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

ABSTRACT 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.