The effectiveness of surface neuromuscular electrical stimulation for relieving post-stroke dysphagia: A meta-analysis of randomized and controlled trials

Objective To evaluate the effectiveness of swallowing training supplemented with neuromuscular electrical stimulation to provide a reference for clinical treatment and further study. Methods Reports of randomized and controlled trials of surface neuromuscular electrical stimulation in treating post-stroke dysphagia were sought in the Cochrane library, the PubMed and Embase databases, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and also in the ProQuest, PsycARTICLES, CBMdisc, China National Knowledge Infrastructure (CNKI), CQVIP database and Wanfang databases. All of the literature found was evaluated by 2 researchers according to predefined inclusion and exclusion criteria and the data were extracted and combined. Then meta-analysis was performed using version 5.3 of the RevMan software package. Results Eleven randomized and controlled trials involving 576 patients were included in the meta-analysis. Together, the data showed that swallowing training supplemented by neuromuscular electrical stimulation is significantly more effective than swallowing training alone in improving swallowing function. It reduces the risk of aspiration and improves quality of life. It does not, however, generally shorten the pharyngeal transmit time. Conclusions Swallowing training supplemented with neuromuscular electrical stimulation is a promising approach for treatment of post-stroke dysphagia and warrants further study. Key words: Dysphagia; Neuromuscular electrical stimulation; Swallowing training; Meta-analyses