Chi-Nung Lin, Chia-Lung Shih
Neuromuscular electrical stimulation (NMES) has been proposed as an adjunct to conventional swallowing therapy; however, evidence regarding its additive benefit in early-stage stroke remains inconclusive. This study aimed to determine whether NMES combined with traditional swallowing therapy provides superior outcomes compared with traditional therapy alone in enteral tube-dependent patients with acute and subacute post-stroke dysphagia. A total of 57 participants with post-stroke dysphagia who met the inclusion criteria were randomly assigned to either the NMES combined with traditional swallowing therapy group or the traditional swallowing therapy with sham stimulation group. Both groups were scheduled to receive 10 treatment sessions over a 2-week period. Outcomes were assessed at baseline, after the first week of the intervention, at the end of the 2-week intervention period, and 2 weeks after completion of the intervention. The primary outcome was functional oral intake measured by the Functional Oral Intake Scale (FOIS). Secondary outcomes included swallowing-related symptom severity (EAT-10) and swallowing-related quality of life (SWAL-QOL). Both groups demonstrated significant improvement over time. However, the NMES group showed significantly greater improvements in FOIS after the first week of the intervention, at the end of the 2-week intervention period, and 2 weeks after completion of the intervention (all p < 0.05). Greater reductions in EAT-10 scores were also observed in the NMES group across all post-intervention assessments. Improvements in SWAL-QOL total scores were significant in both groups, with a between-group difference observed only after the first week of the intervention. Adjunctive NMES enhances early functional recovery and symptom reduction in acute and subacute post-stroke dysphagia.