Effects of neuromuscular electrical stimulation in patients with Parkinson’s disease and dysphagia: A randomized, single-blind, placebo-controlled trial

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Abstract
BACKGROUND: Neuromuscular electrical stimulation has been used to improve swallowing function in neurologic patients with dysphagia, but its effect on patients with dysphagia and Parkinson’s disease remains unclear. OBJECTIVES: This study aimed to identify the effect of effortful swallowing combined with neuromuscular electrical stimulation as a novel treatment approach in dysphagic patients with Parkinson’s disease. METHODS: Participants were randomly allocated to an experimental group ( n = 9) or a placebo group ( n = 9). The experimental group simultaneously received neuromuscular electrical stimulation with effortful swallowing, while the placebo group received sham neuromuscular electrical stimulation with effortful swallowing. All participants received the treatment for 30 min/day at five sessions per week for 4 weeks. Both groups also received the same conventional dysphagia therapy. RESULTS: The experimental group showed significant differences in horizontal movement ( p = 0.038) and vertical movement ( p = 0.042) compared to the placebo group, but showed no significant differences in the oral ( p = 0.648) or pharyngeal phase ( p = 0.329) of the Videofluoroscopic Dysphagia Scale compared to the placebo group, except for the Penetration-Aspiration Scale ( p = 0.039). CONCLUSIONS: We demonstrated that neuromuscular electrical stimulation applied to the infrahyoid region combined with effortful swallowing effectively increased hyoid bone movement and reduced aspiration in dysphagic patients with Parkinson’s disease.

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