Electroacupuncture treatment for post-stroke oropharyngeal dysphagia: a randomized controlled trial

Dysphagia is a common complication after stroke and can negatively affect patients' quality of life. Despite electroacupuncture (EA) being widely used to treat dysphagia, its effectiveness and underlying mechanism of action have not been thoroughly examined. The aim of this study was to gather preliminary data on the efficacy of EA when used as an adjunct to a standardized but individually adjusted rehabilitation program for patients with post-stroke oropharyngeal dysphagia (PSOD) and to compare EA with adjunctive neuromuscular electrical stimulation (NMES).

Forty-five patients who fulfilled the inclusion criteria were randomly assigned to EA, NMES or control groups. All groups received traditional rehabilitation training for dysphagia. The EA and NMES group additionally received EA at bilateral Jialianquan and NMES of the suprahyoid muscle group, respectively. Before and 3 weeks after treatment, the swallowing function of the patients was assessed by surface electromyography (sEMG), videofluoroscopic swallowing study (VFSS), standardized swallowing assessment (SSA) and water swallow test (primary outcomes). Post hoc secondary outcome measures included the functional oral intake scale (FOIS), penetration-aspiration scale (PAS) and deglutition duration.

All outcome measures improved within each group. When compared to the control group, greater improvements were seen in the EA group for SSA, FOIS, modified barium swallow impairment profile (MBSImp) and PAS scores, as well as several different sEMG parameters (average EMG (AEMG), peak amplitude and deglutition duration for both saliva and water) in PSOD patients. Only deglutition duration for water and saliva was significantly improved in NMES versus control groups. EA was superior to NMES only with respect to the AEMG for water and saliva.

This study provides preliminary evidence demonstrating that PSOD patients may benefit from EA at bilateral Jialianquan. Relative to a control group receiving traditional rehabilitation alone, the addition of EA was associated with improvements in a range of different outcome measures in PSOD patients, with medium to large effect sizes.Trial registration number: ChiCTR2200058198 (Chinese Clinical Trial Registry).