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

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.