Neuromuscular Electrical Stimulation

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The subject of Neuromuscular Electrical Stimulation (NMES) in the treatment of dysphagia triggers much controversy within the field of speech-language pathology. The argument created between professionals with opposing views is mainly due to a lack of sufficient empirical evidence that NMES either improves or decreases swallow function. Currently, studies examining the outcome of NMES application are not of high quality and often yield inconclusive results. Despite limited evidence-based support, many clinicians incorporate NMES into dysphagia treatment plans in a variety of clinical cases. This is problematic as the American Speech-Language Hearing Association (ASHA) has promoted evidence-based practice as an integral component of clinical decision-making in recent years (ASHA 2005). To better understand the debate surrounding NMES and its implementation, several aspects of this treatment modality must be considered. While NMES in the treatment of dysphagia is a relatively new clinical practice, NMES itself is not. In physical and occupational therapy, electrical stimulation of the trunk and limbs has been a successful and well-documented component of rehabilitation (Clark, Lazarus, Arvedson, Schooling, & Frymark 2009). However, generalizing the possible benefits of NMES across disciplines to the swallowing mechanism is difficult because the oral, pharyngeal, and laryngeal systems are unique in structure and function. Regardless of these apparent differences, Defabrizio
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