Dysphagia in Duchenne muscular dystrophy: practical recommendations to guide management.
Michel Toussaint, Zoe Davidson, Veronique Bouvoie and 3 others
PMID 26728920WHAT IT FOUND
Screen late non-ambulatory Duchenne patients for swallowing problems every 6 months, per expert recommendations.
If residue or penetration, stop solids, minced and mashed food; use purees and water. If aspiration, stop oral food and consider gastrostomy and cough assistance.
Key findings
01The algorithm recommends assessing late non-ambulatory patients with DMD every 6 months with a swallowing questionnaire.
02For frequent penetration or residue without aspiration, the algorithm recommends stopping solid, minced and mashed food and using pureed food with water during and after meals.
03When aspiration is evident, the algorithm recommends stopping oral feeding and considering PEG placement.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is expert recommendation and service experience, not a tested intervention or formal systematic review. The centre reported 205 patients with neuromuscular disorders in 2013, including 48 patients with DMD, but the paper does not report outcomes for them. The algorithm is designed for late non-ambulatory patients, so it may not apply to ambulatory patients. The paper gives no original outcome data showing that the algorithm changes weight, chest infections or aspiration.
The easy way to misread this
Do not read the algorithm as proof that these swallowing treatments work. The paper is expert recommendation and service experience, and it does not report trial outcomes for the recommended steps.