Abstract
Background: Swallowing is a complicated mechanism, principally because the pharynx sub serves respiration as well as swallowing. Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal Neuromuscular Electrical Stimulation with Mendelsohn manuever is a novel treatment for post stroke. This study focuses on specific treatment for Dysphagia as well as the improvement strategies between the ischemic and hemorrhagic stroke.
Method: The study sample comprised 30 patients, of which 15 were ischemic stroke patients and 15 were haemorrhagic stroke patients who are have a age between 40 to 60years.The median time interval between and FOIS & DOSS applied before and after therapy was 2 weeks. Among 30 patients were treated with Neuromuscular Electrical stimulation with Mendelsohn Manuever was given for both the groups.
Result: The paired ‘t’ test values have shows that Pharyngeal Neuromuscular Electrical Stimulation with Mendelsohn manuever was more effective in both ishemic and haemorraghic stroke patients. The unpaired ‘t’ test values have shown that there was significant difference between two groups in showing improvement in their swallowing between hemorrhagic than ischemic type of subacute stroke patients .
Conclusion: There is significant difference between the improvement of dysphagia in between ischemic and hemorrhagic stroke of subacute stage using neuromuscular pharyngeal stimulation with Mendelsohn manuever. Further concluded that the Patients with hemorrhagic stroke was recovered faster than the ischemic stroke.
Keywords: Dysphagia, Pharyngeal Neuromuscular Electrical Stimulation, Mendelsohn manuever, Functional Oral Intake Scale, Dysphagia Severity and Outcome Scale.
References
- Bath PM, Bath FJ, Smithard DG Interventions for dysphagia in acute stroke. 2000;(2):CD000323.
- Bath PM, Lindenstrom E, Boysen G, De Deyn P, Friis P, Leys D, Marttila R, Olsson J, O'Neill D, Orgogozo J, Ringelstein B, van der Sande J, Turpie AG. Tinzaparin in acute ischaemic stroke (TAIST): a randomised aspirin-controlled trial. 2001 Sep 1;358(9283):702-10
- Cecconi E, Di Piero V. Dysphagia--pathophysiology, diagnosis and treatment. 2012;30:86-9. doi: 10.1159/000333423. Epub 2012 Feb 14.
- Chun MH, Kim D, Chang MC Comparison of dysphagia outcomes between rostral and caudal lateral medullary infarct patients.2017 Jan 31:1-6. doi: 10.1080/00207454.2017.1282479. [Epub ahead of print]
- Cohen SM, Dupont WD, Courey MS. Quality-of-life impact of non-neoplastic voice disorders: a meta-analysis. 2006 Feb;115(2):128-34.
- Cohen SM, Elackattu A, Noordzij JP, Walsh MJ, Langmore SE. Palliative treatment of dysphonia and dysarthria. 2009 Feb;42(1):107-21, x. doi: 10.1016/j.otc.2008.09.010.
- Dziewas R, Warnecke T, Olenberg S, Teismann I, Zimmermann J, Kramer C, Ritter M, Ringelstein EB, Schabitz WR. Towards a basic endoscopic assessment of swallowing in acute stroke development and evaluation of a simple dysphagia score. 2008;26(1):41-7. doi: 10.1159/-000135652. Epub 2008 May 30.
- Ertzgaard P, Ward AB, Wissel J, Borg J. Practical considerations for goal attainm-ent scaling during rehabilitation following acquired brain injury 2011 Jan;43(1):8-14. doi:10.2340/16501977-0664.
- Foley N, Teasell R, Salter K, Kruger E, Martino R. Dysphagia treatment post stroke: a systematic review of randomised controlled trials.2008 May;37(3):258-64. doi: 10.1093/ageing/afn064.
- Foley NC, Martin RE, Salter KL, Teasell RW A review of the relationship between dysphagia and malnutrition following stroke.2009 Sep;41(9):707-13. doi: 10.2340/16501977-0415.
- Freed ML, Freed L, Chatburn RL, Christian M. Electrical stimulation for swallowing disorders caused by stroke.2001 May;46(5):466-74.
- Geeganage C, Beavan J, Ellender S, Bath PM Interventions for dysphagia and nutritional support in acute and subacute stroke. 2012 Oct 17;10:CD000323. doi: 10.1002/14651858.CD000323.pub2.
- Hamdy S, Aziz Q, Rothwell JC, Crone R, Hughes D, Tallis RC, Thompson DG Explaining oropharyngeal dysphagia after unilateral hemispheric stroke. 1997 Sep 6;350(9079):686-92.
- Jayasekeran V, Singh S, Tyrrell P, Michou E, Jefferson S, Mistry S, Gamble E, Rothwell J, Thompson D, Hamdy S Adju-nctive functional pharyngeal electrical stimulation reverses swallowing disability after brainlesions. 2010 May;138(5):1737-46. doi: 10.1053/j.gastro.2010.01.052. Epub 2010 Feb 2.
- Langmore SE, Grillone G, Elackattu A, Walsh M. Disorders of swallowing: palliative care. 2009 Feb;42(1):87-105, ix. doi: 10.1016/j.otc.2008.09.005.
- Lim KB, Lee HJ, Lim SS, Choi YI. Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial. 2009 Feb;41(3):174-8. doi: 10.2340/16501977-0317.
- Ragab S, Soda H, Warusevitane A, Woisard V, Hamdy S; Pharyngeal Electrical Stimulation for Treatment of Dysphagia in Subacute Stroke: A Randomized Controlled Trial.
- Restivo DA, Casabona A, Centonze D, Marchese-Ragona R, Maimone D, Pavone A Pharyngeal electrical stimulation for dysphagia associated with multiple sclerosis:a pilot study.2013 May;6(3):418-23. doi: 10.1016/j.brs.2012.09.001. Epub 2012 Sep 23.
- Scutt P, Lee HS, Hamdy S, Bath PM Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials. 2015;2015: 429053. doi: 10.1155/2015/429053. Epub 2015 Nov 24.
- Tan C, Liu Y, Li W, Liu J, Chen L Transcutaneous neuromuscular electrical stimulation can improve swallowing function in patients with dysphagA1:A25ia caused by non-stroke diseases: a meta-analysis.2013 Jun;40(6):472-80. doi: 10.1111/joor.12057. Epub 2013 Apr 23.
Corresponding Author
Prof. V.Vijayaraj M.P.T., Ph.D (Research Scholar)
HoD, Department of Neurology,
Nandha College of Physiotherapy Erode-52