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Volume 46 Number 2, 2009
   Pages 195 — 204

Abstract - Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Part III-Impact of dysphagia treatments on populations with neurological disorders

John Ashford, PhD;1 Daniel McCabe, DMA;2 Karen Wheeler-Hegland, PhD;3 Tobi Frymark, MA;4* Robert Mullen, MPH;4 Nan Musson, MA;3 Tracy Schooling, MA;4 Carol Smith Hammond, PhD5-6

1Tennessee State University/Vanderbilt University, Nashville, TN; 2Davenport and Taylor Memorial Hospital, Bath, NY; 3Malcom Randall Department of Veterans Affairs Medical Center (VAMC), Gainesville, FL; 4American Speech-Language-Hearing Association, Rockville, MD; 5Durham VAMC, Durham, NC; 6Duke University, Durham, NC

Abstract — This evidence-based systematic review (EBSR) is part of a series of reviews examining the state of the research regarding behavioral interventions for dysphagia. This EBSR focuses primarily on dysphagia secondary to neurological disorders (e.g., brain injury, stroke, Parkinson's disease, and dementia). The seven behavioral treatments investigated were three postural interventions (side lying, chin tuck, and head rotation) and four swallowing maneuvers (effortful swallow, Mendelsohn, supraglottic swallow, and super-supraglottic swallow). We systematically searched the dysphagia literature from March 2007 to April 2008 using 14 electronic databases. Seven studies met the inclusion and exclusion criteria and were evaluated for methodological quality and stage of research. Of the included studies, only two were judged to be efficacy research; the remaining five were considered exploratory. Methodological quality of studies ranged from one to seven out of eight possible quality markers. Five of seven treatment interventions were addressed by at least one study. No studies were found to address the effortful swallow or the super-supraglottic swallow. Currently, limited evidence from seven studies shows the potential effects of dysphagia behavioral interventions for select groups of individuals with neurologically induced dysphagia. Further research is needed to evaluate the effectiveness of these and the remaining interventions with various populations with neurological disorders.

Key words: chin-tuck posture, dysphagia, effortful swallow maneuver, evidence-based practice, evidence-based systematic review, head-rotation posture, Mendelsohn maneuver, rehabilitation, side-lying posture, super-supraglottic swallow maneuver, supraglottic swallow maneuver, treatment.

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