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Título

CONVENTIONAL SPEECH THERAPY COMBINED WITH FUNCTIONAL ELECTRICAL STIMULATION IN PATIENTS WITH DYSPHAGIA AFTER ACUTE CVA

Resumo

INTRODUCTION: CVA is the main cause of neurogenic oropharyngeal dysphagia. Electrostimulation has been used as a therapeutic tool in these cases. However, few studies prove its efficacy. We evaluated the effect of functional electrostimulation complementing standard speech therapy in patients with dysphagia after stroke in a stroke unit. OBJECTIVES: To evaluate the effect of short-term functional electrostimulation in a CVA unit to complement standard speech therapy in dysphagic patients after acute CVA and to indicate the benefits of different dysphagia techniques rehabilitation as standard therapy and electrotherapy. METHODS: It is a randomized clinical trial, divided into an intervention group (IG) (n = 16) and a control group (CG) (n = 17). Data collection occurred from July 2017 to July 2020. The study included patients with ischemic CVA who had oropharyngeal dysphagia and required enteral feeding. Individuals with degenerative neurological diseases, neoplasia, pacemaker, cochlear implant, febrile state, and pregnancy were excluded. Patients underwent video endoscopy of deglutition (VED), an initial evaluation of the epidemiological and socioeconomic profile, a dysphagia risk assessment protocol (DRAP), and a functional oral intake scale (FOIS). Informed consent was obtained, and all methods were performed under the relevant guidelines and regulations (Declaration of Helsinki). The study was approved under number 2,388,931 and previously registered at ClinicalTrials.gov (NCT03649295) and the Brazilian Registry of Clinical Trials (RBR-56QK5J). RESULTS: There was a significant difference in FOIS scores at follow-up for both groups. Both groups also tended to have improved levels of dysphagia as measured by FEES, although they were not statistically significant. Improvement in feeding occurred in both groups. No significant differences were detected between the groups before and after intervention by DRAP scores. Electrical stimulation showed no additional benefits beyond standard therapy when comparing results between groups. CONCLUSION: Based on the present study results there was a significant difference in FOIS level improvements of the patients in both the intervention group and the placebo group, with no significant difference between the groups.Electrical stimulation protocol use for five days in the acute phase of ischemic CVA did not generate additional benefits beyond conventional therapy and the variables analyzed improved in both groups.

Palavras Chave

Electrical stimulation; dysphagia; stroke; rehabilitation