Dysphagia Interventions
Study interventions and outcome measures are presented in Table 2. Of
the 17 studies included, there were nine different interventions used
for dysphagia rehabilitation.
Three RCTs and one PCT examined the use of neuromuscular electrical
stimulation (NMES) versus sham stimulation in their study populations,
which had either <50% ABI (31, 32), or the study authors did
not specify the proportion (37, 40).
A PCT with <50% ABI
population examining the use of laryngopharyngeal NMES coupled with
conventional swallowing therapy (CST) was compared to CST alone (25). An
additional case report examined the use of a specific type of
neuromuscular stimulation, VitaStim
(VsT), versus CST (including
swallowing exercises, shaker exercise, hyoid lift, compensation
postures, and dietary changes) alone to manage dysphagia symptoms (34).
A unique bilateral muscle stimulation intervention that targeted the
“k-point” intraorally was examined by Kojima et al. (39), with an
unknown proportion of participants having an ABI.
Three studies examined dysphagia-specific rehabilitation programs
including combined muscle exercises and a prescribed swallowing routine,
two of which had <50% ABI populations (24, 26); the remaining
post-test conference abstract had >50% ABI population
(35).
Swallowing therapies that involved manipulating participants’ diet and
adjusting bolus viscosity and velocity were studied in two articles,
including a TBI-specific case report (33) and a post-test study with
22% ABI population (24).
Single studies made up the remaining intervention types. Terre and
Mearin (30) conducted a RCT with 37% ABI population, where patients
either performed a chin-down maneuver compared to anatomical positioning
while eating and drinking to investigate if there was improvement in
swallowing ability or presence of aspiration. A PCT by Seedat and Penn
(28) investigated the effect of scheduled oral care versus inconsistent
oral care in relation to dysphagic symptoms in a 70% stroke and 30%
TBI population. Facio-oral tract therapy, which used a combination of
interventions targeting nutrition, oral hygiene, non-verbal
communication, stimulation of the oral cavity, and speech therapy, was
performed by Seidl et al. (29) on a study population of <50%
TBI. A training program focused on improving tongue-pressure strength
and accuracy (TPSAT) for improving dysphagia and aspiration outcomes was
studied among six individuals who had a TBI (36). Finally, a unique
program that offered a remote, online tele-dysphagia swallowing
intervention compared to a traditional, in-person dysphagia management
program was presented as a conference abstract (ABI % unknown) (38).