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What is VitalStim
Ting-Ting Hsu, a Speech Language Pathologist and LVST LOUD certified therapist, explores VitalStim therapy and how it can benefit patients within the program.
Featured Speaker:
Ting-Ting Hsu, SLP
Ting-Ting Hsu is a bilingual certified speech language pathologist, who speaks English and Mandarin, and joined our team at the Rehabilitation and Orthopedic Institute at PRMC. She has a Master's degree in Communication Sciences and Disorders from the University of Hawaii. She holds post-graduate specialization in the LSVT Loud (specialized treatment program for Parkinson's disease) and Neuromuscular Electrical Stimulation (NMES) certified with VitalStim. She enjoys working with people who have difficulties with communication, eating/ drinking, swallowing, and voicing. Transcription:
What is VitalStim
Prakash Chandran: Welcome to Palmdale Regional Radio. I'm Prakash Chandran. And today, we are discussing VitalStim Therapy with Ting-Ting Hsu, speech-language pathologist and LSVT LOUD certified therapist for Palmdale Regional Medical Center. So Ting-Ting, it's really great to have you here today. I've been hearing about VitalStim, but I was hoping that you would just explain at a high level what it is.
Ting-Ting Hsu: Hi, Prakash. Thank you for having me today. So VitalStim is a non-invasive therapy. We use electrical current to stimulate the muscles for swallowing. So it's a good therapy method for people who have difficulty swallowing.
Prakash Chandran: Okay. And tell me a little bit about how it works.
Ting-Ting Hsu: So the VitalStim System, it uses a neuromuscular electrical stimulation to stimulate your nerve muscles, especially responsible for swallowing. So the device will then shoot out the electrical current. The current will be produced by the machine and it helps to strengthen the muscles involved in the swallowing mechanism in order to rehabilitate the swallow.
Prakash Chandran: Okay, understood. And before I ask who benefits from this, can you talk a little bit about where those electrical nodes are placed? Is it just on a person's throat or neck?
Ting-Ting Hsu: Yeah. So usually, we will place the electrodes on their front of their neck. And then, the machine will shoot out the current. So by stimulating the muscles, it will like send the message to your brain and then strengthening your muscles and then to also to coordinate your muscles and your brain connection.
Prakash Chandran: Okay. And So who exactly benefits from VitalStim?
Ting-Ting Hsu: So as mentioned earlier, this kind of therapy is beneficial for people who have difficulty swallowing. And it's more specific for people who have oropharyngeal dysphagia. It's like their difficulty is because of their mouth or there's muscle weakness in their throat. For example, people who had stroke or who had progressive neuromuscular disorders or people who had head and neck cancer, especially they went through a lot of radiotherapy. Their throat muscles are getting really stiff, very tight. The VitalStim Therapy will help them to retrain those muscles and to rehabilitate their swallowing.
Prakash Chandran: Yeah, that sounds fascinating. So, how effective is the VitalStim System?
Ting-Ting Hsu: So, they did a lot of research and then this kind of therapy is approved by the US Food and Drug Administration in 2001 for treatment for people who have dysphagia. So usually, by doing the therapy, they will see a good result from between six to 20 treatment sessions. It really depends on patient's severity of their disorders.
Prakash Chandran: Okay, understood. And before VitalStim existed, because you said that it was kind of approved in 2001, what were the alternative or traditional methods of treatment for this?
Ting-Ting Hsu: Yeah. So for traditional dysphagia therapy, we just do exercises. If you come to the speech therapy and you have difficulty swallowing, we'll do some we call swallowing maneuvers or swallowing strengthening exercises. So by doing the exercises, you strengthen your muscles.
But after 2001, they have this device. So the device would just help kind of like assess you to have a better movement of your muscles. For example, you're going to a gym, you're going to work out more. So those kinds of devices will help you kind of give you some weight, kind of if you're like practicing your muscles, you're lifting some weight. So the muscles will give you some kind of strengthening to help you to strengthen your muscles.
Prakash Chandran: I see. So clearly, as technology has progressed and medicine has progressed, VitalStim is a, I guess, a much better option because it's something that doesn't really require any of that weighted technique. It's just something that you attach on your neck and starts working over the different sessions. Is that correct?
Ting-Ting Hsu: Yes. Yes. Correct.
Prakash Chandran: Is there anyone that cannot receive VitalStim?
Ting-Ting Hsu: So we talked about this is good for people who have difficulty swallowing especially in their mouth and their throat. But if their difficulty swallowing is caused by their esophageal area, then it might not be a good fit. We'll kind of recommend to see the GI doctor to fix the problem in their esophageal area. And then if they still have the problem swallowing, then definitely come back to speech therapy. And besides that, you have very severe reflux or you have a tumor or active infection around your neck, we don't recommend those patients to do the VitalStim therapy, because the current, we just don't want those current to go through those tumors to like agitate it or irritate the infection or the tumor. And also for people who have pacemaker and then some deep brain stimulators. Like you can do it if you have a pacemaker, but definitely double check with your PCP before you want to come to speech therapy and do VitalStim.
Prakash Chandran: Okay. So we talked about the different VitalStim sessions. Can you just walk us through what a typical session looks like?
Ting-Ting Hsu: So a typical VitalStim session, each session begins by putting the electrodes on the front of your neck. So first thing I'll use a alcohol pad to clean your skin and then place the electrodes. So in the beginning, you will feel a little bit like tingling, you might feel like kind of like needles, like maybe like needles pinging on you. And then once I increase the inputs, the sensation will be more like tugging and pulling, that kind of sensation. And once you feel that tugging and pulling, that's the good amount of the input I will like. And at the same time, so when the device is attached on you, I will start giving you some exercises or some food to trial because, like we said, the traditional therapy is doing the exercises.
So for VitalStim, the research shows that we can receive the most effective therapy from doing VitalStim and traditional therapy together. So if you were just doing VitalStim, we just attach the device on you and letting you sit in there is not going to help you the most. So besides the device, we'll ask you to do the exercises at the same time, so that way it will help your muscles to gain more strength back.
Prakash Chandran: Now, you talked about kind of a pulling sensation, but I have to ask, does it hurt at all?
Ting-Ting Hsu: No, if it goes really high, it might. But of course, we're not going that high. We will like increase the input little by little until, "Tell me like, okay, it's enough," then we'll stop right there. The numbers, it doesn't matter because everybody's tolerance is different. So it really depends on how you feel.
Prakash Chandran: Okay. That makes sense. So how long exactly does a treatment session last?
Ting-Ting Hsu: So we usually do it for an hour. But of course, we will decrease the amount of time depending on people's like daily condition. Maybe they are more tired that day or they are maybe more sensitive to the current, the stimulation. So usually, I'll do an hour. But of course, I will cut the time a little bit shorter if needed.
Prakash Chandran: So, how do you go about diagnosing what area to focus on for VitalStim and how many sessions are needed?
Ting-Ting Hsu: Like before the VitalStim starts, I will like the patients to go through I call it a modified barium swallow study. So by doing that study, we'll be able to know where the weakness is, what are the areas that we can really work on. And by that study, we'll probably be able to kind of gauge like, "Okay. I think by the eighth session, we'll be okay. And after the eight sessions, I will want you to do a repeat a video swallow to know if there's improvement." But the initial video swallow shows kind of severe, then of course, I will add the time. I'll be for 16 sessions or 15 sessions. It really depends on need for each people, for individuals.
Prakash Chandran: Yeah. So finally, are there any side effects that people should be aware of when it comes to VitalStim?
Ting-Ting Hsu: So the only side effect I would say is just a skin irritation. Because like I said, before I put on the electrodes on your neck, I need to use the alcohol pad to clean your skin to make sure the electrodes can attach there very well. But for a typical man, let's say, you shave your beard and then, you know, you might get cut, so the alcohol might sometimes be a little bit painful if you put alcohol on your cut. And then also as I clean your skin too well, it gets kind of irritated and fragile too. So that's the only thing, I would say that's the only side effect for VitalStim.
Prakash Chandran: So just before we close here today, is there anything else that you wanted to share with our audience around getting VitalStim or considering it for a loved one?
Ting-Ting Hsu: Yeah. I would say if you start feeling like you have difficulty swallowing, you just feel like, especially during the meal time, you're drinking, even though you don't feel you're choking, but you cough a lot, I would say that's kind of a sign of the food went down to the wrong way. So please reach out to your PCP and get a speech therapy evaluation. So we'll have a better idea if you need a VitalStim therapy or not. So definitely reach out to your PCP and get a referral.
Prakash Chandran: Okay. And just to be clear as a lay person, PCP is your primary care physician, is that correct?
Ting-Ting Hsu: Yes. Yes. Correct.
Prakash Chandran: Okay, fantastic. Well, thank you for educating us today about VitalStim. This has been really informative. Thanks, Ting-Ting.
Ting-Ting Hsu: No problem. Thank you.
Prakash Chandran: That's Ting-Ting Hsu, speech language pathologist and LSVT LOUD certified therapist for Palmdale Regional Medical Center.
And that concludes another episode of Palmdale Regional Radio with Palmdale Regional Medical Center, please visit our website at palmdaleregional.com for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all other Palmdale Regional Medical Center podcasts. And for more health tips and updates, follow us on your social channels
Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians.
Thank you so much for listening. My name is Prakash Chandran, and we'll talk next time.
What is VitalStim
Prakash Chandran: Welcome to Palmdale Regional Radio. I'm Prakash Chandran. And today, we are discussing VitalStim Therapy with Ting-Ting Hsu, speech-language pathologist and LSVT LOUD certified therapist for Palmdale Regional Medical Center. So Ting-Ting, it's really great to have you here today. I've been hearing about VitalStim, but I was hoping that you would just explain at a high level what it is.
Ting-Ting Hsu: Hi, Prakash. Thank you for having me today. So VitalStim is a non-invasive therapy. We use electrical current to stimulate the muscles for swallowing. So it's a good therapy method for people who have difficulty swallowing.
Prakash Chandran: Okay. And tell me a little bit about how it works.
Ting-Ting Hsu: So the VitalStim System, it uses a neuromuscular electrical stimulation to stimulate your nerve muscles, especially responsible for swallowing. So the device will then shoot out the electrical current. The current will be produced by the machine and it helps to strengthen the muscles involved in the swallowing mechanism in order to rehabilitate the swallow.
Prakash Chandran: Okay, understood. And before I ask who benefits from this, can you talk a little bit about where those electrical nodes are placed? Is it just on a person's throat or neck?
Ting-Ting Hsu: Yeah. So usually, we will place the electrodes on their front of their neck. And then, the machine will shoot out the current. So by stimulating the muscles, it will like send the message to your brain and then strengthening your muscles and then to also to coordinate your muscles and your brain connection.
Prakash Chandran: Okay. And So who exactly benefits from VitalStim?
Ting-Ting Hsu: So as mentioned earlier, this kind of therapy is beneficial for people who have difficulty swallowing. And it's more specific for people who have oropharyngeal dysphagia. It's like their difficulty is because of their mouth or there's muscle weakness in their throat. For example, people who had stroke or who had progressive neuromuscular disorders or people who had head and neck cancer, especially they went through a lot of radiotherapy. Their throat muscles are getting really stiff, very tight. The VitalStim Therapy will help them to retrain those muscles and to rehabilitate their swallowing.
Prakash Chandran: Yeah, that sounds fascinating. So, how effective is the VitalStim System?
Ting-Ting Hsu: So, they did a lot of research and then this kind of therapy is approved by the US Food and Drug Administration in 2001 for treatment for people who have dysphagia. So usually, by doing the therapy, they will see a good result from between six to 20 treatment sessions. It really depends on patient's severity of their disorders.
Prakash Chandran: Okay, understood. And before VitalStim existed, because you said that it was kind of approved in 2001, what were the alternative or traditional methods of treatment for this?
Ting-Ting Hsu: Yeah. So for traditional dysphagia therapy, we just do exercises. If you come to the speech therapy and you have difficulty swallowing, we'll do some we call swallowing maneuvers or swallowing strengthening exercises. So by doing the exercises, you strengthen your muscles.
But after 2001, they have this device. So the device would just help kind of like assess you to have a better movement of your muscles. For example, you're going to a gym, you're going to work out more. So those kinds of devices will help you kind of give you some weight, kind of if you're like practicing your muscles, you're lifting some weight. So the muscles will give you some kind of strengthening to help you to strengthen your muscles.
Prakash Chandran: I see. So clearly, as technology has progressed and medicine has progressed, VitalStim is a, I guess, a much better option because it's something that doesn't really require any of that weighted technique. It's just something that you attach on your neck and starts working over the different sessions. Is that correct?
Ting-Ting Hsu: Yes. Yes. Correct.
Prakash Chandran: Is there anyone that cannot receive VitalStim?
Ting-Ting Hsu: So we talked about this is good for people who have difficulty swallowing especially in their mouth and their throat. But if their difficulty swallowing is caused by their esophageal area, then it might not be a good fit. We'll kind of recommend to see the GI doctor to fix the problem in their esophageal area. And then if they still have the problem swallowing, then definitely come back to speech therapy. And besides that, you have very severe reflux or you have a tumor or active infection around your neck, we don't recommend those patients to do the VitalStim therapy, because the current, we just don't want those current to go through those tumors to like agitate it or irritate the infection or the tumor. And also for people who have pacemaker and then some deep brain stimulators. Like you can do it if you have a pacemaker, but definitely double check with your PCP before you want to come to speech therapy and do VitalStim.
Prakash Chandran: Okay. So we talked about the different VitalStim sessions. Can you just walk us through what a typical session looks like?
Ting-Ting Hsu: So a typical VitalStim session, each session begins by putting the electrodes on the front of your neck. So first thing I'll use a alcohol pad to clean your skin and then place the electrodes. So in the beginning, you will feel a little bit like tingling, you might feel like kind of like needles, like maybe like needles pinging on you. And then once I increase the inputs, the sensation will be more like tugging and pulling, that kind of sensation. And once you feel that tugging and pulling, that's the good amount of the input I will like. And at the same time, so when the device is attached on you, I will start giving you some exercises or some food to trial because, like we said, the traditional therapy is doing the exercises.
So for VitalStim, the research shows that we can receive the most effective therapy from doing VitalStim and traditional therapy together. So if you were just doing VitalStim, we just attach the device on you and letting you sit in there is not going to help you the most. So besides the device, we'll ask you to do the exercises at the same time, so that way it will help your muscles to gain more strength back.
Prakash Chandran: Now, you talked about kind of a pulling sensation, but I have to ask, does it hurt at all?
Ting-Ting Hsu: No, if it goes really high, it might. But of course, we're not going that high. We will like increase the input little by little until, "Tell me like, okay, it's enough," then we'll stop right there. The numbers, it doesn't matter because everybody's tolerance is different. So it really depends on how you feel.
Prakash Chandran: Okay. That makes sense. So how long exactly does a treatment session last?
Ting-Ting Hsu: So we usually do it for an hour. But of course, we will decrease the amount of time depending on people's like daily condition. Maybe they are more tired that day or they are maybe more sensitive to the current, the stimulation. So usually, I'll do an hour. But of course, I will cut the time a little bit shorter if needed.
Prakash Chandran: So, how do you go about diagnosing what area to focus on for VitalStim and how many sessions are needed?
Ting-Ting Hsu: Like before the VitalStim starts, I will like the patients to go through I call it a modified barium swallow study. So by doing that study, we'll be able to know where the weakness is, what are the areas that we can really work on. And by that study, we'll probably be able to kind of gauge like, "Okay. I think by the eighth session, we'll be okay. And after the eight sessions, I will want you to do a repeat a video swallow to know if there's improvement." But the initial video swallow shows kind of severe, then of course, I will add the time. I'll be for 16 sessions or 15 sessions. It really depends on need for each people, for individuals.
Prakash Chandran: Yeah. So finally, are there any side effects that people should be aware of when it comes to VitalStim?
Ting-Ting Hsu: So the only side effect I would say is just a skin irritation. Because like I said, before I put on the electrodes on your neck, I need to use the alcohol pad to clean your skin to make sure the electrodes can attach there very well. But for a typical man, let's say, you shave your beard and then, you know, you might get cut, so the alcohol might sometimes be a little bit painful if you put alcohol on your cut. And then also as I clean your skin too well, it gets kind of irritated and fragile too. So that's the only thing, I would say that's the only side effect for VitalStim.
Prakash Chandran: So just before we close here today, is there anything else that you wanted to share with our audience around getting VitalStim or considering it for a loved one?
Ting-Ting Hsu: Yeah. I would say if you start feeling like you have difficulty swallowing, you just feel like, especially during the meal time, you're drinking, even though you don't feel you're choking, but you cough a lot, I would say that's kind of a sign of the food went down to the wrong way. So please reach out to your PCP and get a speech therapy evaluation. So we'll have a better idea if you need a VitalStim therapy or not. So definitely reach out to your PCP and get a referral.
Prakash Chandran: Okay. And just to be clear as a lay person, PCP is your primary care physician, is that correct?
Ting-Ting Hsu: Yes. Yes. Correct.
Prakash Chandran: Okay, fantastic. Well, thank you for educating us today about VitalStim. This has been really informative. Thanks, Ting-Ting.
Ting-Ting Hsu: No problem. Thank you.
Prakash Chandran: That's Ting-Ting Hsu, speech language pathologist and LSVT LOUD certified therapist for Palmdale Regional Medical Center.
And that concludes another episode of Palmdale Regional Radio with Palmdale Regional Medical Center, please visit our website at palmdaleregional.com for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all other Palmdale Regional Medical Center podcasts. And for more health tips and updates, follow us on your social channels
Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians.
Thank you so much for listening. My name is Prakash Chandran, and we'll talk next time.