrast, patients in the control group were only treated with traditional swallowing rehabilitation for 30 minutes. Masseter muscle thickness was measured using ultrasonography before and after intervention, and bite force was measured using an bite force meter. Results: The experimental group showed significant improvement in masseter muscle thickness and bite force compared to the control group. Conclusion: NMES combined with traditional dysphagia rehabilitation is effective in improving masseter muscle thickness and bite force in patients with dysphagia after stroke.

Keywords

Acknowledgement

This research was supported by Kyungdong University Research Fund, 2021.

References

  1. Park JS, Jung YJ, Kim MJ. Effects of neuromuscular electrical stimulation synchronized with chewing exercises on bite force and masseter muscle thickness in community-dwelling older adults in south korea: A randomized controlled trial. Int J Environ Res Public Health. 2020;17(13):4902. https://doi.org/10.3390/ijerph17134902
  2. Ide Y. Structural characterictics of the swallowing organ. Jpn J Rehabil Med. 2010;47:683-690. https://doi.org/10.2490/jjrmc.47.683
  3. Mishellany A, Woda A, Labas R, Peyron MA. The challenge of mastication: preparing a bolus suitable for deglutition. Dysphagia. 2006;21(2):87-94. https://doi.org/10.1007/s00455-006-9014-y
  4. Okada K, Enoki H, Izawa S, Iguchi A, Kuzuya M. Association between masticatory performance and anthropometric measurements and nutritional status in the elderly. Geriatr Gerontol Int. 2010;10(1):56-63. https://doi.org/10.1111/j.1447-0594.2009.00560.x
  5. 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. https://doi.org/10.1007/s00455-006-9029-4
  6. Suiter DM, Leder SB, Ruark JL. Effects of neuromuscular electrical stimulation on submental muscle activity. Dysphagia. 2006;21(1):56-60. https://doi.org/10.1007/s00455-005-9010-7
  7. Freed ML, Freed L, Chatburn RL, Christian M. Electrical stimulation for swallowing disorders caused by stroke. Respiratory care. 2001;46(5):466-474.
  8. Meng P, Zhang S, Wang Q, et al. The effect of surface neuromuscular electrical stimulation on patients with post-stroke dysphagia. J Back Musculoskelet Rehabil. 2018;31(2):363-370. https://doi.org/10.3233/BMR-170788
  9. Alamer A, Melese H, Nigussie F. Effectiveness of neuromuscular electrical stimulation on post-stroke dysphagia: A systematic review of randomized controlled trials. Clin Interv Aging. 2020;15:1521. https://doi.org/10.2147/CIA.S262596
  10. Sproson L, Pownall S, Enderby P, Freeman J. Combined electrical stimulation and exercise for swallow rehabilitation post-stroke: a pilot randomized control trial. Int J Lang Commun Disord. 2018;53(2):405-417. https://doi.org/10.1111/1460-6984.12359
  11. Lee KW, Kim SB, Lee JH, Lee SJ, Park JG, Jang KW. Effects of neuromuscular electrical stimulation for masseter muscle on oral dysfunction after stroke. Ann Rehabil Med. 2019;43(1):11. https://doi.org/10.5535/arm.2019.43.1.11
  12. Ferreira AP, Costa DR, Oliveira AI, et al., Shortterm transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular disorder patients: A randomized controlled trial. J Appl Oral Sci. 2017;25(2):112-120. https://doi.org/10.1590/1678-77572016-0173
  13. Farina D, Merletti R, Enoka RM. The extraction of neural strategies from the surface EMG. J Appl Physiol. 2004;96(4):1486-1495. https://doi.org/10.1152/japplphysiol.01070.2003
  14. Rau G, Schulte E, Disselhorst-Klug C. From cell to movement: to what answers does EMG really contribute? J Electromyogr Kinesiol. 2004;14(5):611-617. https://doi.org/10.1016/j.jelekin.2004.02.001
  15. Chang MY, Lee G, Jung YJ, Park JS. Effect of Neuromuscular Electrical Stimulation on Masseter Muscle Thickness and Maximal Bite Force among Healthy Community-Dwelling Persons Aged 65 Years and Older: A Randomized, Double Blind, Placebo-Controlled Study. Int J Environ Res Public Health. 2020;17(11):3783. https://doi.org/10.3390/ijerph17113783