To find out the combined effect of rTMS and sensory motor stimulation on patients with swallowing difficulty in acute stroke patients

Not yet recruiting

Conditions: Sequelae of other cerebrovasculardiseases, (2) ICD-10 Condition: G998||Other specified disorders of nervous system in diseases classified elsewhere,

Brief Summary: Stroke is a leading cause of disability worldwide, and dysphagia (difficulty swallowing) is acommon and debilitating complication. Current treatments for post-stroke dysphagia, such astraditional swallowing therapy, often have limited success.Stoke with severe dysphagia has a devastating impact on quality of life as it can eliminate thepleasure of eating and drinking. It is associated with significant morbidity and mortalityincluding dehydration, malnutrition, airway obstruction, and aspiration pneumonia. Lessrecognized is the impact of dysphagia on psychosocial functions. It can lead to isolation as thepatient withdraws from activities involving food such as family mealtimes, group dinners, andteatime.The earlier studies have focused on either oropharyngeal muscle re-education andstrengthening or non-invasive brain stimulation (NIBS) such as rTMS separately but not in combined form. Sensory motor stimulation and rTMS may work together to enhanceneuroplasticity, promoting the formation of new neural connections and facilitating recoveryof swallowing function. This combined approach may lead to improved clinical outcomes, suchas reduced aspiration risk, improved nutritional status, and enhanced quality of life for strokesurvivors with dysphagia.Hence to find out the effectiveness of rTMS over sham TMS on clinical outcomes in subjectswith dysphagia in acute stroke has to be conducted.

Recruitment & Eligibility

Inclusion Criteria

Subjects diagnosed with ischemic or haemorrhagic stroke who are in acute phase (2-4 weeks of onset).
Presence of dysphagia secondary to stroke, referred by ENT department, Neurology department to neurophysiotherapy department 3.
No swallowing disorder attributed to conditions other than stroke.
Subjects who are willing to participate in the study 5.Subjects who are conscious, oriented and co-operative.
Subjects with GCS scoring more than 12.

Exclusion Criteria

Subjects with recurrent stoke.
Subjects with trauma, infections, recently operated.
Subjects with on external appliance that is mechanical ventilator, endotracheal tube tracheostomy tube.
Subjects with sensory loss, cognitive impairment.
Subjects with epilepsy.
Subjects with intracranial metallic implants and pacemakers.
Hemodynamically unstable subjects.

Primary Outcome Measures

Name	Time	Method
1. Mann Assessment of Swallowing Ability (MASA)	Baseline to 4weeks
2. Dysphagia Outcome and Severity Scale (DOSS)	Baseline to 4weeks

Secondary Outcome Measures

Name	Time	Method
Swallowing Quality of Life (SWAL-QOL) scale	Baseline to 4 weeks

Locations (1): Acharya Vinoba Bhave Rural Hospital
🇮🇳
Wardha, MAHARASHTRA, India
Acharya Vinoba Bhave Rural Hospital
🇮🇳Wardha, MAHARASHTRA, India
Dr Tejaswini Lakde
Principal investigator
8600880087
tejaswinilakde86@gmail.com