Neuromuscular Electrical Stimulation and Electromyographic Biofeedback as Adjunctive Modalities in the Treatment of Oropharyngeal Dysphagia in Stroke

C. T. Mituuti, Marcela Maria Alves da Silva, G. Berretin-Félix
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Abstract

Dysphagia is a symptom related to swallowing disorders that impede or hamper safe, efficient, and comfortable oral ingestion. In addition to compromising the swallowing process, dysphagia may impair overall health, the nutritional status, and lung conditions, impacting quality of life as well. Different proposals for the rehabilitation of oropharyngeal dysphagia have been researched over the years. As a therapeutic strategy aimed at the rehabilitation of oropharyngeal dysphagias, the electromyographic (EMG) biofeedback provides improved strength in swallowing and its coordination, understood as the best muscle recruitment during the function, associated with the attention and performance of cortical functions, simultaneously. Neuromuscular electrical stimulation (NMES) is another therapeutic approach used in the rehabilitation of oropharyngeal dysphagia (NMES). NMES has been recommended as an adjunctive modality to improve the results of exercises based on dysphagia therapy. In view of the possibility of using technological resources in the diagnosis and treatment of oropharyngeal dysphagia, this chapter presents the theoretical and procedural framework aimed at the application of EMG biofeedback and NMES as supporting methods in the treatment of oropharyngeal dysphagia, in cases affected by stroke.
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神经肌肉电刺激和肌电图生物反馈作为辅助治疗脑卒中口咽吞咽困难的方法
吞咽困难是一种与吞咽障碍有关的症状,它阻碍或妨碍安全、有效和舒适的口服摄入。除了影响吞咽过程外,吞咽困难还可能损害整体健康、营养状况和肺部状况,并影响生活质量。多年来,人们对口咽吞咽困难的康复提出了不同的建议。作为一种旨在康复口咽吞咽困难的治疗策略,肌电(EMG)生物反馈提供了吞咽力量及其协调性的改善,被理解为功能期间最佳的肌肉招募,同时与注意力和皮质功能的表现相关。神经肌肉电刺激(NMES)是用于口咽吞咽困难(NMES)康复的另一种治疗方法。NMES已被推荐作为一种辅助方式,以改善基于吞咽困难治疗的运动结果。鉴于在口咽吞咽困难的诊断和治疗中利用技术资源的可能性,本章提出了理论和程序框架,旨在将肌电生物反馈和NMES作为支持方法应用于脑卒中患者的口咽吞咽困难的治疗。
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