O efeito da eletroestimulação neuromuscular na contração da musculatura supra-hióidea durante a deglutição de indivíduos com disfagia

Abstract

Purpose: the purpose of this study is to verify the effect of Neuromuscular Electrical Stimulation on the suprahyoid muscle activity during swallowing, in post stroke subjects, with oropharyngeal dysphagia. Methods: participated eight post-stroke subjects with dysphagia, male and female, referred to speech--language therapy to early swallowing rehabilitation. Before the first rehabilitation session, the patient´s muscular electrical activity of suprahyoid muscle was measured using Surface Electromyography Biofeedback. Patients were randomly divided into two groups: Experimental Group (n=4): patients who received both traditional speech-language therapy and the application of Neuromuscular Electrical Stimulation. Control Group (n=4): patients submitted to traditional speech-language therapy. After eight sessions, all patients measured the suprahyoid activity with the Surface Electromyography Biofeedback. The pre and post treatment results were compared in both groups. Results: comparing the two groups average of time and amplitude of the muscle contraction during swallowing of saliva and two swallows of paste, no statistically significant differences were observed in the pre and post treatment values. Conclusion: the use of Neuromuscular Electrical Stimulation on the parameters and methodology used did not prove efficient in promoting greater contraction of the suprahyoid muscles during the swallowing, in post-stroke individuals with oropharyngeal dysphagia. The data obtained may be due to the methodology used in this study relative to the protocol application and the way to measure the results. Keywords: Transcutaneous Electric Nerve Stimulation; Deglutition Disorders; Stroke; Speech Therapy; Electromyography RESUMO Objetivo: verificar o efeito da Eletroestimulação Neuromuscular na contração da musculatura supra--hióidea durante a deglutição em indivíduos pós-Acidente Vascular Cerebral com disfagia orofarín-gea. Métodos: participaram da pesquisa oito indivíduos pós-Acidente Vascular Cerebral com disfagia, de ambos os sexos, encaminhados para terapia fonoaudiológica com objetivo de trabalhar a função da deglutição, em início de processo terapêutico. Anteriormente ao início da primeira sessão, foi realizada a mensuração do tempo e amplitude da atividade elétrica muscular através da Eletromiografia de Superfície de Biofeedback. Os pacientes foram divididos aleatoriamente em dois grupos: Grupo Experimental (n=4): pacientes que receberam a fonoterapia tradicional e aplicação da Eletroestimulação Neuromuscular; Grupo Controle (n=4): pacientes que receberam a fonoterapia tradicional. Após oito sessões, todos os pacientes passaram novamente pela Eletromiografia de Superfície de Biofeedback para verificar a atividade elétrica da musculatura supra-hióidea. Os registros dos exames pré e pós intervenção foram comparados nos dois grupos. Resultados: comparando-se as médias das variáveis de amplitude e tempo da atividade elétrica muscular durante a deglutição de saliva e nas duas deglutições de pastoso, não foram obse...

Suprahyoid Muscle Activity in Patients with Chagasic Megaesophagus

“…EMG has been used to assess the activity of swallowing muscles, both in people with normal swallowing and in those with swallowing disorders 29 . When studying the electromyographic activity of individuals with and without CD, we observed that patients with CD had lower activity than those without CD.…”

“…It is important to consider that the amplitude of the electrical activity, recorded by EMG in this study, is one of the important factors in the relationship between muscle recruitment and electrical activity 29 . However, amplitude variations in EMG are not only due to biological causes, but also due to technical factors such as skin/electrode impedance, anatomical location of recording electrodes, differences in muscle size between individuals, and temperature 15 .…”

Electroestimulacion neuromuscular aplicada en disfagia.

“…Para tratar la disfagia orofaríngea se requiere un abordaje de rehabilitación, entre diversas técnicas tenemos la modalidad terapéutica de electroestimulación neuromuscular, dicha intervención comprende la aplicación de electrodos en la región del cuello provocando la estimulación de contracciones en los músculos responsables de la deglución con el fin de potenciar la funcionalidad de dicha musculatura: Como ser restablecer las condiciones mínimas de contracción muscular, funcionalidad muscular, propiocepción y cinestesia vinculada directa e indirectamente a la movilidad laríngea en el proceso deglutorio. Existe un acuerdo literario a considerar que resultados son en su mayoría efectivos si se aplica electroterapia en combinación con ejercicios de compensación enfocados en la rehabilitación de disfagia (12)(13)(14)(15).…”