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In The ASHA Leader article "Electrical Stimulation Aids Dysphagia" (March 16), the study by Burnett et al. (2003) was cited, stating: "Intramuscular stimulation using electrodes inserted into these muscles has been shown to produce laryngeal elevation similar to that which occurs during normal swallowing." Although it was made clear later in the article that only normal volunteers have been studied to date, it should be emphasized that this study was done with healthy males receiving neuromuscular stimulation while at rest, and not with dysphagic patients receiving neuromuscular stimulation while attempting to swallow. In that particular study, the mean stimulated laryngeal elevation was half the distance and 80% of the velocity achieved during a normal swallow of 5 ml liquid.
There are several reports in the literature of the use of various forms of electrical stimulation in dysphagic patients (see references online). The results of these studies are thought-provoking but need to be confirmed with well-controlled clinical trials. Fortunately such trials are underway and eventually the results will be published in peer-reviewed journals. As always, the best interests of our patients and the credibility of our profession mandate that we conform to the principles of evidence-based clinical practice.
Teri Burnett
Christy Ludlow
Bethesda, MD
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