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Guo X, Mu H, Sun Y, Wang J, Wei J. Analysis of the Improvement Effect of Combined Application of Oral Rehabilitation Training and Neuromuscular Electrical Stimulation on Pediatric Swallowing Disorders. Int J Neurosci 2024:1-10. [PMID: 38651277 DOI: 10.1080/00207454.2024.2346802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/18/2024] [Indexed: 04/25/2024]
Abstract
Pediatric swallowing disorders are common yet often overlooked neuro-muscular system diseases that significantly impact the quality of life and development of affected children. This study aims to explore the effect of combined application of oral rehabilitation training and neuromuscular electrical stimulation on improving pediatric swallowing disorders. Children meeting the inclusion criteria for swallowing disorders were divided into control and experimental groups based on different intervention protocols. The experimental group received combined oral rehabilitation training and neuromuscular electrical stimulation, while the control group received only oral rehabilitation training. Results showed that the intervention was more effective in the experimental group, with shorter recovery time for normal swallowing function and improved nutritional status and quality of life. This study provides scientific evidence for clinical treatment of pediatric swallowing disorders. In conclusion, the combined application of oral rehabilitation training and neuromuscular electrical stimulation effectively improves pediatric swallowing disorders, with superior efficacy compared to single treatment methods. Further research is needed to elucidate the mechanism of action and optimize treatment protocols to enhance the therapeutic outcomes and prognosis of pediatric swallowing disorders.
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Affiliation(s)
- Xiangjun Guo
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
| | - Hong Mu
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
| | - Yang Sun
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
| | - Jing Wang
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
| | - Jianming Wei
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
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Francis J, Flynn P, Naowar M, Indic P, Dickton D. Lactation physiokinetics-using advances in technology for a fresh perspective on human milk transfer. Front Pediatr 2023; 11:1264286. [PMID: 37908966 PMCID: PMC10613710 DOI: 10.3389/fped.2023.1264286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/27/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction Though the nature of breastfeeding is critical, scant information is available on how the action of the milk transfer from mother to infant is regulated in humans, where the points of dysfunction are, and what can be done to optimize breastfeeding outcomes. While better therapeutic strategies are needed, before they can be devised, a basic scientific understanding of the biomechanical mechanisms that regulate human milk transfer from breast to stomach must first be identified, defined, and understood. Methods Combining systems biology and systems medicine into a conceptual framework, using engineering design principles, this work investigates the use of biosensors to characterize human milk flow from the breast to the infant's stomach to identify points of regulation. This exploratory study used this framework to characterize Maternal/Infant Lactation physioKinetics (MILK) utilizing a Biosensor ARray (BAR) as a data collection method. Results Participants tolerated the MILKBAR well during data collection. Changes in breast turgor and temperature were significant and related to the volume of milk transferred from the breast. The total milk volume transferred was evaluated in relation to contact force, oral pressure, and jaw movement. Contact force was correlated with milk flow. Oral pressure appears to be a redundant measure and reflective of jaw movements. Discussion Nipple and breast turgor, jaw movement, and swallowing were associated with the mass of milk transferred to the infant's stomach. More investigation is needed to better quantify the mass of milk transferred in relation to each variable and understand how each variable regulates milk transfer.
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Affiliation(s)
- Jimi Francis
- Integrated Nutrition and Performance Laboratory, Department of Kinesiology, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
| | - Paul Flynn
- Department of Electrical & Computer Engineering, Klesse College of Engineering and Integrated Design, University of Texas at San Antonio, San Antonio, TX, United States
| | - Maisha Naowar
- Department of Public Health, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
| | - Premananda Indic
- Department of Electrical Engineering, Center for Health Informatics & Analytics (CHIA) University of Texas at Tyler, Tyler, TX, United States
| | - Darby Dickton
- Department of Clinical Research, Foundation for Maternal, Infant, and Lactation Knowledge, San Antonio, TX, United States
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Propp R, Gill PJ, Marcus S, Ren L, Cohen E, Friedman J, Mahant S. Neuromuscular electrical stimulation for children with dysphagia: a systematic review. BMJ Open 2022; 12:e055124. [PMID: 35338059 PMCID: PMC8961156 DOI: 10.1136/bmjopen-2021-055124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Dysphagia in childhood has important health impacts for the child and their family as well as the healthcare system. This systematic review aims to determine the effectiveness of neuromuscular electrical stimulation (NMES) for treatment of oropharyngeal dysphagia in children. METHODS A search was performed on November 2020 in MEDLINE (from 1946), EMBASE (from 1947), PsycINFO (from 1806), CINAHL (from 1937), CENTRAL (from 1996) and Scopus (from 1970) databases. Studies of children (≤18 years) diagnosed with oropharyngeal dysphagia using NMES in the throat/neck region were included. Screening, data extraction, and risk of bias assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed using the Cochrane Collaboration's tool for randomised controlled trials (RCTs) and a modified Newcastle-Ottawa assessment for observational studies. A meta-analysis was not conducted due to clinical heterogeneity in studies. RESULTS Ten studies were included (5 RCTs, 4 case series, 1 cohort study; including 393 children, mean or median age below 7 years, including children with neurologic impairments). In all studies, swallowing function improved after NMES treatment. The standardised mean difference (SMD) for improvement of swallowing dysfunction in treatment compared with control groups in the RCTs ranged from 0.18 (95% CI -0.7 to 1.06) to 1.49 (95% CI 0.57 to 2.41). Eight of 10 studies reported on the child's feeding ability, and, with one exception, there was improvement in feeding ability. Few studies reported on health status (N=2), impact on caregiver (N=1), adverse events and harms (N=2), and child's quality of life (N=1). In most studies, outcome follow-up was less than 6 months. The studies demonstrated moderate to high risk of bias. CONCLUSIONS NMES treatment may be beneficial in improving swallowing function for children with dysphagia, however, given the quality of the studies, inadequate outcome reporting, and short follow-up duration, uncertainty remains. Well-designed RCTs are needed to establish its effectiveness before its adoption in clinical practice. PROSPERO REGISTRATION NUMBER CRD42019147353.
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Affiliation(s)
- Roni Propp
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter J Gill
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
- Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sherna Marcus
- Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lily Ren
- Lane Medical Library, Stanford Medicine, Stanford, California, USA
| | - Eyal Cohen
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
- Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jeremy Friedman
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
- Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sanjay Mahant
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
- Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Deschenes MR, Patek LG, Trebelhorn AM, High MC, Flannery RE. Juvenile Neuromuscular Systems Show Amplified Disturbance to Muscle Unloading. Front Physiol 2021; 12:754052. [PMID: 34759841 PMCID: PMC8573242 DOI: 10.3389/fphys.2021.754052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/27/2021] [Indexed: 11/21/2022] Open
Abstract
Muscle unloading results in severe disturbance in neuromuscular function. During juvenile stages of natural development, the neuromuscular system experiences a high degree of plasticity in function and structure. This study aimed to determine whether muscle unloading imposed during juvenile development would elicit more severe disruption in neuromuscular function than when imposed on fully developed, mature neuromuscular systems. Twenty juvenile (3 months old) and 20 mature (8 months old) rats were equally divided into unloaded and control groups yielding a total of four groups (N = 10/each). Following the 2 week intervention period, soleus muscles were surgically extracted and using an ex vivo muscle stimulation and recording system, were examined for neuromuscular function. The unloading protocol was found to have elicited significant (P ≤ 0.05) declines in whole muscle wet weight in both juvenile and mature muscles, but of a similar degree (P = 0.286). Results also showed that juvenile muscles displayed significantly greater decay in peak force due to unloading than mature muscles, such a finding was also made for specific tension or force/muscle mass. When examining neuromuscular efficiency, i.e., function of the neuromuscular junction, it again was noted that juvenile systems were more negatively affected by muscle unloading than mature systems. These results indicate that juvenile neuromuscular systems are more sensitive to the effects of unloading than mature ones, and that the primary locus of this developmental related difference is likely the neuromuscular junction as indicated by age-related differences in neuromuscular transmission efficiency.
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Affiliation(s)
- Michael R Deschenes
- Department of Kinesiology and Health Sciences, College of William & Mary, Williamsburg, VA, United States.,Program in Neuroscience, College of William & Mary, Williamsburg, VA, United States
| | - Leah G Patek
- Department of Kinesiology and Health Sciences, College of William & Mary, Williamsburg, VA, United States
| | - Audrey M Trebelhorn
- Department of Kinesiology and Health Sciences, College of William & Mary, Williamsburg, VA, United States
| | - Madeline C High
- Program in Neuroscience, College of William & Mary, Williamsburg, VA, United States
| | - Rachel E Flannery
- Department of Kinesiology and Health Sciences, College of William & Mary, Williamsburg, VA, United States
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Sandoval-Munoz CP, Haidar ZS. Neuro-Muscular Dentistry: the "diamond" concept of electro-stimulation potential for stomato-gnathic and oro-dental conditions. Head Face Med 2021; 17:2. [PMID: 33499906 PMCID: PMC7836574 DOI: 10.1186/s13005-021-00257-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 01/19/2021] [Indexed: 01/17/2023] Open
Abstract
Oro-Pharyngeal Dysphagia - or simply dysphagia - is the difficulty (persistent) in swallowing/passing food and/or liquid from the mouth to the pharynx into the esophagus and finally the stomach; a deglutition disorder (a symptom, by definition, often due to neuro-degenerative/−muscular, drug-induced or localized structural pathologies such as head and neck tumors, lesions and associated surgical and/or radiation injuries) linked to severe consequences on Quality of Life (QoL), including malnutrition, dehydration, and even sudden death. Likewise, Temporo-Mandibular Jaw and Joint disorder(s) – or simply TMD – is a multifactorial etiological condition, regularly encountered in the dental office. Whether due to malocclusion, bruxism, stress and/or trauma, TMD destabilizes the whole cranio-mandibular system structurally and functionally, via affecting mastication, teeth, supporting structures, comfort and aesthetics, and thus, QoL, again. While several treatment regimens do exist for such conditions, some of which have been standardized for use over the years, most continue to lack proper evidence-based literature support. Hence, (1) caution is to be exercised; and (2) the need for alternative therapeutic strategies is amplified, subsequently, the door for innovation is wide open. Indeed, neuromuscular electrical stimulation or “NMES”, is perhaps a fine example. Herein, we present the interested oro-dental health care provider with an up-dated revision of this therapeutic modality, its potential benefits, risks and concerns, to best handle the dysphagic patient: an intra-disciplinary approach or strategy bridging contemporary dentistry with speech and language therapy; a rather obscure and un-discovered yet critical allied health profession. A pre-clinical and clinical prospectus on employing inventive NMES-based regimens and devices to manage TMD is also highlighted.
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Affiliation(s)
- Catalina P Sandoval-Munoz
- BioMAT'X (Laboratorio de Biomateriales, Farmacéuticos y Bioingeniería de Tejidos Cráneo Máxilo-Facial), Universidad de los Andes, Mons. Álvaro del Portillo 12.455 - Las Condes, Santiago, Chile
| | - Ziyad S Haidar
- BioMAT'X (Laboratorio de Biomateriales, Farmacéuticos y Bioingeniería de Tejidos Cráneo Máxilo-Facial), Universidad de los Andes, Mons. Álvaro del Portillo 12.455 - Las Condes, Santiago, Chile. .,Programa de Doctorado en BioMedicina, Facultad de Medicina, Universidad de los Andes, Mons. Álvaro del Portillo 12.455 - Las Condes, Santiago, Chile. .,Centro de Investigación e Innovación Biomédica (CIIB), Universidad de los Andes, Mons. Álvaro del Portillo 12.455 - Las Condes, Santiago, Chile. .,Facultad de Odontología, Universidad de los Andes, Mons. Álvaro del Portillo 12.455 - Las Condes, Santiago, Chile.
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