Electromagnetic Therapy for Cervicogenic Dysphagia

Overview

Cervicogenic dysphagia (CD) is a swallowing disorder in patients with cervicogenic pathology. Pulsed electromagnetic therapy (PEMT) is a widely utilized therapeutic modality. Objective: To investigate the effects of PEMT on swallowing function (SF) and dysphagia handicapping effects in patients with CD. Methods: 40 volunteer participants (50-60 years old) with CD and cervical spondylosis were randomly and equally assigned to the study group (PEMT+swallowing resistance training program "SRTP") and control group (placebo PEMT+SRTP). Intervention: All participants received 3 sessions of SRTP (resisted chin tuck-in and resisted swallowing exercises) and 2 PEMT sessions (20 minutes of 20 Hz low frequency, 0.8 milli Tesla low intensity) per week for 8 weeks. Outcome Measures: The SF was evaluated using the swallow difficulty questionnaire "SDQ", and the dysphagia handicapping effects were evaluated using the dysphagia handicap index (DHI) pre-and post-study. Statistical analysis: Within-group comparisons were done using a paired t-test, and the between-group differences were examined using two-way ANOVA; a significant value was set at P\<0.05.

Swallowing represents an integrated sensorimotor process accomplished by coordinated muscular actions. Cervical spine structures, under normal conditions, play an important role in maintaining coordinated swallowing. The muscular and neural structures of the cervical spine are responsible for the coordinated movement of the larynx, pharynx, and hyoid bone during swallowing. Sensory information ascends from cervical structures to the brainstem, providing feedback to help synchronize the complex and harmonized contributions of the neck and throat muscles during swallowing. Disruption of this sensory feedback loop can result in coordination deficits and difficulty swallowing. Biomechanical alterations or degenerative changes in the cervical spine can affect its position and stability. These alterations may further impact the surrounding neural and muscular structures' functions, resulting in a variety of alarming symptoms and dysfunctional patterns that predispose to mechanical obstruction and difficulty swallowing. Cervicogenic dysphagia (CD) is an alarming disorder characterized by disturbed swallowing secondary to cervical structures dysfunction. Cervical spondylosis and associated pathological consequences can contribute to the development of CD. Cervical spine biomechanical alterations and malalignments, such as cervical kyphosis, a condition commonly encountered in cervical spondylosis, can predispose to pharyngeal dysfunction and difficult swallowing. The combined effects of neck muscular and articular dysfunctions represented in muscle weakness, poor cervical posture, and limited range of motion can disturb the cricopharyngeal sphincter action and the normal laryngeal function, ultimately predisposing to CD. Although cure of dysphagia is not always possible, conservative approaches can provide an effective path to alleviate patients' complaints. A comprehensive dysphagia management program is not only important to restore normal swallowing function, but also to eliminate the economic burden and the dysphagia-related health hazards. Low-frequency, low-intensity electromagnetic field therapy (EMT) is a safe, non-invasive therapeutic modality of clinical interest and effective applicability in the treatment of a variety of pathologies. Although the effectiveness of pulsed electromagnetic field therapy (PEMFT) as a safe and effective therapeutic modality was investigated in a variety of cervical pathologies, there is a lack of evidence supporting the effectiveness of PEMFT in the treatment of patients with cervicogenic dysphagia. Considering the reported safety and effectiveness of PEMFT therapy in the treatment of different pathologies, this study aimed to investigate the effects of PEMFT therapy on swallowing function and the dysphagia handicapping effects in patients with CD.