Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation Purpose To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method A systematic search was conducted ... Review Article
Review Article  |   November 01, 2009
Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation
 
Author Affiliations & Notes
  • Heather Clark
    Appalachian State University, Boone, NC
  • Cathy Lazarus
    NYU Langone Medical Center, New York
  • Joan Arvedson
    Children’s Hospital of Wisconsin, Milwaukee
  • Tracy Schooling
    Appalachian State University, Boone, NC
  • Tobi Frymark
    American Speech-Language-Hearing Association, Rockville, MD
  • Contact author: Tracy Schooling, National Center for Evidence-Based Practice in Communication Disorders, American Speech-Language-Hearing Association, 2200 Research Boulevard #245, Rockville, MD 20850-3289. E-mail: tschooling@asha.org.
Article Information
Swallowing, Dysphagia & Feeding Disorders / Review Articles
Review Article   |   November 01, 2009
Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation
American Journal of Speech-Language Pathology, November 2009, Vol. 18, 361-375. doi:10.1044/1058-0360(2009/08-0088)
History: Received December 19, 2008 , Accepted May 12, 2009
 
American Journal of Speech-Language Pathology, November 2009, Vol. 18, 361-375. doi:10.1044/1058-0360(2009/08-0088)
History: Received December 19, 2008; Accepted May 12, 2009
Web of Science® Times Cited: 40

Purpose To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation.

Method A systematic search was conducted to identify relevant studies published in peer-reviewed journals from 1960 to 2007. All studies meeting the exclusion/inclusion criteria were appraised for quality and categorized as efficacy or exploratory research based on predetermined criteria.

Results Out of 899 citations initially identified for the broad review of OMEs, 14 articles relating to NMES qualified for inclusion. Most of the studies (10/14) were considered exploratory research, and many had significant methodological limitations.

Conclusions This systematic review reveals that surface NMES to the neck has been most extensively studied with promising findings, yet high-quality controlled trials are needed to provide evidence of efficacy. Surface NMES to the palate, faucial pillars, and pharynx has been explored in Phase I research, but no evidence of efficacy is currently available. Intramuscular NMES has been investigated in a single Phase I exploratory study. Additional research is needed to document the effects of such protocols on swallowing performance.

Acknowledgments
This evidence-based review was supported by ASHA’s National Center for Evidence-Based Practice in Communication Disorders (N-CEP). We thank the following individuals who participated in the evidence panel to review the state of the evidence on nonspeech OMEs: Dr. Rebecca McCauley, Dr. Edythe Strand, and Dr. Gregory Lof. We also thank the following individuals who contributed to the preparation of this document: Beverly Wang, N-CEP Information Manager; Hillary Leech, N-CEP Research Assistant; and Rob Mullen, N-CEP Director.
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