{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T02:05:10Z","timestamp":1793239510605,"version":"4.5.0"},"reference-count":86,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Dysphagia is one of the common complications after stroke. It is closely related to lung infection and malnutrition. Neuromuscular electrical stimulation (NMES) is widely used in the treatment of post-stroke dysphagia, but the evidence-based medical evidence of NMES is limited. Therefore, this study aimed to evaluate the clinical efficacy of NMES in patients with post-stroke dysphagia by systematic review and meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched the CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Cochrane Library, and Web of Science databases for all randomized controlled trials (RCTs) of NMES in the treatment of post-stroke dysphagia from the establishment of the database to 9 June 2022. The risk of bias assessment tool recommended by Cochrane and the GRADE method was used to assess the risk of bias and the quality of evidence. RevMan 5.3 was used for statistical analysis. Sensitivity and subgroup analyses were performed to evaluate the intervention effect more specifically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 46 RCTs and 3,346 patients with post-stroke dysphagia were included in this study. Our meta-analysis showed that NMES combined with routine swallowing therapy (ST) could effectively improve swallowing function in Penetration-Aspiration Scale (MD = \u22120.63, 95% CI [\u22121.15, \u22120.12], <jats:italic>P<\/jats:italic> = 0.01), Functional Oral Intake Scale (MD = 1.32, 95% CI [0.81, 1.83], <jats:italic>P<\/jats:italic> &amp;lt; 0.00001), Functional Dysphagia Scale (MD = \u2212 8.81, 95% CI [\u221216.48, \u22121.15], <jats:italic>P<\/jats:italic> = 0.02), the Standardized Swallowing Assessment (MD = \u22126.39, 95% CI [\u22126.56, \u22126.22], <jats:italic>P<\/jats:italic> &amp;lt; 0.00001), the Videofluoroscopic Swallow Study (MD = 1.42, 95% CI [1.28, 1.57], <jats:italic>P<\/jats:italic> &amp;lt; 0.00001) and the Water swallow test (MD = \u22120.78, 95% CI [\u22120.84, \u22120.73], <jats:italic>P<\/jats:italic> &amp;lt; 0.00001). Furthermore, it could improve the quality of life (MD = 11.90, 95% CI [11.10, 12.70], <jats:italic>P<\/jats:italic> &amp;lt; 0.00001), increase the upward movement distance of hyoid bone (MD = 2.84, 95% CI [2.28, 3.40], <jats:italic>P<\/jats:italic> &amp;lt; 0.00001) and the forward movement distance of hyoid bone (MD = 4.28, 95% CI [3.93, 4.64], <jats:italic>P<\/jats:italic> &amp;lt; 0.00001), reduce the rate of complications (OR = 0.37, 95%CI [0.24, 0.57], <jats:italic>P<\/jats:italic> &amp;lt; 0.00001). Subgroup analyses showed that NMES+ST was more effective at 25 Hz, 7 mA or 0\u201315 mA, and at courses ( \u2264 4 weeks). Moreover, patients with an onset of fewer than 20 days and those older than 60 years appear to have more positive effects after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NMES combined with ST could effectively increase the forward and upward movement distance of the hyoid bone, improve the quality of life, reduce the rate of complications, and improve the swallowing function of patients with post-stroke dysphagia. However, its safety needs to be further confirmed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO<\/jats:ext-link>, identifier: CRD42022368416.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1163045","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T05:45:53Z","timestamp":1683611153000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":29,"title":["Effects of transcutaneous neuromuscular electrical stimulation on post-stroke dysphagia: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuhan","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linjia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjiao","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1016\/S0140-6736(17)32152-9","article-title":"Global, regional, and national age-sex specific mortality for 264 causes of death, 1980\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"Naghavi","year":"2017","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Vos","year":"2020","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","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","year":"2005","journal-title":"Stroke"},{"key":"B4","doi-asserted-by":"publisher","first-page":"707","DOI":"10.2340\/16501977-0415","article-title":"A review of the relationship between dysphagia and malnutrition following stroke","volume":"41","author":"Foley","year":"2009","journal-title":"J Rehabil Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1111\/j.1365-2036.2008.03664.x","article-title":"Dysphagia: epidemiology, risk factors and impact on quality of life\u2013a population-based study","volume":"27","author":"Eslick","year":"2008","journal-title":"Aliment Pharmacol Ther."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.physbeh.2015.02.025","article-title":"Transcranial non-invasive brain stimulation in swallowing rehabilitation following stroke\u2014a review of the literature","volume":"143","author":"Doeltgen","year":"2015","journal-title":"Physiol Behav."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/2907293","article-title":"Effectiveness of conventional swallowing therapy in acute stroke patients with dysphagia","volume":"2020","author":"Jongprasitkul","year":"2020","journal-title":"Rehabil Res Pract."},{"key":"B8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1177\/026921559701100111","article-title":"Aspiration following stroke: is it related to the side of the stroke?","volume":"11","author":"Smithard","year":"1997","journal-title":"Clin. 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