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I had to respond to the article on "Electrical Stimulation Aids Dysphagia," (March 16). I completed neuromuscular electrical stimulation (NMES)-dysphagia research which was published in 1997-1998. The article referenced the Freed et al. (2001; see references online) article regarding E-stim over the surface of the skin, which was not shown to elicit movement. This may apply to Freed et al. protocol and placement of electrodes, but there are other protocols that have and are showing success using appropriate placement of NMES.
Our protocol/placement of the electrodes in our research study did elicit movement to control laryngeal elevation and this was proven by measurements taken on the Computerized Laryngeal Analyzer (CLA). The CLA measures the biomechanical movement of the anatomical structures associated with swallowing and automatically calculates and displays the duration of laryngeal motion. The CLA transducer was placed on the thyroid cartilage. Two NMES electrodes were placed over the region of each belly of the anterior digastric and mylohyoid muscles. With our parameters and protocol, movement of the larynx was displayed on the CLA at the initiation of the stimulation. During the stimulation, the pharynx was held in position. At stimulation release it returned from its elevated position. It is significant that the sustained elevation was achieved by stimulation only. This process was also used during videofluoroscopy to support laryngeal elevation. E-stim can promote laryngeal elevation. Freed et al. is not the only E-stim research completed on this subject and using this reference is misleading to the scientific community.
Ronda Polansky
Dallas/ Ft. Worth, Texas
dysphagiadiagnostex@juno.com
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