The Guardian Way: A Better E-Stim for Dysphagia

Dysphagia is one of the major public health issues affecting our world today, with approximately 1 in 25 adults experiencing a swallowing problem in the United States each year. The reported prevalence varies among children, but is reported to affect 30-80% of children with developmental disorders.

Dysphagia is defined as difficulty swallowing, which can occur anywhere between the mouth and the stomach, and often presents as one or more of the following symptoms:

  • Pain while swallowing
  • Being unable to swallow
  • Having the sensation of food getting stuck in your throat or chest
  • Coughing or gagging when swallowing
  • Drooling
  • Hoarse voice
  • Bringing food back up (regurgitation)
  • Frequent heartburn
  • Food or stomach acid backing up into your throat
  • Unexpected weight loss

For therapists looking to help patients improve their ability to swallow, e-stim devices have become increasingly popular as an adjunct to traditional exercises. Delivering electrical current to the nerves and muscles for swallowing, they help the user learn to contract these muscles, strengthening them and improving their muscle memory for proper swallowing procedure.

While VitalStim is the old standby, a new contender on the market is the Guardian Way Protocol by Spectramed, offering an improvement on this technology for therapists looking to time e-stim with functional swallowing and maneuvers.

The Guardian Way Difference

The major difference between the Guardian Way Protocol and other e-stim programs on the market is the rest/work cycle. While many e-stim devices are on continuously, Guardian Way focuses on the ability to time a swallow or a swallow maneuver with NMES.

For the Guardian devices, the stim is on for 4 seconds and then off for 12 seconds, so the patient can swallow and then rest, continuing for a treatment time of about 30 minutes. 

Additionally, the Guardian Way Protocol includes a two-second ramp-up time to help patients adjust more comfortably to the presence of the stimulation. Other devices often feature ramp times of less than a second, which can be jolting for the patient and make them less willing to participate in therapy.

Finally, the Guardian Way ensures that their electrode placements mimic the natural muscle movement patterns associated with swallowing, ensuring that the therapy is helping the patient perform exercises which will strengthen and improve muscle function.

Choosing the Aspire2 or the Unity

The Guardian Way Protocols for neuromuscular electrical stimulation (NMES) are included in both e-stim devices offered by Spectramed.

The Guardian Aspire2 Swallow Stim Device includes both NMES and sEMG in a single unit, allowing therapists to move easily between measurement and treatment with just the touch of a button. A single channel of NMES is perfect for two electrode therapy on the suprahyoid muscles, or for facial stimulation, and sEMG can be easily viewed and controlled both on the device itself or via the convenient iPad app.  The use of biofeedback on the iPad app can improve patient understanding of swallowing maneuvers and exercises during therapy and for carryover.

The Aspire2 Swallow Stim Device includes:

  • 1 channel of NMES
  • 4 built-in NMES programs
  • Option to customize all parameters to individualize treatment
  • Surface electromyography (sEMG)
  • iPad app for real-time sEMG biofeedback and gamification

The Guardian Unity Swallow Stim Device is a two-channel NMES device, offering the ability to stimulate muscles with four electrodes if needed. It also features a full seven built-in programs that accommodate a range of patient needs from more sensitive users to those with fibrotic tissue or timing challenges. 

The Unity Swallow Stim includes:

  • 2 channels of NMES
  • 7 built-in NMES programs


NMES therapy is a great tool for therapists and caregivers alike to improve their patients’ and loved one's ability to swallow, eat, and drink safely and comfortably.

Spectramed offers an innovative selection of devices that integrate improved treatment protocols for better patient comfort, more customization, and the ability to time stimulation with a functional swallow or exercise.

Whether you choose the Aspire2 for its great sEMG and NMES combination, or the Unity for the dual channels and breadth of program selection, either device is guaranteed to provide exceptional comfort and customization for any patient or treatment environment.

Want to learn more about e-stim devices for dysphagia? Check out our full selection of Dysphagia Stimulation Devices on And, if you liked this article and want to learn more about other innovative products on the market, caregiving tips, and more, make sure you check out Caregiver University’s full library.


Lindsay Douglas is a licensed speech-language pathologist specializing in geriatric dysphagia. Her clinical background includes acute care, skilled nursing, rehabilitation, and home health. Her time in corporate director positions added valuable experience in skilled documentation, interdisciplinary teams, and CMS regulations. When not working with patients and clinicians, Lindsay enjoys adventures with her husband, two boys, and their adopted hound dog.

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