Review Article

Transcutaneous Electrical Stimulation and Dysphagia Rehabilitation: A Narrative Review

Table 1

Summaries of studies regarding the effects of transcutaneous electrical stimulation (TES) on the clinical aspect of swallowing.

StudyStudy designSample sizeDysphagia etiologyType of interventionOutcome measuresKey findings

Freed et al. [2]Case-control study11StrokeTES vs. TTSwallow function scoreSwallowing function was improved in both groups. The score change was greater in TES vs. TT group.

Blumenfeld et al. [3]Retrospective cohort study80 (40 patients and 40 controls)MixedTES vs. TTSwallow severity scalePatients who underwent TES demonstrated better swallowing function.

Kushner et al. [4]Case-control study92 (46 patients and 46 controls)StrokeTES+TT vs. TTFOISBoth TES+TT and TT improved swallowing functions. Swallowing function was greater when TES was combined with TT compared with TT alone.

Lee et al. [5]RCT57 (31 patients and 26 controls)StrokeTES+TT vs. TTFOISBoth TES+TT and TT improved swallowing functions. Swallowing function was greater when TES was combined with TT compared with TT alone.

Sun et al. [6]Case-series29StrokeTES+FEES+TTFOISCombined dysphagia rehabilitation (TES+FEES+TT) improved swallowing function.

Tang et al. [7]Retrospective cohort study103 (53 patients, 50 control)Alzheimer’s diseaseTES+sEMG vs. TTWater swallow test. MNA aspiration pneumoniaSwallowing function, nutritional status, and airway safety were better in the experimental group

Ortega1 et al. [9]RCT38 (19 patients and 19 controls)AgingSensory TES vs. capsaicinEAT-10 PAS VFSSBoth therapies improved the safety of swallow and oropharyngeal swallow response.

Zhang1 et al. [11]RCT64 (16 TES+sham rTMS vs. 16 TES+ipsilateral rTMS vs. 16 TES+contralateral rTMS vs. 16 TES+bilateral rTMS)StrokeTES+sham rTMS vs. TES+ipsilateral rTMS vs. TES+contralateral rTMS vs. TES+bilateral rTMS)Motor evoked potential, standardized swallowing assessmentBi-rTMS/TES produced higher cortical activation and better swallowing function.

Baijens et al. [12]RCT90 (30 TT, 30 motor TES, and 30 sensory TES)Parkinson’s diseaseMotor TES+TT vs. Sensory TES+TT vs. TTVisuoperceptual ordinal variables in FEES and VFSSBoth TES groups had no significant impacts on swallowing function

Heijens et al. [13]RCT85 (26 TT, 27 motor TES, and 30 sensory TES)Parkinson’s diseaseMotor TES vs. sensory TES vs. TTFOIS SWAL-QOL MDADI DSSDSS was significantly improved after treatment for all groups. Limited improvements on the SWAL-QOL and the MDADI for all groups. No significant differences were observed between groups.

Guillén-Solà et al. [15]RCT62 (21 TT, 21 TT+IEMT, and 20 sham IEMT+ TES)StrokeTT vs. TT+IEMT vs. sham IEMT+TESPAS maximal inspiratory and expiratory pressuresMaximal respiratory pressures were mostly improved in group two (TT+IEMT). Swallowing security signs were improved in both groups two (TT+IEMT) and three (sham IEMT+ TES). No differences in PAS or respiratory complications were detected among three groups.

Carnaby et al. [16]RCT53 (17 TT, 18 TES+ MDTP, 18 sham TES+MDTP)StrokeTT vs. TES+MDTP vs. sham TES+MDTPMASA FOISTES+MDTP had poor outcome compared with sham TES +MDTP

Langmore et al. [17]RCT127 (91 patients and 36 controls)HNCTES+TT vs. sham TES+TTPAS OPSE VFSS PSS HNCITES+TT group had worse PAS scores compared with the control group. Nutrition and quality of life were improved for both groups. No other significant changes compared with baseline for both groups.

TES: transcutaneous electrical stimulation; RCT: randomized controlled trial; TT: traditional treatment; FOIS: functional oral intake; FEES: fiberoptic endoscopic examination of swallowing; SWAL-QOL: Swallowing Quality of Life Questionnaire; MDADI: MD Anderson dysphagia inventory; DSS: dysphagia severity scale; VFSS: videofluoroscopic swallowing study; MDTP: McNeill Dysphagia Therapy Program; PAS: penetration aspiration scale; OPSE: oropharyngeal swallow efficiency; PSS: performance status scale; HNC: head neck cancer; HNCI: head and neck cancer inventory; EAT-10: Eating Assessment Tool 10; IEMT: inspiratory/expiratory muscle training; sEMG: surface electromyography; MNA: mini nutritional assessment; rTMS: repetitive transcranial magnetic stimulation.