Scoping Review to Identify and Map Non-pharmacological, Non-surgical Treatments for Dysphagia Following Moderate-To-Severe Acquired Brain Injury
BMJ Open
Eskildsen, S. J., Poulsen, I., et al. (2021).
BMJ Open, 11(12), e053244.
This systematic review investigates the effects of non-surgical, non-pharmacological interventions on dysphagia in individuals with moderate and severe acquired brain injury in the acute and subacute phases. Only findings pertaining to dysphagia treatments within the scope of SLP practice are included in the summary.
No funding received
From database inception to March 14, 2021
Any study design. Excludes conference abstracts, letters, book chapters, and registered trials.
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<div>Electrical stimulation interventions demonstrated inconsistent effects on dysphagia outcomes for individuals with moderate to severe acquired brain injury in the acute and subacute phase. </div>
<ul>
<li><span style="color: #333333;">Four studies investigating pharyngeal electrical stimulation (PES) reported inconsistent effects. </span></li>
<li><span style="color: #333333;">Two studies showed improved rates of decannulation after PES, while another reported no difference in decannulation between the intervention and control groups. </span></li>
<li><span style="color: #333333;">Another study found significant improvement from baseline to 3 months post-PES on the Dysphagia Severity Rating Scale. </span></li>
<li><span style="color: #333333;">Two studies investigating neuromuscular electrical stimulation found no difference between intervention and control groups for individuals with acquired brain injury.</span></li>
</ul>
<div>For individuals with moderate to severe acquired brain injury in the acute and subacute phases, complex swallowing interventions using a combination of exercise and compensatory interventions demonstrated inconsistent results between treatment and control groups.</div>
<div>Three case studies/series investigating the effects of Facial Oral Tract Therapy (F.O.T.T.) reported increased oral intake and improved swallow safety in individuals with moderate to severe acquired brain injury. One retrospective cohort study also showed oral intake improvements. One randomized controlled trial reported no significant difference in swallowing outcomes between F.O.T.T. intervention and control groups.</div>
<div>Two studies investigating sensory stimulation and conventional dysphagia therapy found mixed outcomes for individuals with moderate to severe acquired brain injury as follows: </div>
<ul>
<li>One retrospective cohort study showed fewer pulmonary infections after sensory electrical stimulation.</li>
<li>One prospective cohort study noted improved oral intake and increased decannulation after thermo-stimulation.</li>
</ul>
<div>One randomized controlled trial investigating the effects of respiratory muscle training found no significant difference in swallowing outcomes when compared to controls for individuals with moderate to severe acquired brain injury.</div>
