Research  |   November 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
  • 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
Research   |   November 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: 27

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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