VitalStim Therapy
An effective tool for treating dysphagia
by Sarah Pagano, MS,CCC-SLP, a speech lanuage-pathologist at Helen Hayes Hospital,
an internationally renowned physical rehabilitation hospital in West Haverstraw, NY.
A swallowing disorder, clinically referred to as dysphagia (dis-fah-jah), occurs when there is a problem with any part of the swallowing process, from the mouth to the stomach. Symptoms may include coughing or choking during or after swallowing, pain in the throat during a swallow, the sensation of food stuck in the throat or shortness of breath while eating.
Dysphasia can arise from a wide-variety of causes, including spinal cord or head injury; stroke; head/neck/esophageal cancers and their treatment (radiation); meningitis; degenerative neurological disorders (Parkinson’s Disease, Amyotrophic Lateral Sclerosis, Multiple Sclerosis, Guillain-Barre Syndrome, Myasthenia Gravis); respiratory conditions (Chronic Obstructive Pulmonary Diseases); burns and tracheotomies. Research has noted that as much as 60% of patients with SCI have co-existing brain injury, which can have a direct effect on the neurological processes that control the swallowing mechanism. According to the National Spinal Cord Injury Association, 50% of individuals with SCI have other associated medical condition.
Dysphasia can have devastating side effects if not diagnosed and managed properly. The most severe is aspiration pneumonia, which occurs when food, liquid or saliva descends the windpipe and enters the lungs. Aspiration pneumonia is an extremely serious condition. Other side effects of dysphagia may include choking, chronic malnutrition, bronchospasm, weight loss, physical deterioration and depression.
Until recently, dysphagia has mostly been treated with traditional therapeutic methods such as oral/pharyngeal/laryngeal exercises, thermal stimulation, compensatory strategies for safe swallowing and dietary modification. Now, a relatively new treatment method has become available.
VitalStim Therapy (VST), which is a modified form of neuromuscular electrical stimulation (NMES) has been designed to specifically treat dysphagia through muscle re-education. NMES therapy has been used for many years by physical therapists to retrain the larger muscles in the body, such as________However, VST is the only NMES device that is cleared by the FDA and declared as a “safe and effective” dysphagia treatment method.
VST must be administered by a trained speech-language pathologist and should be used in conjunction with traditional therapeutic approaches. Speech-language pathologists much have at least three years experience with treatment in swallowing disorders and must take and pass comprehensive course that provides hands on training. Five certified speech-language pathologists at Helen Hayes Hospital are utilizing VST with appropriate patients and have hand notable success.
So how does it work? VST uses small electrical currents to stimulate the swallowing muscles. The process works by placing small, specially designed electrodes onto specific areas of the face or neck and the weakened muscles are then stimulated to contract.
Along with the muscles of swallowing, VST can also be use to strengthen damaged facial muscles that have become weakened from the neurological injuries.
The validated contraindications for VST are specific to patients with dysphagia. VST in contrast indicated with patients who are severely demented and demonstrate non-stop verbalization, which could result in aspiration during feeding trials. VST is also contraindicated in patients with significant reflux due to a feeding tube and in patients with dysphagia as a result of drug toxicity. The only side effect reported to date with VST is minor redness or irritation of the skin where the electrodes were placed.
VST is the newest approach for the remediation of certain swallowing disorders. It is a safe, effective, painless and clinically proven treatment method that can be used to treat dysphagia in patients with SCI and co-existing neurological damage. A physician must prescribe VST. The specific goals and length of treatment are tailored to each individual patient and should be clearly outlines by a certified speech language pathologist