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NMES-Facilitated Mandibular Rehabilitation for Spasticity-Related Trismus in ALS
Journal article   Open access   Peer reviewed

NMES-Facilitated Mandibular Rehabilitation for Spasticity-Related Trismus in ALS

Kelly Salmon, Hristelina Ilieva and Daniel Kelly
Muscle & Nerve, Forthcoming
01 Jul 2026
PMID: 42386387
Featured in Collection :   Drexel's Newest Publications
url
https://doi.org/10.1002/mus.70332View
Published, Version of Record (VoR) Open Access via Drexel Libraries Read and Publish Program 2026 Open CC BY-NC-ND V4.0

Abstract

Trismus is a debilitating manifestation of upper motor neuron predominant disease that may occur in individuals with amyotrophic lateral sclerosis (ALS) [1]. Increased tone and spasticity of the jaw-closing musculature can result in reduced oral opening, impairing oral intake, speech, oral hygiene, and overall quality of life. Treatment options for ALS-related trismus are limited and often include pharmacologic management, chemodenervation, and compensatory strategies [2, 3]. Neuromuscular electrical stimulation (NMES) has been investigated as a treatment for spasticity in other neurologic populations, including stroke and spinal cord injury [4, 5]. However, the use of NMES-facilitated mandibular rehabilitation for neurogenic trismus has not previously been reported. Given the potential adverse effects associated with interventions that weaken masticatory musculature, conservative rehabilitation approaches may represent an important treatment option before consideration of chemodenervation. We describe two patients with upper motor neuron–dominant ALS and spasticity-related trismus who underwent a combined NMES and mandibular range-of-motion rehabilitation program.

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