[Dysphagia] e stim

[LSterling at aol.com (LSterling@aol.com)]

In a message dated 6/3/2004 12:54:33 PM Central Standard Time, 
pasekoffde@upmc.edu writes:

> Is there a set of criteria for patient eligibility for Vital Stim?
> 
I don't know what the Vital Stim course teaches re: patient eligibility and 
I'm not going to address my own opinion of the Vital Stim movement.  I am 
curious as to what the course suggests as appropriate patient populations, and 
allow me to tell you why and hopefully provide some education.  

At our MDA ALS Clinic today, a patient brought us a flyer from a local SLP at 
a national rehab facility (which shall remain nameless but the company logo 
was all over this flyer) offering services for Vital Stim and extolling the 
benefit of Vital Stim on ALS, MS, and Parkinson's patients...as well as H/N 
Cancer, CVA.  

E-stim is contraindicated in patients with a degenerative neurological 
disease.   What function is no longer there cannot be regained no matter how much a 
muscle is stimulated.  In spastic patients, it can increase the spasticity.  
To speak specifically of the ALS population, as I follow 300 patients, use of 
e-stim can exacerbate the condition.  E-stim results in max contraction of the 
muscles which in turn results in fatigue and overuse.   I guarantee you there 
is no efficacy data...in fact not even anecdotal evidence...that e-stim is 
beneficial for this population.  

Laurie Sterling, M.S., CCC-SLP
Team Speech-Language Pathologist
The Vicki Appel MDA/ALS Clinic
Baylor College of Medicine/The Methodist Hospital
Houston, TX