Combined conventional speech therapy and functional electrical stimulation in acute stroke patients with dyphagia: a randomized controlled trial.

Abstract

BACKGROUND:

Stroke is the main cause of oropharyngeal neurogenic dysphagia. Electrostimulation has been used as a therapeutic tool in these cases. However, there are few studies that prove its effectiveness. We evaluated the effect of functional electrostimulation as a complement to conventional speech therapy in patients with dysphagia after a stroke in a stroke unit.

METHODS:

We performed a clinical, randomized, and controlled trial divided into intervention group (IG) (n = 16) and control group (CG) (n = 17). All patients were treated with conventional speech therapy, and the IG also was submitted to the functional electrotherapy. Primary outcomes were Functional Oral Ingestion Scale (FOIS) and Swallowing videoendoscopy (FEES). The degree of dysphagia was scored in functional, mild, moderate and severe dysphagia according to FEES procedure. Dysphagia Risk Evaluation Protocol (DREP) was considered a secondary outcome.

RESULTS:

There was a significant difference regarding FOIS scores after 5 days of intervention in groups. Both groups also showed a tendency to improve dysphagia levels measured by FEES, although not statistically significant. Improvements on oral feeding was seen in both groups. No significant differences between groups before and after the intervention were detected by DREP scores. Electrical stimulation did not show additional benefits beyond conventional therapy when comparing outcomes between groups.

CONCLUSION:

Conventional speech therapy improved oral ingestion even regardless the use of electrostimulation in a stroke unit.

TRIAL REGISTRATION:

This research was registered in ClinicalTrials.gov (Identifier: NCT03649295 ) in 28/08/2018 and in the Brazilian Registry of Clinical Trials (ReBEC) (Register Number: RBR-56QK5J), approval date: 18/12/2018. HGF Ethics Committee Approval Number: N. 2.388.931.

• Authors: Klayne Cunha Matos, Vanessa Fernandes de Oliveira, Paula Luanna Carvalho de Oliveira, Fabíola Aureliano Carvalho, Maria Renata Matos de Mesquita, Camila Gabriella da Silva Queiroz, Levi Mota Marques, Débora Lilian Nascimento Lima, Fernanda Martins Maia Carvalho, Pedro Braga-Neto
• Journal: BMC neurology (BMC Neurol) Vol. 22 Issue 1 Pg. 231 (Jun 22 2022) ISSN: 1471-2377 [Electronic] England
• PMID: 35733098 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2022. The Author(s).

Topics

• Deglutition
• Deglutition Disorders (etiology, therapy)
• Electric Stimulation (adverse effects)
• Electric Stimulation Therapy (methods)
• Humans
• Speech Therapy
• Stroke (complications, therapy)
• Stroke Rehabilitation (methods)
• Treatment Outcome