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KMID : 0603920190270040107
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Journal of Korean Academy of Occupational Therapy
2019 Volume.27 No. 4 p.107 ~ p.124
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Effects of Repetitive Transcranial Magnetic Stimulation (rTMS), Transcranial Direct Current Stimulation (tDCS) and Neuromuscular Electrical Stimulation Therapy (NMES) on Stroke Dysphagia Using Meta-Analysis
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Shin Chi-Hwan
Cha Sun-A
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Abstract
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Objective: Randomized controlled trials (RCTs) using neuromuscular electronic stimulation (NMES) andnon-invasive brain stimulation (NIBS) were applied for early access to clinicians included in a post-strokeswallowing intervention. A meta-analysis of the research will provide concrete effects and suggestions forimprovement.
Methods: We searched articles from 2008 to 2019 published in Pubmed, CINAHL (EBSCOhost), Psycinfo, KoreanStudies Information Service System (KISS), and the Research Information Sharing Service (RISS). The main keywords are “stroke OR CVA OR cerebrocascular accident OR vascular accident” AND “dysphagia OR swallowingdisorder OR deglutition disorder” AND “tDCS OR transcranial direct current stimulation OR rTMS OR repetitivetranscranial magnetic stimulation OR NMES OR neuromuscular electronic stimulation” AND “RCT OR randomizedcontrol trial,” “뇌졸중” AND “연하장애,” AND “경두기 자기자극 OR 경두개 직류자극 OR 신경근전기자극” AND “무작위대조실험.” The inclusion and exclusion criteria were applied to a total of 11 studies.
Results: The electrical stimulation intensity of transcranial direct current stimulation (tDCS) was 1 mA, theelectrical stimulation intensity of repetitive transcranial magnetic stimulation (rTMS) was 3-5 Hz, theneuromuscular electrical stimulation (NMES) varied from 8 to 15 mA, tDCS and rTMS showed large effect sizes,and NMES demonstrated a medium effect size.
Conclusion: This study confirmed the effects of three treatments through a meta-analysis and confirmed thevarious results according to the patients' characteristics and mediation direction. However, three treatments aredeemed effective for the recovery of swallowing disorder after a stroke in Korea and are considered safe. Inaddition, it is necessary to study various factors leading to a recovery of a swallowing disorder.
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KEYWORD
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rTMS, tDCS, Stroke, Meta-analysis, NMES, Dysphagia
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