Effects of oral care combined with neuromuscular electrical stimulation on clinical outcomes in the acute phase of acute ischemic stroke: a pilot randomized controlled trial
Abstract
Stroke-associated dysphagia significantly increases the risk of pneumonia in persons with acute ischemic stroke (AIS), yet effective early interventions remain limited. This pilot randomized controlled trial examined the feasibility and clinical effects of a nurse-delivered combined intervention involving neuromuscular electrical stimulation (NMES) and comprehensive oral care—including toothbrushing using the Bass method, tongue cleaning, and moisturizing twice daily—during the acute stroke phase. This randomized, parallel group pilot trial assigned persons with AIS into three groups: (i) oral care only, (ii) oral care + NMES, and (iii) standard care (control). Interventions began within 48 h of stroke onset and continued twice daily for five days, starting within 48 h of stroke onset. Outcome measures, including the Revised Oral Assessment Guide (ROAG) and Gugging Swallowing Screening (GUSS), were assessed at baseline, day 4, and day 8 post-stroke. Statistical analysis employed one-way analysis of variance (ANOVA), chi-square tests, and generalized estimating equations (GEE) to analyze group differences and longitudinal trends. Among 35 participants (mean age 68.3 ± 12.5 years; 51.4% men), both intervention groups demonstrated significant improvements in swallowing and oral health outcomes over time, compared to standard care (p < 0.05). Although this pilot study was not powered to determine superiority between the two intervention groups, the oral care + NMES group…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 35 participants or records.
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