Short-term swallowing outcomes associated with inductive electrical stimulation combined with tongue pressure resistance feedback training in post-stroke dysphagia.

OBJECTIVE: To investigate the short-term swallowing outcomes associated with videofluoroscopy-guided inductive electrical stimulation combined with tongue pressure resistance feedback training in patients with post-stroke dysphagia.

METHODS: This non-randomized, single-center prospective study enrolled 238 patients with post-stroke dysphagia between January 2024 and December 2025. Patients were allocated according to preference to receive conventional swallowing rehabilitation or a a time-matched integrated program in which inductive electrical stimulation and tongue pressure resistance feedback training were incorporated within the same 30-minute rehabilitation session. The primary outcome was the change in Penetration-Aspiration Scale (PAS) score from baseline to post-treatment. Secondary outcomes included Functional Oral Intake Scale (FOIS), Swallowing Quality of Life questionnaire, Standardized Swallowing Assessment, videofluoroscopic kinematic parameters, surface electromyography parameters, maximum isometric tongue pressure, and post-treatment swallowing status improvement rate. Adjusted ANCOVA or logistic regression models were used to estimate treatment-associated differences.

RESULTS: Several baseline imbalances were observed, including stroke type, modified Rankin Scale score, baseline FOIS, baseline SWAL-QOL, and baseline tongue pressure. After adjustment for baseline values and clinically relevant covariates, the intervention group showed a greater reduction in PAS score than the control group, with an adjusted difference of -0.21 points; 95% CI, -0.37--0.05; P = 0.012. The intervention group also showed greater improvements in FOIS, SWAL-QOL, SSA, tongue pressure, thyroid cartilage and hyoid bone displacement, and swallowing time. The post-treatment swallowing status improvement rate was 89.9% in the intervention group and 73.1% in the control group, corresponding to an absolute rate difference of 16.8%, 95% CI, 7.2%-26.4%. In adjusted logistic regression, the intervention was associated with higher odds of clinical response, with an adjusted OR of 1.71, 95% CI, 1.15-2.59. Ordinal logistic sensitivity analyses for post-treatment PAS and FOIS yielded consistent findings. No serious adverse events were reported.

CONCLUSION: Videofluoroscopy-guided inductive electrical stimulation combined with tongue pressure resistance feedback training was associated with greater short-term improvements in swallowing-related clinical, kinematic, and tongue pressure outcomes compared with conventional rehabilitation. Given the preference-based allocation and the multicomponent nature of the intervention, these findings should be interpreted as associative rather than definitive evidence of causal association.