Behavioral Interventions Targeting Base of Tongue to Posterior Pharyngeal Wall Approximation: A Scoping Review.
Sebastian H Doeltgen, Rebecca Francis, Stephanie K Daniels and 3 others
PMID 36163399WHAT IT FOUND
Effortful swallowing and similar maneuvers can increase tongue base pressure in the moment.
However, there is almost no evidence that these exercises improve long-term swallowing function in patients. Most studies used healthy volunteers, so results do not guarantee clinical benefit.
Key findings
01Only three studies evaluated long-term exercise regimens for improving base of tongue to posterior pharyngeal wall approximation, and two of these were single case studies.
02The majority of studies on immediate effects involved healthy participants rather than patients with dysphagia, limiting generalizability.
03The overall strength of the evidence base for these behavioral interventions is considered weak, and clear clinical recommendations cannot be made.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Most evidence comes from healthy participants, not patients with dysphagia, so it is unclear if the immediate biomechanical changes translate to clinical improvement in patients. The review excluded studies that did not report specific objective measures of tongue base to posterior pharyngeal wall approximation, which may have missed some relevant clinical outcome data. Only English-language studies were included. The long-term evidence is extremely limited, consisting of just three studies, two of which were single case reports.
Declared interests
The study was funded by Flinders University. No other conflicts of interest were reported.
The easy way to misread this
Do not interpret the immediate increase in pressure during a maneuver as proof that these exercises will improve a patient's swallowing over time. The review found very little evidence for long-term benefits, and most positive results were seen in healthy people rather than patients with dysphagia.