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Review
. 2022 Jan 28;11(3):685.
doi: 10.3390/jcm11030685.

Behavioural Interventions in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analysis of Randomised Clinical Trials

Renée Speyer  1   2   3 , Reinie Cordier  2   4 , Anna-Liisa Sutt  5   6 , Lianne Remijn  7 , Bas Joris Heijnen  3 , Mathieu Balaguer  8 , Timothy Pommée  8 , Michelle McInerney  9 , Liza Bergström  10   11
Affiliations
Review

Behavioural Interventions in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analysis of Randomised Clinical Trials

Renée Speyer et al. J Clin Med. .

Abstract

Objective: To determine the effects of behavioural interventions in people with oropharyngeal dysphagia.

Methods: Systematic literature searches were conducted to retrieve randomized controlled trials in four different databases (CINAHL, Embase, PsycINFO, and PubMed). The methodological quality of eligible articles was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2), after which meta-analyses were performed using a random-effects model.

Results: A total of 37 studies were included. Overall, a significant, large pre-post interventions effect size was found. To compare different types of interventions, all behavioural interventions and conventional dysphagia treatment comparison groups were categorised into compensatory, rehabilitative, and combined compensatory and rehabilitative interventions. Overall, significant treatment effects were identified favouring behavioural interventions. In particular, large effect sizes were found when comparing rehabilitative interventions with no dysphagia treatment, and combined interventions with compensatory conventional dysphagia treatment. When comparing selected interventions versus conventional dysphagia treatment, significant, large effect sizes were found in favour of Shaker exercise, chin tuck against resistance exercise, and expiratory muscle strength training.

Conclusions: Behavioural interventions show promising effects in people with oropharyngeal dysphagia. However, due to high heterogeneity between studies, generalisations of meta-analyses need to be interpreted with care.

Keywords: RCT; compensation; deglutition; intervention; rehabilitation; swallowing disorders.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the reviewing process according to PRISMA.
Figure 2
Figure 2
Risk of bias summary for all included studies (n = 37) in accordance with RoB2.
Figure 3
Figure 3
Risk of bias summary for individual studies (n = 37) in accordance with RoB2 [19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55]. Note. If one or more yellow or red circles (domains) have been identified for a particular study, the Overall score (last column) shows an exclamation mark, indicating that either the study shows some concerns (yellow circle with exclamation mark) or is at high risk (red circle with exclamation mark).
Figure 4
Figure 4
Within intervention group pre-post meta-analysis [21,22,24,25,28,29,30,31,40,41,42,43,44,45,46,49,51,52,54,56]. Note. Refer to Table 2 for explanation of the subgroups.
Figure 5
Figure 5
Between subgroup meta-analysis for different types of interventions: behavioural interventions compared with conventional dysphagia treatment (CDT) or no dysphagia therapy [21,22,25,29,30,31,34,35,41,42,43,44,46,52]. Note. Refer to Table 2 for explanation of the subgroups.
See this image and copyright information in PMC

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