What is Electrical Stimulation Therapy?
E-Stim is a noninvasive therapy that uses controlled neuromuscular electrical stimulation to strengthen the muscles of the throat used for swallowing. The technique basically involves applying tiny pulses of electricity transcutaneously (through the skin) to the pharyngeal muscles.
The E-stim program met some resistance from some doctors in its infancy, but today it has become more recognized as an effective treatment for swallow disorders.
During the treatment, a therapist attaches electrodes to the patient’s neck. The electrodes deliver electrical stimulation from the hand-held transmitter device to the person’s neck. The therapy must be prescribed by a physician and the therapy must be delivered by a VitalStim certified therapist.
There is only one E-stim device in the United States that is approved by the Food and Drug Administration (FDA) for the treatment of dysphagia. This device is marketed under the trade name VitalStim. VitalStim inventor Marcy Freed developed this dysphagia program after her persistence to pursue an idea she had about it for twenty years (Stern, 2003). In June 2001, the FDA approved the use of this external electrical stimulation for the treatment of swallow disorders in children and adults (FDA, 2001).
How Does it Work?
Before the invention of VitalStim, Electrical Muscle Stimulation (EMS) had been used by doctors and physical therapists to prevent or reduce muscle atrophy. Atrophy is the weakening and loss of muscle tone, which is usually experienced after surgeries or injuries. Electrical muscle stimulators are devices used to repeatedly contract muscles by passing electrical currents through electrodes in contact with the body. The electrodes are attached to the stimulator device which may be powered by battery or line voltage and controls the amount of energy flowing through the electrodes. EMS has proven to be an effective means of preventing muscle atrophy. Doctors also see EMS as a means of increasing blood flow to muscles, increasing range of motion, increasing muscle strength, as well as enhancing muscle endurance (FDA Import Alert, 2002). Now this technique has been modified for the combination electrical stimulation and traditional dysphagia techniques the muscles of swallowing.
"It’s a new twist on physical therapy," said Susan Heck, speech language pathologist at Lewis-Gale Medical Center. " Other professionals have been using electrical stimulation for a long time." (Roanoke Times, 2004).
During VitalStim Therapy, electrodes are placed at one of several sites of the throat for muscle re-education and for the creation of functional muscle use patterns in the throat muscles necessary for pharyngeal contraction to restore swallowing. Proper electrode placement is determined from the review of a patients modified barium swallow report and therapist evaluation (Quality Health Products, 2003).
What Is Electrical Stimulation Therapy used for?
Pain Control
Joint stiffness
Lower back pain
Carpal tunnel syndrome
Muscle Relaxation
Muscle spasms
Strengthen Atrophied Muscles
(Casey,2004)
M
ain Effects of Electrical Stimulation |
Restores muscle strength by contracting muscles with an electrical current. |
|
Small electrodes are placed externally on the neck which produces a ‘crawling or grabbing’ sensation. |
|
Enhances muscle performance by increasing ROM, improving strength, re-educating contraction patterns, and correcting abnormal muscle tone (Freed, et al., 2002). |