Neuromuscular Electrical Stimulation (NMES)

  • Krishnakumar Thankappan
  • Subramania Iyer


Neuromuscular electrical stimulation (NMES) is an adjunct treatment modality of dysphagia. This chapter will give an overview of the modality, the mechanism of its action and its indications in head and neck cancer-treated patients. It will also summarize the evidence and discuss the strengths and weaknesses of the modality.


  1. 1.
    Perez M, Lucia A, Rivero JL, et al. Effects of transcutaneous short-term electrical stimulation on M. vastus lateralis characteristics of healthy young men. Pflugers Arch. 2002;443:866–74.CrossRefGoogle Scholar
  2. 2.
    Siff M. Applications of electrical electrostimulation in physical conditioning: a review. J Appl Sports Sci Res. 1990;4:20–6.Google Scholar
  3. 3.
    Freed ML, Freed L, Chatburn RL, Christian M. Electrical stimulation for swallowing disorders caused by stroke. Respir Care. 2001;46:466–74.PubMedGoogle Scholar
  4. 4.
    Freed ML. Clinical trial data in support of VitalStim 510(k) clearance application with FDA; 2001.Google Scholar
  5. 5.
    FDA. VitalStim 510(k) clearance document K023347; 2002.Google Scholar
  6. 6.
    Clark H, Lazarus C, Arvedson J, Schooling T, Frymark T. Evidence-based systematic review: effects of neuromuscular electrical stimulation on swallowing and neural activation. Am J Speech Lang Pathol. 2009;18:361–75.CrossRefGoogle Scholar
  7. 7.
    Humbert IA, Michou E, MacRae PR, Crujido L. Electrical stimulation and swallowing: how much do we know? Semin Speech Lang. 2012;33:203–16.CrossRefGoogle Scholar
  8. 8.
    Burnett TA, Mann EA, Cornell SA, Ludlow CL. Laryngeal elevation achieved by neuromuscular stimulation at rest. J Appl Physiol. 2003;94:128–34.CrossRefGoogle Scholar
  9. 9.
    Burnett TA, Mann EA, Stoklosa JB, Ludlow CL. Self-triggered functional electrical stimulation during swallowing. J Neurophysiol. 2005;94:4011–8.CrossRefGoogle Scholar
  10. 10.
    Humbert IA, Poletto CJ, Saxon KG, et al. The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing. J Appl Physiol. 2006;101:1657–63.CrossRefGoogle Scholar
  11. 11.
    Gordon T, Mao J. Muscle atrophy and procedures for training after spinal cord injury. Phys Ther. 1994;74:50–60.CrossRefGoogle Scholar
  12. 12.
    Snyder-Mackler L, Delitto A, Bailey SLSWS. Strength of the quadriceps femoris muscle and functional recovery after reconstruction of the anterior cruciate ligament. A prospective, randomized clinical trial of electrical stimulation. J Bone Joint Surg Am. 1995;77:1166–73.CrossRefGoogle Scholar
  13. 13.
    Sinacore DR, Delitto A, King DS. Type II fiber activation with electrical stimulation. Phys Ther. 1990;70:416–22.CrossRefGoogle Scholar
  14. 14.
    Leelamanit V, Limsakul C, Geater A. Synchronized electrical stimulation in treating pharyngeal dysphagia. Laryngoscope. 2002;112:2204–10.CrossRefGoogle Scholar
  15. 15.
    Shaw GY, Sechtem PR, Searl J, Keller K, Rawi TA, Dowdy E. Transcutaneous neuromuscular electrical stimulation (vital Stim) curative therapy for severe dysphagia: myth or reality? Ann Otol Rhinol Laryngol. 2007;116:36–44.CrossRefGoogle Scholar
  16. 16.
    Ludlow CL, Humbert I, Saxon K, Poletto C, Sonies B, Crujido L. Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal dysphagia. Dysphagia. 2007;22:1–10.CrossRefGoogle Scholar
  17. 17.
    Freed M, Wijting Y. Training manual for patient assessment and treatment using VitalStim electrical stimulation. Hixon, TN: Chattanooga Group; 2003.Google Scholar
  18. 18.
    Christiaanse M, Glynn J, Bradshaw J. Experience with transcutaneous electrical stimulation: a new treatment option for the management of pediatric dysphagia. Charleston: NCSHA; 2003.Google Scholar
  19. 19.
    Logemann JA, Pauloski BR, Rademaker AW, Lazarus CL, Gaziano J, Stachowiak L, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008;30:148–58.CrossRefGoogle Scholar
  20. 20.
    Pauloski BR, Rademaker AW, Logemann JA, et al. Swallow function and perception of dysphagia in patients with head and neck cancer. Head Neck. 2002;24:555–65.CrossRefGoogle Scholar
  21. 21.
    Kreuzer SH, Schima W, Schober E, et al. Complications after laryngeal surgery: videofluoroscopic evaluation of 120 patients. Clin Radiol. 2000;55:775–81.CrossRefGoogle Scholar
  22. 22.
    Bauer W. Electrical treatment of severe head and neck cancer pain. Arch Otolaryngol. 1983;109:382–3.CrossRefGoogle Scholar
  23. 23.
    Boswell N. Neuroelectric therapy eliminates xerostomia during radiotherapy-a case history. Med Electron. 1989;115:105–7.Google Scholar
  24. 24.
    Boswell N, Bauer W. Noninvasive electrical stimulation for the treatment of radiotherapy side effects. Am J Electromed. 1985;2(3)Google Scholar
  25. 25.
    McDuffie C, Morgan M, Armstrong C, Nathan C. Electrical stimulation of post irradiated head and neck SCCA. AAO-HNS. Los Angeles; 2005.Google Scholar
  26. 26.
    Langmore S, VanDaele D, Logemann J, et al. Electrical stimulation for dysphagia in head and neck cancer patients. A case series. DRS; 2006.Google Scholar
  27. 27.
    Pattani KM, McDuffie CM, Morgan M, Armstrong C, Nathan CA. Electrical stimulation of post-irradiated head and neck squamous cell carcinoma to improve xerostomia. J La State Med Soc. 2010;162:21–5.PubMedGoogle Scholar
  28. 28.
    Peng G, Masood K, Gantz O, Sinha U. Neuromuscular electrical stimulation improves radiation-induced fibrosis through Tgf-Β1/MyoD homeostasis in head and neck cancer. J Surg Oncol. 2016;114:27–31.CrossRefGoogle Scholar
  29. 29.
    Ryu JS, Kang JY, Park JY, et al. The effect of electrical stimulation therapy on dysphagia following treatment for head and neck cancer. Oral Oncol. 2009;45:665–8.CrossRefGoogle Scholar
  30. 30.
    Long YB, Wu XP. A randomized controlled trail of combination therapy of neuromuscular electrical stimulation and balloon dilatation in the treatment of radiation-induced dysphagia in nasopharyngeal carcinoma patients. Disabil Rehabil. 2013;35:450–4.CrossRefGoogle Scholar
  31. 31.
    Lin PH, Hsiao TY, Chang YC, et al. Effects of functional electrical stimulation on dysphagia caused by radiation therapy in patients with nasopharyngeal carcinoma. Support Care Cancer. 2011;19:91–9.CrossRefGoogle Scholar
  32. 32.
    Langmore SE, McCulloch TM, Krisciunas GP, et al. Efficacy of electrical stimulation and exercise for dysphagia in patients with head and neck cancer: a randomized clinical trial. Head Neck. 2016;38(Suppl 1):E1221–31.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Krishnakumar Thankappan
    • 1
  • Subramania Iyer
    • 1
  1. 1.Department of Head and Neck Surgery and OncologyAmrita Institute of Medical Sciences, Amrita Vishwa VidyapeethamKochiIndia

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