{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:07:00Z","timestamp":1780632420914,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Children with cerebral palsy (CP) at Gross Motor Function Classification System (GMFCS) IV\u2013V commonly present with dysphagia that limits oral feeding and increases malnutrition risk. We evaluated whether adding transcutaneous electrical nerve stimulation\/neuromuscular electrical stimulation (TENS\/EMS) to speech\u2010language therapy (SLT) improves orofacial function and acceptance of more advanced food textures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Experimental study including 50 children aged 4\u20138 years with CP (GMFCS IV\/V) and neurogenic dysphagia. Participants were allocated (concealed envelopes) to SLT alone (control) or SLT\u2009+\u2009TENS\/EMS (experimental) in a random order. The intervention comprised three 5\u2010day treatment cycles spaced 2 months apart. Each 30\u2010min session included oral\u2010motor exercises and texture advancement per the International Dysphagia Diet Standardization Initiative (IDDSI). TENS (50\u2013100\u2009Hz) and EMS (20\u201350\u2009Hz) were applied to the suprahyoid and infrahyoid muscles. The primary outcome was IDDSI texture acceptance assessed at baseline (I1), mid\u2010cycle (I2), and post\u2010cycle (I3) by blinded evaluators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The experimental group improved in mean IDDSI texture acceptance from 2.1\u2009\u00b1\u20090.8 (I1) to 4.0\u2009\u00b1\u20090.9 (I3), versus 2.0\u2009\u00b1\u20090.7 to 2.8\u2009\u00b1\u20090.8 in controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Advancement by two IDDSI levels occurred in 72% (18\/25) of the experimental group compared with 28% (7\/25) of controls (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2\u2009=\u200910.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SLT augmented with TENS\/EMS significantly enhances orofacial sensory\u2010motor performance and tolerance of more complex food textures in children with severe CP. TENS\/EMS appears to be a promising adjunct in pediatric feeding therapy; longer\u2010term efficacy and nutritional outcomes warrant further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70413","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T06:08:13Z","timestamp":1774937293000},"page":"1466-1471","source":"Crossref","is-referenced-by-count":0,"title":["Electrical stimulation as a promising strategy to enhance feeding development in children with severe cerebral palsy"],"prefix":"10.1002","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6377-1345","authenticated-orcid":false,"given":"Aleksandra","family":"Kaczy\u0144ska","sequence":"first","affiliation":[{"name":"Department of Gastrology, Hepatology, Feeding Disorders and Pediatrics Children's Memorial Health Institute Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Socha","sequence":"additional","affiliation":[{"name":"Department of Gastrology, Hepatology, Feeding Disorders and Pediatrics Children's Memorial Health Institute Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-011-1570-y"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(02)90084-2"},{"issue":"2","key":"e_1_2_8_4_1","article-title":"Gastrostomy feeding versus oral feeding alone for children with cerebral palsy","volume":"2004","author":"Sleigh G","year":"2004","journal-title":"Cochrane Database Syst 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electrical stimulation therapy among stroke patients with persistent pharyngeal dysphagia: a randomized controlled study","volume":"92","author":"Permsirivanich W","year":"2009","journal-title":"J Med Assoc Thailand = Chotmaihet thangphaet"},{"issue":"5","key":"e_1_2_8_12_1","first-page":"345","article-title":"Neuromuscular electrical stimulation for oropharyngeal dysphagia: a systematic review and meta\u2010analysis","volume":"95","author":"Chen YW","year":"2016","journal-title":"Am J Phys Med Rehabil"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-012-9403-3"},{"issue":"4","key":"e_1_2_8_14_1","first-page":"347","article-title":"Evidence\u2010based systematic review: effects of neuromuscular electrical stimulation for swallowing disorders in children","volume":"19","author":"Arvedson JC","year":"2010","journal-title":"Am J Speech Lang Pathol"},{"issue":"1","key":"e_1_2_8_15_1","first-page":"96","article-title":"Effects of neuromuscular electrical stimulation on swallowing function in children with cerebral palsy","volume":"61","author":"Park Y","year":"2019","journal-title":"Dev Med Child Neurol"},{"issue":"2","key":"e_1_2_8_16_1","first-page":"143","article-title":"Efficacy of TENS in oral\u2010motor function recovery: a randomized controlled trial","volume":"34","author":"Kim JH","year":"2020","journal-title":"Clin Rehabil"},{"issue":"4","key":"e_1_2_8_17_1","first-page":"711","article-title":"Influence of neuromuscular stimulation on oropharyngeal muscle activation","volume":"36","author":"Ko EJ","year":"2021","journal-title":"Dysphagia"},{"issue":"3","key":"e_1_2_8_18_1","first-page":"540","article-title":"Systematic review on electrical stimulation in pediatric dysphagia","volume":"47","author":"Yoon WL","year":"2022","journal-title":"Clin Otolaryngol"},{"issue":"1","key":"e_1_2_8_19_1","first-page":"101","article-title":"Effect of NMES on swallowing function in children with dysphagia","volume":"104","author":"Park JS","year":"2023","journal-title":"Arch Phys Med Rehabil"},{"issue":"3","key":"e_1_2_8_20_1","first-page":"227","article-title":"Effect of oromotor therapy in children with cerebral palsy: a randomized controlled trial","volume":"10","author":"Arslan SS","year":"2017","journal-title":"J Pediatr Rehabil Med"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2005\/003)"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2009\/08-0088)"},{"issue":"4","key":"e_1_2_8_23_1","first-page":"225","article-title":"Pediatric feeding and swallowing disorders: state of health, population trends, and application of the International Dysphagia Diet Standardisation Initiative","volume":"37","author":"Lefton\u2010Greif MA","year":"2016","journal-title":"Semin Speech Lang"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-016-9758-y"},{"issue":"3","key":"e_1_2_8_25_1","first-page":"435","article-title":"Assessment and 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