Comparison of the Efficacy of Electrical Stimulation Modalities in Treating Post-Stroke Dysphagia: A Meta-Analysis

Evidence on electrical stimulation for post‑stroke dysphagia (PSD) remains inconsistent. This meta‑analysis evaluated the efficacy of neuromuscular electrical stimulation (NMES), transcranial direct current stimulation (tDCS), and peripheral electrical stimulation (PES).Randomized controlled trials (RCTs) investigating electrical stimulation therapy for patients with post-stroke dysphagia were searched in PubMed, Embase, and the Cochrane Library from inception to December 12, 2024. The primary outcomes were the Functional Oral Intake Scale (FOIS), Dysphagia Outcome and Severity Scale (DOSS), Penetration-Aspiration Scale (PAS), and Standardized Swallowing Assessment (SSA). Secondary outcomes included pharyngeal transit time (PTT), oral transit time (OTT), and surface electromyography (sEMG) signals of swallowing muscles. Meta-analysis was performed by pooling the Mean Difference (MD) with 95% confidence intervals (CI). Short‑term: <4 weeks; long‑term: ≥4 weeks.39 RCTs were included. Electrical stimulation improved short-term DOSS (MD = 1.13, 95% CI 0.15 to 2.11, P = 0.02), long-term FOIS (MD = 1.20, 95% CI 0.64 to 1.77, P < 0.01), long-term PAS (MD = -1.47, 95% CI -2.60 to -0.33, P = 0.01), and long-term SSA (MD = -0.65, 95% CI -1.28 to -0.01, P = 0.05), but not PTT or OTT. Daily treatment <30 minutes and total duration ≤3 weeks were associated with greater improvement. NMES showed stronger long‑term effects, whereas tDCS effects emerged immediately and persisted. Female proportion did not significantly affect outcomes (P > 0.05). Electrical stimulation is effective for post‑stroke dysphagia, with efficacy influenced by stimulation type and duration.