Methods of diagnosis and rehabilitation of dysphagia in patients with spinal cord injury: a systematic review.
Roberta Zupo, Beatrice Poggi, Nicole Caggiano and 6 others
PMID 39679797WHAT IT FOUND
Swallowing assessment after spinal cord injury is varied, with bedside evaluation, a severity scale, a self-report questionnaire, and a moving x-ray swallowing study most common.
Four rehabilitation protocols were reported, so no standard treatment protocol can be recommended.
Key findings
01The most frequently used swallowing assessment tools were the Bedside Swallow Evaluation, Bazaz score, EAT-10, and videofluoroscopy.
02Only four included studies reported a rehabilitation protocol for dysphagia after spinal cord injury.
03The review found too few studies, too few patients, and too much variation to define a rehabilitation program.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The 43 included studies varied in design, population, and reported outcomes, so the review could not combine them into a single evidence estimate. Injury severity was reported in only 18 of the 43 studies, and some studies mixed spinal cord injury with stroke, head and neck disease, or poor general condition. Only four studies described rehabilitation protocols, and those protocols varied widely in patients, intensity, and outcome measures. Most assessment scales used in the included studies were not shown to be validated for people with spinal cord injury. The review did not compare instrumental swallowing tests, so it cannot say which test is better for spinal cord injury.
Declared interests
The authors declared no financial conflict of interest. The research was funded by the European Union Next Generation EU National Recovery and Resilience Plan.
The easy way to misread this
Do not read this review as evidence that any dysphagia treatment works for spinal cord injury. It mapped reported methods and protocols, and the rehabilitation evidence came from only four heterogeneous studies without comparison.