![]() ![]() These primarily address the need for dysphagia evaluation and dietary management with little emphasis placed on behavioral interventions. To date, a number of published guidelines and evidence-based systematic reviews have focused on dysphagia within various populations and treatment settings. They include posturing of the head and neck, physical maneuvers altering oral and pharyngeal physiology, tactile and electrical stimulation, oral and facial exercises, and diet modifications. These behavioral therapeutic approaches have been used clinically, primarily by speech-language pathologists trained in dysphagia management. Treatment to improve disordered oropharyngeal deglutition has traditionally centered on behavioral interventions, with the intended purpose of facilitating safe and efficient oral feeding. Swallowing dysfunction, or dysphagia, can occur in adult patients as a result of significant primary illnesses, including cerebrovascular accidents, neurodegenerative disorders, head and neck cancer, or head injury. Key words: chin-tuck posture, dysphagia, effortful swallow maneuver, evidence-based practice, evidence-based systematic review, head-rotation posture, Mendelsohn maneuver, rehabilitation, side-lying posture, super-supraglottic swallow maneuver, supraglottic swallow maneuver, treatment. Avenues for future research are suggested. Some effects reinforced existing recommendations for the applications of the interventions, while others suggested new ways that the treatments may impact swallow function. For nondisordered populations, the existing evidence demonstrates differential effects of postural changes and maneuvers on swallowing physiology. ![]() Three studies examined the Mendelsohn maneuver, chin tuck, supraglottic swallow, and super-supraglottic swallow and two studies addressed head rotation. The majority of studies (8 of 17) investigated effortful swallow. All studies were exploratory research ranging from two to five of seven possible quality markers. Effect sizes were calculated when possible. Seventeen studies meeting the inclusion criteria were evaluated for methodological quality with the American Speech-Language-Hearing Association's levels-of-evidence scheme and were characterized by research stage (i.e., exploratory, efficacy, effectiveness, cost-benefit/public policy research). ![]() A systematic search of the dysphagia litera-ture was conducted in 14 electronic databases. The behavioral treatments investigated were three postural interventions-side lying, chin tuck, and head rotation-and four swallowing maneuvers-effortful swallow, the Mendelsohn maneuver, supraglottic swallow, and super-supraglottic swallow. Data reported cover the impact of dysphagia behavioral interventions on swallow physiology in healthy adults. University/Vanderbilt University, Nashville, TN 3American Speech-Language-Hearing Association, Rockville, MD 4Davenport and Taylor Memorial Hospital, Bath, NY 5Durham VAMC, Durham, NC 6Duke University, Durham, NCĪbstract - This article is the second in a series of evidence-based systematic reviews. 1Malcom Randall Department of Veterans Affairs Medical Center (VAMC), Gainesville, FL 2Tennessee State ![]()
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