Effect of swallowing rehabilitation using traditional therapy, kinesiology taping and neuromuscular electrical stimulation on dysphagia in post-stroke patients: A randomized clinical trial.

OBJECTIVE: We aimed to evaluate the functional recovery of stroke patients with orophyaryngeal dysphagia after treatment with traditional swallowing therapy (TST), neuromuscular electrical stimulation (NMES), and kinesiology taping (KT), by using clinical swallowing assessments and objective fiberoptic endoscopic evaluation of swallowing (FEES). METHODS: A total of 37 patients were randomized in three groups: those who received TST and NMES as Group 1 (n:12), those who received both TST and KT as Group 2 (n:13), and those who received TST, NMES, and KT together as Group 3 (n:12). Patients were evaluated before treatment, after treatment, and three months after treatment onset with bedside water-swallow test, Eating Assessment Tool (EAT-10), Functional Oral Intake Scale (FOIS), penetration-aspiration scale (PAS), and National Institute of Health-Swallow Safety Scale (NIH-SSS). FOIS, PAS, and NIS-SSS were completed according to results of fiberoptic endoscopic evaluation of swallowing (FEES). RESULTS: A statistically significant decrease was observed in bedside water-swallow test, EAT-10, PAS, and NIH-SSS scores in all treatment groups 5 weeks and 3 months after treatment onset compared to pre-treatment scores (p < 0.05). There was a statistically significant increase in FOIS scores 5 weeks and 3 months after treatment compared to pretreatment scores in all treatment groups (p < 0.05). When the pre-treatment, 3-week, and 5-month swallow scale scores of all groups were compared, there was no significant different difference in terms of bedside water-swallow test, EAT-10, FOIS, PAS, or NIH-SSS scores (p > 0.05). CONCLUSION: According to the results of our study, KT is a new option in the treatment of stroke-related dysphagia, is an effective treatment approach and its efficacy is maintained throughout long-term follow-up.

Efficacy of Pulsed Radiofrequency Therapy to Dorsal Root Ganglion Adding to TENS and Exercise for Persistent Pain after Total Knee Arthroplasty.

The majority of patients achieve substantial pain relief and improved function after total knee arthroplasty (TKA), but a proportion continues to experience life-disturbing persistent postsurgical pain (PPSP) in the months and years after surgery. This study aimed to assess the efficacy of transcutaneous electrical nerve stimulation (TENS), exercise, and pulsed radiofrequency (PRF) treatment on pain severity, neuropathic pain, knee flexion range of motion (ROM), functional status, and patient satisfaction in patients with PPSP after TKA. This is a retrospective study of prospectively collected data. Patients who were identified retrospectively from hospital charts were divided into two groups: group 1 (n = 17) received TENS and exercise treatment and group 2 (n = 22) received TENS, exercise, and PRF application to the dorsal root ganglion (DRG). The following procedure-related parameters were collected from the special registry form: visual analog scale (VAS), Douleur Neuropathique 4 (DN4) questionnaire, knee flexion ROM, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and patient satisfaction scale scores. The mean follow-up was 253.8 ± 109 days. When the two groups were compared, a significant difference of at least 50% improvement in the VAS (activity) and a significant reduction in the DN4 scores following the last control examination were found in group 2. There was a significant reduction in total WOMAC scores in group 1 compared with group 2 for the four study periods. Higher scores for the patient satisfaction scale were found in group 1 compared with group 2 following the last control examination. Adding PRF to TENS and exercise therapy is useful in reducing the degree of pain and the neuropathic component of PPSP in patients with PPSP.

The efficacy of electrical stimulation in reducing the post-stroke spasticity: a randomized controlled study.

PURPOSE: The purpose of this study is to evaluate the efficacy of surface electrical stimulation on the spasticity occurring in the wrist flexor muscles after a cerebrovascular event. METHOD: Hemiplegic patients with stage 2-3 spasticity in the wrist muscles based on the Ashworth scale were divided into two groups. Both groups were applied stretching. One group was additionally administered neuromuscular electrical stimulation (NMES) to the wrist extensors, in the form of pulsed current, 100 Hz, with a pulse duration of 0.1 msec, and a resting duration of 9 seconds, for 15 minutes to provide the maximum muscular contraction. The efficacy of the treatment was evaluated using the following: modified Ashworth scale (MAS), Fmax/Mmax ratio, Hmax/Mmax ratio, wrist extension range of motion (ROM). The daily activities were assessed by Functional Independence Measurement (FIM) and the motor recovery was evaluated by Brunnstrom motor staging. RESULTS: Both groups revealed a significant recovery after the treatment based on the MAS, the electrophysiological evaluation results, wrist ROM, FIM and Brunnstrom motor staging. The group receiving the combined treatment showed a better recovery in terms of MAS, wrist ROM, FIM and Brunnstrom motor staging compared to the group doing the stretching alone. CONCLUSIONS: The results of this study showed that NMES given together with stretching of the wrist extensor muscles was more effective than stretching of the wrist extensor muscles alone in reducing spasticity.