Issue №5-22, 2023

Original article

https://doi.org/10.38025/2078-1962-2023-22-5-30-39

Expiratory Muscle Training Versus Functional Electrical Stimulation on Pulmonary and Swallowing Functions in Acute Stroke Patients

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1,2 ORCIDMohamed S. Zidan, 1 ORCID Marwa M. Elsayed, 1,2 ORCIDAzza F. Ismail,  3 ORCIDSandra M. Ahmed, 1 ORCIDHany E. Obaya

1 Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
2 Department of Physical Therapy for Internal Medicine and Elderly, Faculty of Physical Therapy, Modern University for Technology and Information, Cairo, Egypt
3 Department of Neurology, Faculty of Medicine, Cairo University, Giza, Egypt


ABSTRACT

INTRODUCTION. Post-stroke dysphagia is reported in 30–50 % of stroke population. It increases mortality rate and leads to serious complications such as expiratory muscle affection which is a major cause of defective swallowing and ineffective airway protection.
Expiratory muscle strength training (EMST) and functional electrical stimulation (FES) are recommended techniques to improve expiratory muscles performance.
AIM. To compare the effect of EMST to that of FES on pulmonary and swallowing functions in acute stroke patients.
MATERIAL AND METHODS. Seventy-two patients with post-stroke dysphagia were divided into two groups. Both groups received traditional dysphagia treatment. In addition, the first group received EMST and the second received neck and abdominal FES. Pulmonary functions were measured before and after in form of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/ FVC ratio and peak expiratory flow (PEF), and arterial blood gases (ABG) while the Gugging Swallowing Scale (GUSS) was used as an indicator of swallowing function results of both groups were compared after one month of treatment.
RESULTS. The post-treatment GUSS, FVC, FEV1 and PEF of the EMST group showed more significant increase compared to the FES group (p < 0.05) with no significant differences in FEV1/FVC (p > 0.05). Regarding ABG, there was more significant decrease in PaCO2 and HCO3 of EMST group compared to FES group (p < 0.01).
CONCLUSION. EMST was more effective than FES when it comes to improving expiratory and swallowing functions in patients with post-stroke dysphagia.

KEYWORDS: humans, deglutition, deglutition disorders, forced expiratory volume, vital capacity, electric stimulation

Acknowledgments: The study had no sponsorship.

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation: Zidan M.S., Elsayed M.M., Ismail A.F., Ahmed S.M., Obaya H.E. Expiratory Muscle Training Versus Functional Electrical Stimulation on Pulmonary and Swallowing Functions in Acute Stroke Patients. Bulletin of Rehabilitation Medicine. 2023; 22(5): 30-39. https://doi.org/10.38025/2078-1962-2023-22-5-30-39 

For correspondence: Marwa M. Elsayed, E-mail: marwadd999@gmail.com



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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.