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Randomized Controlled Trial
. 2017 Nov 7:12:1879-1886.
doi: 10.2147/CIA.S140746. eCollection 2017.

Interferential current sensory stimulation, through the neck skin, improves airway defense and oral nutrition intake in patients with dysphagia: a double-blind randomized controlled trial

Keisuke Maeda  1   2 , Takayuki Koga  3 , Junji Akagi  4
Affiliations
Randomized Controlled Trial

Interferential current sensory stimulation, through the neck skin, improves airway defense and oral nutrition intake in patients with dysphagia: a double-blind randomized controlled trial

Keisuke Maeda et al. Clin Interv Aging. .

Abstract

Background: Neuromuscular electrical stimulation with muscle contraction, administered through the skin of the neck, improves a patient's swallowing ability. However, the beneficial effects of transcutaneous electrical sensory stimulation (TESS), without muscle contraction, are controversial. We investigated the effect of TESS, using interferential current, in patients undergoing dysphagia rehabilitation.

Methods: This double-blind, randomized controlled trial involved 43 patients who were prescribed in-hospital dysphagia rehabilitation for ≥3 weeks. Patients were randomly assigned to the sensory stimulation (SS) or sham groups; all received usual rehabilitative care plus 2 weeks of SS or sham intervention. Outcome measures included cough latency times against a 1% citric acid mist, functional oral intake scale (FOIS) scores, and oral nutritional intake - each determined after the second and third week following treatment initiation.

Results: Mean patient age was 84.3±7.5 years; 58% were women. The SS and sham groups had similar baseline characteristics. Changes in cough latency time at 2 weeks (-14.1±14.0 vs -5.2±14.2 s, p=0.047) and oral nutrition intake at 3 weeks (437±575 vs 138±315 kcal/day, p=0.042) improved more in the SS group than in the sham group. Changes in cough frequency and FOIS scores indicated better outcomes in the SS group, based on substantial effect sizes.

Conclusion: TESS, using interferential current through the neck, improved airway defense and nutrition in patients suffering from dysphagia. Further large-scale studies are needed to confirm the technique's effect on swallowing ability.

Keywords: deglutition disorders; nutritional intake; rehabilitation; transcutaneous electric nerve stimulation.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study flow diagram. Notes: Patients (n=47) were randomly divided into two groups. Ultimately, the two groups contained 21 and 22 patients who were included in the final analysis.
Figure 2
Figure 2
Electrode placement. Note: Two different alternating currents (2,000 and 2,050 Hz) are carried between pairs of electrodes, generating a 50-beat interferential current.
Figure 3
Figure 3
Changes from baseline in cough latency time and oral nutrition intake. Notes: Interferential current (IFC) stimulation improves cough latency time (A) and oral nutrition intake (B), compared with sham stimulation, based on changes from baseline values. The closed and open bars represent the IFC sensory stimulation and sham stimulation groups, respectively. Error bars represent the standard errors of the mean.
See this image and copyright information in PMC

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