Dysphagia affects approximately 1 in 25 adults each year in the United States (Bhattacharyya, 2014). While there are several different approaches to treatment, whether it be rehabilitative or compensatory, understanding the underlying neurological impairment and medical conditions related to dysphagia is important for treatment considerations. Sensory stimulation, such as thermal tactile stimulation (TTS), is a common method of treatment that focuses on rubbing the faucial pillars for triggering the pharyngeal swallow more rapidly. Neuromuscular electrical stimulation (NMES) is a method of treatment that focuses on strengthening the swallow by muscle contraction through electrical currents (Lim et al., 2009). Prompt swallow initiation is important for decreasing risk of aspiration and premature spillage to the vallecula (Martin-Harris et al., 2007). The purpose of this investigation using an alternating treatment design, was to determine the effectiveness ofNMES when combined with TTS for improving swallow initiation time compared to the implementation of TTS alone among three adults with dysphagia concomitant of chronic respiratory failure who presented with a delayed swallow initiation of greater than three seconds. VitalStim was used as the NMES device and a chilled laryngeal mirror (-1 to 3 Celsius) was used for TTS. The Logemann four finger method in conjunction with a stopwatch were used to measure the swallow. Swallow initiation time was assessed at baseline and after each session of NMES with TTS and TTS alone. Each participant received two sessions a day, five days a week for two weeks, for a total of twenty sessions. The investigation’s results revealed that while all three participants demonstrated improved swallow initiation time, data from two out of the three participants did not support the hypothesis that there will be greater decreased swallow initiation time when NMES is combined with TTS.
