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Volume 46 Number 2, 2009
   Pages 205 — 214

Abstract - Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Part IV-Impact of dysphagia treatment on individuals' postcancer treatments

Daniel McCabe, DMA;1 John Ashford, PhD;2 Karen Wheeler-Hegland, PhD;3 Tobi Frymark, MA;4*
Robert Mullen, MPH;4 Nan Musson, MA;3 Carol Smith Hammond, PhD;5-6 Tracy Schooling, MA4

1Davenport and Taylor Memorial Hospital, Bath, NY; 2Tennessee State University/Vanderbilt University, Nashville, TN; 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 investigating swallowing behavioral treatments for individuals with dysphagia. This EBSR focuses primarily on individuals with dysphagia postcancer treatments. The seven behavioral interventions under review included 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. Six studies that met the inclusion and exclusion criteria were evaluated for methodological quality and characterized by research stage. Effect sizes were calculated when possible. All studies included were considered exploratory, with quality-marker scores ranging from 1 to 4 out of 7 possible markers. Five studies examined one or more of the four swallowing maneuvers, and one study addressed the chin-tuck posture. No studies addressed side lying or head rotation. Currently, limited evidence exists from six studies showing the positive effects of behavioral swallowing interventions for populations with structural disorder. Because of the range of structural deficits resulting from cancers and their treatments, further research is needed that evaluates specific intervention effectiveness.

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

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