Combined Neuromuscular Electrical Stimulation and Ice Stimulation Improves 90-Day Outcomes in Patients With Post-Ischemic Stroke Dysphagia.

BACKGROUND

Dysphagia is a major complication after ischemic stroke. Although neuromuscular electrical stimulation (NMES) and pharyngeal ice stimulation both improve swallowing function, evidence for their combined efficacy remains limited.

METHODS

This retrospective study analysed a prospective cohort of inpatients with post-stroke dysphagia admitted to Mianyang Central Hospital between January 1, 2022, and August 31, 2025. The primary outcome was 90-day swallowing function assessed by the Water Swallowing Test (WST); a score < 3 indicated a favourable prognosis and ≥ 3 indicated a poor prognosis. Baseline characteristics were compared between groups, and multivariable logistic regression was used to evaluate the independent association between treatment and outcome.

RESULTS

A total of 1033 patients were enrolled in the final analysis. Overall, 778 patients (75.31%) achieved a favourable prognosis, and 255 (24.69%) had a poor prognosis. Compared with the NMES alone group, the NMES combined with ice stimulation group exhibited a significantly higher favourable prognosis rate (77.3% vs. 73.3%, p < 0.001) and a more concentrated distribution of lower WST scores (median [IQR]: 2.0 [1.0, 2.0] vs. 2.0 [1.0, 3.0], p = 0.029). After adjusting for confounding variables, multivariable regression analysis confirmed combined therapy as an independent protective factor against poor prognosis (OR = 0.533, 95% CI: 0.389-0.732, p < 0.001).

CONCLUSION

NMES combined with ice stimulation therapy is associated with a lower risk of a poor prognosis compared to NMES alone therapy in post-ischemic stroke dysphagia patients, suggesting a synergistic effect that could inform optimised clinical management.