Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials
Background. Dysphagia after stroke is common, associated independently with poor outcome, and has limited treatment options. Pharyngeal electrical stimulation (PES) is a novel treatment being evaluated for treatment of poststroke dysphagia. Methods. We searched electronically for randomised controll...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-01-01
|
| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2015/429053 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832560796199026688 |
|---|---|
| author | Polly Scutt Han S. Lee Shaheen Hamdy Philip M. Bath |
| author_facet | Polly Scutt Han S. Lee Shaheen Hamdy Philip M. Bath |
| author_sort | Polly Scutt |
| collection | DOAJ |
| description | Background. Dysphagia after stroke is common, associated independently with poor outcome, and has limited treatment options. Pharyngeal electrical stimulation (PES) is a novel treatment being evaluated for treatment of poststroke dysphagia. Methods. We searched electronically for randomised controlled trials of PES in dysphagic patients within 3 months of stroke. Individual patient data were analysed using regression, adjusted for trial, age, severity, and baseline score. The coprimary outcomes were radiological aspiration (penetration aspiration score, PAS) and clinical dysphagia (dysphagia severity rating scale, DSRS) at 2 weeks; secondary outcomes included functional outcome, death, and length of stay in hospital. Results. Three completed trials were identified: 73 patients, age 72 (12) years, severity (NIHSS) 11 (6), DSRS 6.7 (4.3), mean PAS 4.3 (1.8). Compared with no/sham stimulation, PES was associated with lower PAS, 3.4 (1.7) versus 4.1 (1.7), mean difference −0.9 (p=0.020), and lower DSRS, 3.5 (3.8) versus 4.9 (4.4), mean difference −1.7 (p=0.040). Length of stay in hospital tended to be shorter: 50.2 (25.3) versus 71.2 (60.4) days (p=0.11). Functional outcome and death did not differ between treatment groups. Conclusions. PES was associated with less radiological aspiration and clinical dysphagia and possibly reduced length of stay in hospital across three small trials. |
| format | Article |
| id | doaj-art-2ec3efbd93514a018a1be786a72dd25d |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-2ec3efbd93514a018a1be786a72dd25d2025-02-03T01:26:41ZengWileyStroke Research and Treatment2090-81052042-00562015-01-01201510.1155/2015/429053429053Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled TrialsPolly Scutt0Han S. Lee1Shaheen Hamdy2Philip M. Bath3Stroke, Division of Clinical Neuroscience, University of Nottingham, Nottingham NG5 1PB, UKStroke, Division of Clinical Neuroscience, University of Nottingham, Nottingham NG5 1PB, UKCentre for Gastrointestinal Sciences, University of Manchester, Salford M6 8HD, UKStroke, Division of Clinical Neuroscience, University of Nottingham, Nottingham NG5 1PB, UKBackground. Dysphagia after stroke is common, associated independently with poor outcome, and has limited treatment options. Pharyngeal electrical stimulation (PES) is a novel treatment being evaluated for treatment of poststroke dysphagia. Methods. We searched electronically for randomised controlled trials of PES in dysphagic patients within 3 months of stroke. Individual patient data were analysed using regression, adjusted for trial, age, severity, and baseline score. The coprimary outcomes were radiological aspiration (penetration aspiration score, PAS) and clinical dysphagia (dysphagia severity rating scale, DSRS) at 2 weeks; secondary outcomes included functional outcome, death, and length of stay in hospital. Results. Three completed trials were identified: 73 patients, age 72 (12) years, severity (NIHSS) 11 (6), DSRS 6.7 (4.3), mean PAS 4.3 (1.8). Compared with no/sham stimulation, PES was associated with lower PAS, 3.4 (1.7) versus 4.1 (1.7), mean difference −0.9 (p=0.020), and lower DSRS, 3.5 (3.8) versus 4.9 (4.4), mean difference −1.7 (p=0.040). Length of stay in hospital tended to be shorter: 50.2 (25.3) versus 71.2 (60.4) days (p=0.11). Functional outcome and death did not differ between treatment groups. Conclusions. PES was associated with less radiological aspiration and clinical dysphagia and possibly reduced length of stay in hospital across three small trials.http://dx.doi.org/10.1155/2015/429053 |
| spellingShingle | Polly Scutt Han S. Lee Shaheen Hamdy Philip M. Bath Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials Stroke Research and Treatment |
| title | Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials |
| title_full | Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials |
| title_fullStr | Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials |
| title_full_unstemmed | Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials |
| title_short | Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials |
| title_sort | pharyngeal electrical stimulation for treatment of poststroke dysphagia individual patient data meta analysis of randomised controlled trials |
| url | http://dx.doi.org/10.1155/2015/429053 |
| work_keys_str_mv | AT pollyscutt pharyngealelectricalstimulationfortreatmentofpoststrokedysphagiaindividualpatientdatametaanalysisofrandomisedcontrolledtrials AT hanslee pharyngealelectricalstimulationfortreatmentofpoststrokedysphagiaindividualpatientdatametaanalysisofrandomisedcontrolledtrials AT shaheenhamdy pharyngealelectricalstimulationfortreatmentofpoststrokedysphagiaindividualpatientdatametaanalysisofrandomisedcontrolledtrials AT philipmbath pharyngealelectricalstimulationfortreatmentofpoststrokedysphagiaindividualpatientdatametaanalysisofrandomisedcontrolledtrials |