What are the effects of swallowing therapy for people up to six months post stroke?

CIAPPONI, AGUSTÍN

Cochrane Clinical Answers

Cochrane Clinical Answers

Año: 2019

Compared with usual care for people up to six months post stroke, swallowing therapy (acupuncture, behavioral intervention, drug therapy, neuromuscular or pharyngeal electrical stimulation, physical stimulation, transcranial direct current stimulation, and transcranial magnetic stimulation) may slightly improve penetration aspiration scores, and may slightly decrease pharyngeal transit time (by 0.23 seconds; all values on average). In addition, swallowing therapy may reduce the number of people with dysphagia (344 vs 556 per 1000 people). Reviewers classified the evidence for the effects of swallowing therapy on swallowing ability and chest infections as very low certainty; therefore, although benefits were observed, no firm conclusions can be drawn regarding these outcomes. Behavioral interventions and acupuncture were assessed in the greatest number of participants, and both showed benefits over usual care in terms of dysphagia. The evidence for other types of swallowing therapy was too sparse for assessment. Although moderate‐certainty evidence probably shows that duration of hospital stay would be shorter by approximately three days for people receiving swallowing therapy, evidence for the other outcomes is of low certainty, making it difficult to draw firm conclusions.