Effects of Sequential 4‐Channel Neuromuscular Electrical Stimulation on Hyoid Excursion, Swallowing Safety and Oral Intake in Older Adults With Sarcopenic Dysphagia: A Randomized Controlled Trial

ABSTRACT Background Sequential 4‐channel neuromuscular electrical stimulation (NMES) was originally developed to mimic the physiological activation sequence of the swallowing‐related muscles; however, its efficacy in older adults with sarcopenic dysphagia remains unclear. This study investigated the effects of sequential 4‐channel NMES on hyoid excursion, swallowing safety, and oral intake in older adults with sarcopenic dysphagia. Methods Forty older adults with sarcopenic dysphagia were randomly assigned to either the sequential 4‐channel ( n = 20) or the conventional 2‐channel ( n = 20) NMES groups. Both groups received NMES intervention for 30 min per session, five times per week, for 6 weeks. Outcome measures included anterior and superior hyoid excursion assessed using the videofluoroscopic swallowing study (VFSS), penetration–aspiration scale (PAS), and functional oral intake scale (FOIS). Two‐way repeated‐measures analysis of variance was conducted to evaluate group × time interaction effects. Results Significant group × time interaction effects were observed for anterior hyoid excursion ( F = 18.46, p < 0.001, η 2 p = 0.327), superior hyoid excursion ( F = 6.94, p = 0.012, η 2 p = 0.154), PAS ( F = 7.96, p = 0.008, η 2 p = 0.173), and FOIS ( F = 8.66, p = 0.006, η 2 p = 0.186). Overall, the 4‐channel NMES group demonstrated greater improvements in hyoid excursion, swallowing safety, and oral intake function than the 2‐channel NMES group. Conclusion These findings support the use of physiologically‐sequenced stimulation as a promising rehabilitation strategy to address swallowing impairments associated with sarcopenic dysphagia.