Comparison of NMES, tDCS, and TMS Treatments in Post-Stroke Dysphagia

This randomized, single‐blind, controlled clinical trial aims to compare theeffectiveness of neuromuscular electrical stimulation (NMES) administered alone or incombination with transcranial direct current stimulation (tDCS) or transcranial magneticstimulation (TMS) in adults with post‐stroke dysphagia.A total of 40 participants will be randomly assigned to four parallel groups, with 10participants in each group: NMES combined with sham tDCS, NMES combined with sham TMS,active tDCS combined with NMES, and active TMS combined with NMES. Each participant willreceive 10 treatment sessions.Swallowing function will be assessed before and after treatment using clinical swallowingassessments and videofluoroscopic swallowing examinations. Treatment effectiveness willbe evaluated using the Toronto Bedside Swallowing Screening Test, Functional Oral IntakeScale, Penetration‐Aspiration Scale, Dynamic Imaging Grade of Swallowing Toxicity(DIGEST) and Bolus Residue Scale. The study seeks to determine whether combining centralstimulation methods with NMES provides greater improvements in swallowing safety,dysphagia severity, pharyngeal residue, and oral intake than NMES‐based controlinterventions.