Evidence-Based Systematic Review: Oropharyngeal Dysphagia Behavioral Treatments. Part IV—Impact of Dysphagia Treatment on Individuals' Postcancer Treatments
Journal of Rehabilitation Research & Development
McCabe, D., Ashford, J., et al. (2009).
Journal of Rehabilitation Research & Development, 46(2), 250-214.
This evidence-based systematic review investigates the effects of seven behavioral swallowing treatments (e.g., side lying posture, chin tuck posture, head rotation posture, effortful swallow maneuver, Mendelssohn maneuver, supraglottic swallow maneuver, super supraglottic swallow maneuver) on swallowing physiology, functional swallowing, and pulmonary health outcomes in adults, 18 years or older, with structurally-induced dysphagia (i.e., post-head and neck cancer treatments). This systematic review is part of a series of systematic reviews on dysphagia.
This review was unfunded and based on work supported by ASHA's National Center for Evidence-based Practice in Communication Disorders.
<div>This systematic review was reviewed with the following supporting documents listed here and in the associated article section below:</div><div><ol><li><span style="line-height: 1.5;">Frymark, T., Schooling, T., et al. (2009). Evidence-Based Systematic Review: Oropharyngeal Dysphagia Behavioral Treatments. Part I</span><span class="_Tgc" style="line-height: 1.5;">—</span><span style="line-height: 1.5;">Background and Methodology. </span><em style="line-height: 1.5;">Journal of Rehabilitation Research & Development, 46</em><span style="line-height: 1.5;">(2), 175-183.</span></li><li><span style="line-height: 1.5;">Wheeler-Hegland, K., Frymark, T., et al. (2009). Evidence-Based Systematic Review: Oropharyngeal Dysphagia Behavioral Treatments. Part V</span><span class="_Tgc" style="line-height: 1.5;">—</span><span style="line-height: 1.5;">Applications for Clinicians and Researchers. </span><em style="line-height: 1.5;">Journal of Rehabilitation Research & Development, 46</em><span style="line-height: 1.5;">(2), 215-222.</span></li></ol></div><div><span style="line-height: 1.5;">These supporting documents, which provide the systematic search results and address the application of the findings of this review to assist in clinical decision making, are available in the <span style="line-height: 1.5;"><a href="http://www.rehab.research.va.gov/jour/09/46/2/index.html" class="ApplyClass" title="http://www.rehab.research.va.gov/jour/09/46/2/index.html" style="line-height: 1.5;">Journal of Rehabilitation Research and Development</a></span>.</span></div>
1985-2007
Published, peer-reviewed, English-language studies (not further specified)
6
"The Mendelsohn maneuver with or without sEMG [surface electromyography] appears to be the treatment approach that produces the best results in returning patients to oral feeding. Promising intervention results that pair the Mendelsohn maneuver and sEMG suggest that the use of this biofeedback approach produces positive effects in patients with swallowing problems secondary to structurally based cancers" (p. 212).
"Depending on the circumstances with each individual patient, this maneuver [the effortful swallow maneuver] may assist some to approach near-normal swallowing pressures, thus improving oropharyngeal clearing efficiency. As with all postural or maneuver interventions, patients with head and neck cancer should only be recommended the effortful swallow maneuver after observation of its effectiveness under fluoroscopic or endoscopic evaluation" (p. 211).
"No studies were found that investigated the use of side lying or head rotation in the population with head and neck cancer" (p. 208).
Findings from one study indicated fewer swallowing disorders among participants using the super-supraglottic swallowing maneuver than control participants. "However, data reported from two additional studies suggest that this maneuver may not be as effective in preventing aspiration as other interventions, such as the Mendelsohn maneuver" (p. 210).
"Ultimately, with little evidence available at this time, the impact of the supraglottic swallow is difficult to determine in populations with head and neck cancer" (p. 212).
