{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:59:55Z","timestamp":1785286795922,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Dysphagia is a major complication after ischemic stroke. Although neuromuscular electrical stimulation (NMES) and pharyngeal ice stimulation both improve swallowing function, evidence for their combined efficacy remains limited.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective study analysed a prospective cohort of inpatients with post\u2010stroke dysphagia admitted to Mianyang Central Hospital between January 1, 2022, and August 31, 2025. The primary outcome was 90\u2010day swallowing function assessed by the Water Swallowing Test (WST); a score <\u20093 indicated a favourable prognosis and \u2265\u20093 indicated a poor prognosis. Baseline characteristics were compared between groups, and multivariable logistic regression was used to evaluate the independent association between treatment and outcome.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 1033 patients were enrolled in the final analysis. Overall, 778 patients (75.31%) achieved a favourable prognosis, and 255 (24.69%) had a poor prognosis. Compared with the NMES alone group, the NMES combined with ice stimulation group exhibited a significantly higher favourable prognosis rate (77.3% vs. 73.3%,\n p<\/jats:italic>\n \u2009<\u20090.001) and a more concentrated distribution of lower WST scores (median [IQR]: 2.0 [1.0, 2.0] vs. 2.0 [1.0, 3.0],\n p<\/jats:italic>\n \u2009=\u20090.029). After adjusting for confounding variables, multivariable regression analysis confirmed combined therapy as an independent protective factor against poor prognosis (OR\u2009=\u20090.533, 95% CI: 0.389\u20130.732,\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n NMES combined with ice stimulation therapy is associated with a lower risk of a poor prognosis compared to NMES alone therapy in post\u2010ischemic stroke dysphagia patients, suggesting a synergistic effect that could inform optimised clinical management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/joor.70277","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:32:53Z","timestamp":1785285173000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Neuromuscular Electrical Stimulation and Ice Stimulation Improves 90\u2010Day Outcomes in Patients With Post\u2010Ischemic Stroke Dysphagia"],"prefix":"10.1111","author":[{"given":"Ji","family":"Li","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China Mianyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China Mianyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China Mianyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China Mianyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9063-7233","authenticated-orcid":false,"given":"Yan","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China Mianyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"issue":"5","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1161\/STROKEAHA.122.040073","article-title":"Projected Global Trends in Ischemic Stroke Incidence, Deaths and Disability\u2010Adjusted Life Years From 2020 to 2030","volume":"54","author":"Pu L.","year":"2023","journal-title":"Stroke"},{"issue":"12","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1161\/01.STR.0000190056.76543.eb","article-title":"Dysphagia After Stroke: Incidence, Diagnosis, and Pulmonary Complications","volume":"36","author":"Martino R.","year":"2005","journal-title":"Stroke"},{"issue":"12","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"2343","DOI":"10.1016\/j.apmr.2021.07.788","article-title":"Status of Dysphagia After Ischemic Stroke: A Korean Nationwide Study","volume":"102","author":"Ko N.","year":"2021","journal-title":"Archives of Physical Medicine and Rehabilitation"},{"issue":"1","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1038\/nrgastro.2015.199","article-title":"Oropharyngeal Dysphagia: Manifestations and Diagnosis","volume":"13","author":"Rommel N.","year":"2016","journal-title":"Nature Reviews. Gastroenterology & Hepatology"},{"issue":"5","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1159\/000350199","article-title":"Stroke\u2010Associated Pneumonia: Major Advances and Obstacles","volume":"35","author":"Hannawi Y.","year":"2013","journal-title":"Cerebrovascular Diseases"},{"issue":"8","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-031629","article-title":"Healthcare\u2010Related Cost of Oropharyngeal Dysphagia and Its Complications Pneumonia and Malnutrition After Stroke: A Systematic Review","volume":"10","author":"Marin S.","year":"2020","journal-title":"BMJ Open"},{"issue":"4","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s00455-023-10644-4","article-title":"Pharyngeal Cavity Electrical Stimulation\u2010Assisted Swallowing for Post\u2010Stroke Dysphagia: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Studies","volume":"39","author":"Liu Z.","year":"2024","journal-title":"Dysphagia"},{"issue":"3","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1007\/s00455-023-10626-6","article-title":"Neuromuscular Electrical Stimulation for Post\u2010Stroke Dysphagia Treatment: A Systemic Evaluation and Meta\u2010Analysis of Randomized Controlled Trials","volume":"39","author":"Wang Z.","year":"2024","journal-title":"Dysphagia"},{"issue":"1","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s41999-023-00896-6","article-title":"Modified Medication Use in Dysphagia: The Effect of Thickener on Drug Bioavailability\u2010A Systematic Review","volume":"15","author":"Atkin J.","year":"2024","journal-title":"European Geriatric Medicine"},{"issue":"8","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1007\/s40265-024-02064-x","article-title":"New and Evolving Treatments for Neurologic Dysphagia","volume":"84","author":"Sasegbon A.","year":"2024","journal-title":"Drugs"},{"issue":"11","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1111\/ene.13392","article-title":"Chronic Post\u2010Stroke Oropharyngeal Dysphagia Is Associated With Impaired Cortical Activation to Pharyngeal Sensory Inputs","volume":"24","author":"Cabib C.","year":"2017","journal-title":"European Journal of Neurology"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","DOI":"10.3389\/fnhum.2024.1404398","article-title":"The Impact of Physical Therapy on Dysphagia in Neurological Diseases: A Review","volume":"18","author":"Li K.","year":"2024","journal-title":"Frontiers in Human Neuroscience"},{"key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.2147\/CIA.S262596","article-title":"Effectiveness of Neuromuscular Electrical Stimulation on Post\u2010Stroke Dysphagia: A Systematic Review of Randomized Controlled Trials","volume":"15","author":"Alamer A.","year":"2020","journal-title":"Clinical Interventions in Aging"},{"issue":"1","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00455-023-10595-w","article-title":"Effectiveness of Conventional Dysphagia Therapy (CDT), Neuromuscular Electrical Stimulation (NMES), and Transcranial Direct Current Stimulation (tDCS) in Acute Post\u2010Stroke Dysphagia: A Comparative Evaluation","volume":"39","author":"Bengisu S.","year":"2024","journal-title":"Dysphagia"},{"issue":"52","key":"e_1_2_13_16_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000046679","article-title":"Application of Early Swallowing Function Training Combined With Ice Stimulation Intervention in Patients With Stroke Swallowing Disorders","volume":"104","author":"Zhou J.","year":"2025","journal-title":"Medicine (Baltimore)"},{"issue":"2","key":"e_1_2_13_17_1","first-page":"1258","article-title":"Effect of Neuromuscular Electrical Stimulation Combined With Swallowing Rehabilitation Training on the Treatment Efficacy and Life Quality of Stroke Patients With Dysphagia","volume":"14","author":"Tan Z.","year":"2022","journal-title":"American Journal of Translational Research"},{"issue":"6","key":"e_1_2_13_18_1","doi-asserted-by":"crossref","DOI":"10.3390\/life12060875","article-title":"Therapeutic Effect and Optimal Electrode Placement of Transcutaneous Neuromuscular Electrical Stimulation in Patients With Post\u2010Stroke Dysphagia: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials","volume":"12","author":"Doan T. N.","year":"2022","journal-title":"Life"},{"issue":"11","key":"e_1_2_13_19_1","doi-asserted-by":"crossref","first-page":"2575","DOI":"10.1111\/jan.13013","article-title":"Systematic Review and Meta\u2010Analysis of the Diagnostic Accuracy of the Water Swallow Test for Screening Aspiration in Stroke Patients","volume":"72","author":"Chen P. C.","year":"2016","journal-title":"Journal of Advanced Nursing"},{"issue":"6","key":"e_1_2_13_20_1","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1080\/01616412.2018.1451015","article-title":"Efficacy of Neuromuscular Electrical Stimulation in Improving the Negative Psychological State in Patients With Cerebral Infarction and Dysphagia","volume":"40","author":"Zeng Y.","year":"2018","journal-title":"Neurological Research"},{"issue":"1","key":"e_1_2_13_21_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S1003-5257(15)30004-0","article-title":"Therapeutic Efficacy of Swallowing Neuromuscular Electrical Stimulation Combined With Acupuncture for Post\u2010Stroke Dysphagia","volume":"25","author":"Zhang Y. W.","year":"2015","journal-title":"World Journal of Acupuncture \u2010 Moxibustion"},{"key":"e_1_2_13_22_1","first-page":"e203","article-title":"Improve of Dysphagia With Electrostimulation After a Stroke","volume":"61","author":"Linares R. 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W.","year":"2022","journal-title":"Frontiers in Neuroscience"},{"issue":"4","key":"e_1_2_13_26_1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.3233\/BMR-181133","article-title":"The Effect of Neuromuscular Electrical Stimulation With Different Electrode Positions on Swallowing in Stroke Patients With Oropharyngeal Dysphagia: A Randomized Trial","volume":"33","author":"Oh D. H.","year":"2020","journal-title":"Journal of Back and Musculoskeletal Rehabilitation"},{"key":"e_1_2_13_27_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2147\/NDT.S341353","article-title":"Analysis of Factors That Influence the Prognosis of Swallowing Function Rehabilitation Therapy in Patients With Dysphagia After Medullary Infarction","volume":"18","author":"Zhang D.","year":"2022","journal-title":"Neuropsychiatric Disease and Treatment"},{"issue":"5","key":"e_1_2_13_28_1","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1161\/STROKEAHA.116.015045","article-title":"Predictors of Dysphagia in Acute Pontine Infarction","volume":"48","author":"Lapa S.","year":"2017","journal-title":"Stroke"},{"key":"e_1_2_13_29_1","doi-asserted-by":"crossref","unstructured":"J.Yoon S.Baek Y.Jang et\u00a0al. \u201cMalnutrition and Associated Factors in Acute and Subacute Stroke Patients With Dysphagia \u201d15 no.17(2023):3739.","DOI":"10.3390\/nu15173739"},{"issue":"4","key":"e_1_2_13_30_1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/jtxs.12189","article-title":"The Impact of Aging and Progressive Neurological Disease on Swallowing: A Concise Overview","volume":"47","author":"Britton D.","year":"2016","journal-title":"Journal of Texture Studies"},{"issue":"1","key":"e_1_2_13_31_1","article-title":"The NIHSS Score and Its Components Can Predict Cortical Stroke","volume":"2","author":"Sartor E. A.","year":"2013","journal-title":"Journal of Neurological Disorders & Stroke"},{"issue":"4","key":"e_1_2_13_32_1","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/jcsm.12297","article-title":"Aspiration Pneumonia Induces Muscle Atrophy in the Respiratory, Skeletal, and Swallowing Systems","volume":"9","author":"Komatsu R.","year":"2018","journal-title":"Journal of Cachexia, Sarcopenia and Muscle"}],"container-title":["Journal of Oral Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70277","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/joor.70277","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:33:02Z","timestamp":1785285182000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joor.70277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":31,"alternative-id":["10.1111\/joor.70277"],"URL":"https:\/\/doi.org\/10.1111\/joor.70277","archive":["Portico"],"relation":{},"ISSN":["0305-182X","1365-2842"],"issn-type":[{"value":"0305-182X","type":"print"},{"value":"1365-2842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"2026-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"joor.70277"}}