Interferential Current Stimulation for Swallowing Disorders in Chronic Obstructive Pulmonary Disease: A Preliminary Study

Abstract

Swallowing function is affected in patients with chronic obstructive pulmonary disease (COPD), putting them at risk of exacerbation of COPD. We previously reported the effectiveness of the repetitive saliva swallowing test (RSST) in screening for patients at risk of COPD exacerbation. However, evidence on how to improve swallowing function in this population is extremely limited. Interferential current transcutaneous electrical sensory stimulation (IFC-TESS) stimulates the larynx and pharynx, thereby improving their sensory function. IFC-TESS is an emerging tool to enhance airway protection and increase swallowing frequency; however, its safety and efficacy in patients with COPD is unknown. Therefore, we performed a preliminary prospective study focusing on stable COPD patients. Methods: Patients with stable COPD who were hospitalized for yearly evaluation were recruited. Patients were included if their RSST was 5 or less. Nurses carried out IFC-TESS twice daily for 10 days. Swallow screening results were compared before and after the 10-day intervention. Results: Ten patients were included in the study. The IFC-TESS intervention was performed safely. Patients and nurses reported no discomfort or concerns regarding the intervention. The EAT-10 and RSST scores improved significantly after the intervention, and tongue pressure also tended to improve. Conclusions: IFC-TESS may be a promising intervention to improve swallowing in patients with COPD who are easily fatigued and struggle to perform swallowing exercises.

Treatment of Post-stroke Dysphagia With Interferential Current: Three Case Reports and a Review of the Literature

“…The limitations of this study are that although patients' swallowing function was evaluated by VFSS and endoscopy, the outcome measure was only FILS, which is an observational tool to assess nutritional status, and it was a retrospective study. All studies in the literature on the treatment of dysphagia with IFC stimulation have used Gentle Stim® (J Craft, Osaka, Japan), a portable device approved for use in Japan [13][14][15][16][17][18]22,23,26,[31][32][33]. As in this study, we believe that an alternative device capable of providing IFC stimulation can also be used for treatment.…”

“…Based on these results, IFC stimulation may contribute to the prevention of aspiration pneumonia [13][14][15]. Other studies have reported that IFC stimulation can reduce dysphagia and chronic obstructive pulmonary disease (COPD) exacerbations in COPD patients with dysphagia [23,31]. It has also been reported that IFC stimulation can increase salivation in people with dry mouth without causing pain or physical distress [33].…”

“…However, IFC treatment has been shown to significantly increase the number of swallows, improve the swallowing reflex, and lower the sensory threshold. This may reflect changes in plasticity in the cerebral cortex and may serve as an indicator of therapeutic efficacy [31,32]. In some studies aimed at demonstrating the efficacy of IFC in patients with dysphagia due to various etiologies, it has been shown that IFC therapy improves the cough reflex and feeding status, reduces aspiration, and regresses the PAS score.…”

Rastreio da disfagia com Repetitive Saliva Swallowing Test (RSST) em pacientes internados em um hospital universitário

“…A incoordenação entre a respiração e deglutição reduz a proteção de vias aéreas superiores, aumentando o risco de aspiração laringotraqueal (Yoshimatsu, 2020;Prestes et al, 2020). Estudos demonstram uma relação entre disfagia e agravamento da DPOC (Yoshimatsu, 2020;Favero;Texeira;Cardoso, 2020;Yoshimatsu et al, 2022). A detecção precoce de alterações na deglutição na fase inicial da DPOC é crucial para prevenir estágios avançados da doença e gerenciar esses pacientes (Ohta et al, 2009).…”