Mitigation of oropharyngeal swallowing impairments and health sequelae: Two meta-analyses and an experiment using surface electromyographic biofeedback

摘要: Behavioral treatments performed in patients with dysphagia are designed to produce immediate or short-term outcomes that eliminate physiologic biomechanical impairments of oropharyngeal swallowing. These expected reduce aspiration swallowed food into the respiratory system, and improve delivery material digestive system. In long-term these interventions justified by expectations they will patient risk for dysphagia-related consequences such as pneumonia, malnutrition, death.Two distinct investigations were this dissertation. The first, a meta-analysis, was evaluate available evidence regarding efficacy individually administered neurogenic dysphagia, effectiveness systematic, institutional protocols at mitigating public health risks associated dysphagia. second investigation, an experimental study, executed whether addition surface electromyographic biofeedback traditional training Mendelsohn maneuver, common intervention, altered initial (first session) volitional prolongation muscle activity responsible upper esophageal sphincter opening during swallow.The meta-analysis revealed well elimination demonstrated small large effect sizes (r = .13 - .45) treatments, all but one which statistically significant, overall, their combined size medium .29) significant (p .03). However studies institutionally deployed moderate (Odds Ratio .44 .79) which, combined, not .08). Overall, few published sufficiently robust quality found justify inclusion suggesting more research type is needed.The experiment maneuver without biofeedback, produced significantly increased duration < .01) average amplitude .02) swallowing myoelectric activity. There no differences between treatment groups swallow amplitude, however trend toward preparatory consistency observed trained group .052) compared non-biofeedback group.