Neuromuscular Electrical Stimulation for Dysphagia Treatment: Adoption, Perceived Barriers, and Clinical Practices

Abstract

Purpose: This study aims to learn about the global adoption of neuromuscular electrical stimulation (NMES) in managing dysphagia, identify the barriers to its adoption, and describe the existing clinical practices. Method: A total of 171 professionals from various international backgrounds initiated a specially developed online survey, and 122 responses were included in the final analysis. The survey consisted of 44 items related to NMES usage, perceived adoption barriers of NMES in dysphagia management, and clinical practices. The data were subjected to descriptive and correlational statistical analysis. Results: NMES is adopted by 50% of the participants' workplaces when considering responses globally and 42.7% in the United States. Most respondents reported both high self-assessed knowledge level and high interest in learning about NMES. Among the 21 posed barriers to NMES adoption, 19 were agreed upon by over 50% of participants, with the most reported being insufficient academic coverage, lack of expert endorsement, and heterogeneity in stimulation parameters. There was considerable diversity in the clinical application of NMES, particularly regarding the duration, frequency, and total number of sessions typically completed when using NMES. Conclusions: NMES is adopted by half of the facilities and utilized by one third of dysphagia practitioners among the international respondents to this survey. The high interest expressed in NMES parallels the increasing volume of related research. Nonetheless, the widespread recognition of barriers and the substantial variability in clinical application underscore the need for international efforts to establish standardized protocols or guidelines, ensuring its effective and consistent use in clinical settings.