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Identifying Non-Traditional Approaches to Swallowing Rehabilitation: A Scoping Review

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Abstract

In recent years, dysphagia care has shifted toward a more patient-centered approach. This means that dysphagia clinicians are considering more factors in the treatment process including the goals of care, quality of life, and cultural values. The purpose of this scoping review was to examine relevant research and identify dysphagia interventions outside of those traditionally used by dysphagia clinicians that may improve swallowing function. A review of relevant studies was conducted using search terms related to swallowing and treatment. The search yielded 8439 unique studies. Of the 283 articles that underwent a full-text review, 37 articles were included in the final review. These articles highlighted three potential areas of non-traditional dysphagia intervention that may serve to provide holistic care, while also aiming to improve swallowing mechanisms: acupuncture and Eastern medicine interventions, vocal exercises, and physical function exercises. The results suggest that dysphagia clinicians should work collaboratively with other allied health professionals and consider non-traditional approaches to dysphagia care. Through the identification of potentially effective but non-traditional or non-Eurocentric interventions for dysphagia care, clinicians may promote a culturally relevant, patient-centered approach, in turn increasing patient acceptance of treatment plans and compliance. Future research should explore the efficacy and feasibility of these interventions in dysphagia rehabilitation, as well as their effectiveness compared to more traditional approaches.

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Data Availability

All data generated or analyzed during this study are included in this published article and its appendix.

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Acknowledgements

This work was funded by the Drummond Foundation.

Funding

This study was funded by the Drummond Foundation.

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Authors and Affiliations

  1. School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada

    Angela Horyacheva, Keara Boyce, Maneetpal Badesha, Hiba Najeeb & Ashwini Namasivayam-MacDonald

  2. St. Mary’s General Hospital, Kitchener, ON, Canada

    Cassandra Kerr & Hiba Najeeb

  3. Hamilton Health Sciences, Hamilton, ON, Canada

    Keara Boyce

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  1. Angela Horyacheva
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Correspondence to Ashwini Namasivayam-MacDonald.

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Appendix A: Information about “traditional” dysphagia interventions provided to reviewers

Appendix A: Information about “traditional” dysphagia interventions provided to reviewers

Interventions that would be excluded (e.g., because they are compensatory or commonly used) include:

  • Bolus modifications (size/volume, viscosity, texture)

  • Thermal-tactile application

  • Chin tuck (w/ or w/o resistance)

  • Jaw opening (w/ or w/o resistance)

  • Head turn/head rotation

  • Head tilt

  • Shaker/head lift exercise

  • Supraglottic swallow

  • Super-supraglottic swallow

  • Effortful swallow

  • Multiple swallows

  • Mendelsohn maneuver

  • McNeill dysphagia therapy program (MDTP)

  • Masako (tongue hold)

  • Tongue strengthening (e.g., tongue press, tongue pressure resistance training, tongue retraction against resistance, tongue resistance training, Isometric Progressive Resistance Oropharyngeal therapy)

  • Lip strengthening (e.g., oral screen)

  • Dry swallow after suction/sucking through straws

  • Effortful pitch glide

  • Expiratory muscle strength training (EMST)

  • Valsalva maneuver/breath hold

  • Respiratory swallow training (e.g., Mechanical inspiration and expiration)

  • Neuromuscular electrical stimulation (NMES)

  • Surface electromyography (sEMG; w/ or w/o other exercises)

  • Transcranial magnetic stimulation (TMS)

  • Transcranial direct current stimulation (tDCS)

  • Proprioceptive neuromuscular facilitation (PNF)

  • Pretend to gargle

  • Pretend to yawn

  • Preparatory tasks

  • Taste changes

  • Carbonated beverages

  • Temperature changes

  • Utensil change

  • Liquid wash

  • Oral hygiene

Interventions that fall outside of this list (e.g., are therefore considered “non-traditional” for the purpose of this study) and are rehabilitative (e.g., not compensatory, pharmacological) would be included. Examples include singing training, physical exercise, acupuncture/traditional Chinese medicine.

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Horyacheva, A., Boyce, K., Badesha, M. et al. Identifying Non-Traditional Approaches to Swallowing Rehabilitation: A Scoping Review. Dysphagia (2023). https://doi.org/10.1007/s00455-023-10622-w

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