Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study
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Objective To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI).Methods Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated.Results There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks.Conclusion The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.
Abstract
Objective To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI).Methods Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated.Results There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks.Conclusion The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.
참고문헌 (29)
- Cohen SM, "Palliative treatment of dysphonia and dysarthria", Otolaryngol Clin North Am, 42, pp.107~121 (2009)
- Cohen SM, "Quality-of-life impact of non-neoplastic voice disorders: a metaanalysis", Ann Otol Rhinol Laryngol, 115, pp.128~134 (2006)
- 이준욱, "뇌손상 장애인의 운전을 위한 인지-지각능력 평가 도구의 개발과 적용: '운전자 인지행동검사'와의 비교", Annals of Rehabilitation Medicine, 28(6), pp.523~531 (2004), 대한재활의학회
- Ertzgaard P, "Practical considerations for goal attainment scaling during rehabilitation following acquired brain injury", J Rehabil Med, 43, pp.8~14 (2011)
- Tanaka T, "A study of upper extremity training for patients with stroke using a virtual environment system", J Phys Ther Sci, 25, pp.575~580 (2013)
- Lagorio LA, "Crosssystem effects of dysphagia treatment on dysphonia: a case report", Cases J, 1, pp.67~ (2008)
- McFarland DH, "Clinical implications of cross-system interactions", Semin Speech Lang, 27, pp.300~309 (2006)
- El Sharkawi A, "Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study", J Neurol Neurosurg Psychiatry, 72, pp.31~36 (2002)
- 윤용순, "뇌졸중 환자의 연하 장애에 대한 기능적 전기자극의 효과", Annals of Rehabilitation Medicine, 30(5), pp.417~423 (2006), 대한재활의학회
- Fowler LP, "An exploratory study of voice change associated with healthy speakers after transcutaneous electrical stimulation to laryngeal muscles", J Voice, 25, pp.54~61 (2011)
- 변해원, "뇌졸중으로 인한 삼킴장애 환자의 경부근육전기자극치료에 따른 음성 변화", 한국산학기술학회논문지, 13(4), pp.1665~1671 (2012), 한국산학기술학회[DOI]
- Humbert IA, "The effect of surface electrical stimulation on vocal fold position", Laryngoscope, 118, pp.14~19 (2008)
- Freed ML, "Electrical stimulation for swallowing disorders caused by stroke", Respir Care, 46, pp.466~474 (2001)
- Hirano M, "Clinical examination of voice" (1981), Springer
- Ko DH, "A study of extracting acoustic parameters for individual speakers", Speech Sci, 10, pp.129~143 (2003)
- Logemann JA, "Evaluation and treatment of swallowing disorders" (1998), Pro-Ed
- Han TR, "Quantifying swallowing function after stroke: a functional dysphagia scale based on videofluoroscopic studies", Arch Phys Med Rehabil, 82, pp.677~682 (2001)
- Rosenbek JC, "A penetration-aspiration scale", Dysphagia, 11, pp.93~98 (1996)
- Wesling M, "Dysphagia outcomes in patients with brain tumors undergoing inpatient rehabilitation", Dysphagia, 18, pp.203~210 (2003)
- 김상범, "급성 뇌경색 환자에서 성대 마비의 빈도와 흡인 위험성과의 상관관계", Annals of Rehabilitation Medicine, 34(1), pp.15~19 (2010), 대한재활의학회
- Kent RD, "Voice dysfunction in dysarthria: application of the Multi-Dimensional Voice Program", J Commun Disord, 36, pp.281~306 (2003)
- Yu P, "Objective voice analysis for dysphonic patients: a multiparametric protocol including acoustic and aerodynamic measurements", J Voice, 15, pp.529~542 (2001)
- Wang YT, "Voice acoustic analysis of Taiwanese adults with dysarthria following stroke", Can Acoust, 38, pp.142~143 (2010)
- "Massachusetts Institute of Technology", 2009
- Burnett TA, "Laryngeal elevation achieved by neuromuscular stimulation at rest", J Appl Physiol (1985), 94, pp.128~134 (2003)
- Zraick RI, "Adult normative data for the KayPENTAX Phonatory Aerodynamic System Model 6600", J Voice, 26, pp.164~176 (2012)
- Mehta RP, "Long-term therapy for spasmodic dysphonia: acoustic and aerodynamic outcomes", Arch Otolaryngol Head Neck Surg, 127, pp.393~399 (2001)
- Lu FL, "Efficacy of intensive phonatory-respiratory treatment (LSVT) for presbyphonia:two case reports", J Voice, 27, pp.786.e11~786.e23 (2013)
- McHenry MA, "Effective airway resistance and vocal sound pressure level in cheerleaders with a history of dysphonic episodes", Folia Phoniatr (Basel), 37, pp.223~231 (1985)