2018 Volume 22 Issue 1 Pages 52-58
Introduction: We used interferential current stimulation (IFCS) in combination with direct therapy to treat a patient with dysphagia due to delayed swallowing reflex and weakness of the suprahyoid and pharyngeal muscle groups, with good results. Case Report: A 78-year-old woman suffering from Parkinson’s syndrome underwent videofluoroscopic examination of swallowing (VF) and was found to exhibit aspiration before swallowing when swallowing liquids and pharyngeal retention of solids. Maximum lingual pressure was also low. Course: Therapy consisted of an 8-week course of a combination of tongue-strengthening exercises and thermal-tactile stimulation with direct therapy (conventional therapy). This therapy improved maximum lingual pressure to within normal limits. However, VF did not show any improvement in aspiration before swallowing when swallowing liquids or in pharyngeal retention of solids. After a 2-week break in therapy, direct therapy was resumed with the addition of IFCS (interferential current therapy) for 2 weeks. A Gentle-Stim (Careido Co., Ltd., Sagamihara, Japan) was used to administer IFCS. Aspiration before swallowing when swallowing liquids and pharyngeal retention of solids both improved on VF as a result. Quantitative analysis of liquid swallowing on VF images showed that there was no change in stage transition duration (STD) and laryngeal elevation delay time (LEDT), which are indicators of the swallowing reflex, after conventional therapy but that these had shortened after IFCS. Forward movement of the hyoid bone increased after both conventional therapy and IFCS. The speed of elevation of the hyoid bone did not change after conventional therapy, but increased after IFCS. Discussion: A combination of direct therapy and IFCS improved dysphagia by improving the motor function of the hyoid bone and reducing delay in the swallowing reflex. This combination of direct therapy and IFCS may be useful for dysphagia patients with delayed swallowing reflex.
