TITLE
The Effect of Repetitive Transcranial Magnetic Stimulation Combined with Traditional Dysphagia Therapy on Post-Stroke Dysphagia: A Pilot Double-Blinded Randomized-Controlled Trial
AUTHORS
Tarameshlu M; Ansari NN; Ghelichi L; Jalaei S.
SOURCE
International Journal of Rehabilitation Research. 42(2):133-138, 2019 Jun.
ABSTRACT
Dysphagia following stroke is common and can lead to severe complications such as aspiration pneumonia, but there is inconclusive evidence on how post-stroke dysphagia should be treated. This study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with the traditional dysphagia therapy on the swallowing function in patients with post-stroke dysphagia. In this pilot double-blind randomized clinical trial, 18 patients with post-stroke dysphagia were allocated randomly to three groups: (i) traditional dysphagia therapy, (ii) rTMS, and (iii) combined intervention. Patients received traditional dysphagia therapy for 18 treatment sessions three times per week. The inhibitory rTMS was applied to the intact cerebral hemisphere at 1 Hz with a train of 1200 for 5 consecutive days. The patients in the combined intervention group received traditional dysphagia therapy and rTMS simultaneously. The Mann Assessment of Swallowing Ability (MASA) and Functional Oral Intake Scale were performed before treatment, after the end of the fifth session, after the end of the 10th session, after the end of the 15th session, and after the end of the 18th session. All groups had improved on MASA and Functional Oral Intake Scale scores over time (P<0.01). The improvements achieved in all outcomes were significantly greater in the combined intervention group than those of the traditional dysphagia therapy and rTMS groups. The large effect sizes were found for the MASA score in all groups: traditional dysphagia therapy group (d = 3.57), rTMS group (d = 2.67), and combined intervention group (d = 3.87). This pilot randomized-controlled trial showed that the combination of rTMS and traditional dysphagia therapy significantly improved swallowing function in patients with poststroke dysphagia.
