Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal Dysphagia

We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation (1) lowered the hyoid bone and/or larynx when applied at rest, and (2) increased aspiration, penetration, or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on...

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Bibliographic Details
Published in:Dysphagia 2007-01, Vol.22 (1), p.1-10
Main Authors: Ludlow, Christy L, Humbert, Ianessa, Saxon, Keith, Poletto, Christopher, Sonies, Barbara, Crujido, Lisa
Format: Article
Language:English
Subjects:
Adult
Aged
Chronic Disease
Deglutition - physiology
Deglutition Disorders - therapy
Electric Stimulation - instrumentation
Female
Humans
Hyoid Bone - innervation
Larynx
Male
Middle Aged
Pharynx - physiology
Pilot Projects
Rest
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Summary:We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation (1) lowered the hyoid bone and/or larynx when applied at rest, and (2) increased aspiration, penetration, or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on the skin overlying the submandibular and laryngeal regions. Maximum tolerated levels of stimulation were applied while patients held their mouth closed at rest. Videofluoroscopic recordings were used to measure hyoid movements in the superior-inferior and anterior-posterior dimensions and the subglottic air column position while stimulation was on or off. Patients swallowed 5 ml liquid when stimulation was off, at low sensory stimulation levels, and at maximum tolerated levels (motor). Speech pathologists, blinded to condition, tallied the frequency of aspiration, penetration, pooling, and esophageal entry from videofluorographic recordings of swallows. Only significant (p = 0.0175) hyoid depression occurred during stimulation at rest. Aspiration and pooling were significantly reduced only with low sensory threshold levels of stimulation (p = 0.025) and not during maximum levels of surface electrical stimulation. Those patients who had reduced aspiration and penetration during swallowing with stimulation had greater hyoid depression during stimulation at rest (p = 0.006). Stimulation may have acted to resist patients' hyoid elevation during swallowing.
ISSN:0179-051X
1432-0460
DOI:10.1007/s00455-006-9029-4