Treatment of Dysphagia in Parkinson's Disease: A Systematic Review.

Remedios López-Liria,Francisco A Vega-Ramírez,Rubén Trigueros-Ramos,Patricia Rocamora-Pérez,María José Morales-Gázquez,Jennifer Parra-Egeda,José Manuel Aguilar-Parra

doi:10.3390/ijerph17114104

Abstract

The incidence of oropharyngeal dysphagia in Parkinson’s disease (PD) is very high. It is necessary to search for effective therapies that could prevent pneumonia. Previous results should be interpreted cautiously as there is a lack of evidence to support the use of compensatory or rehabilitative approaches to dysphagia. We reviewed the scientific literature to describe the treatments of dysphagia in PD. A systematic review was performed in PubMed, Scopus, Elsevier, and Medline according to PRISMA standards in 2018. The articles that did not mention dysphagia secondary to PD or used surgical treatment were excluded. Eleven articles met the criteria with information from 402 patients. The review relates to different protocols, such as training in expiratory muscle strength, postural techniques, oral motor exercises, video-assisted swallowing therapy, surface electrical stimulation, thermal stimulation, touch, compensatory interventions, training regime for swallowing, neuromuscular electrical stimulation, Lee Silverman voice treatment, swallow maneuver, airway protection, and postural compensation maneuvers. This review identifies the rationing interventions in each trial, if they are efficient and equitable. Several rehabilitative therapies have been successful. An improvement was seen in the degenerative function (coordination, speed, and volume), quality of life, and social relationships of people with PD. Further investigations concerning the clinical applicability of these therapies based on well-designed randomized controlled studies are needed. Larger patient populations need to be recruited to evaluate the effectiveness, long-term effects, and new treatment techniques.

Highlights

Langmore et al [8] found that dysphagia is an important risk factor for the development of aspiration pneumonia when combined with other factors
et al [21] promoted a restorative treatment (EMST) was an effective treatment for Parkinson’s disease (PD) patients with risk of aspiration
The most common treatment focuses on changing the texture of the diet, there are other techniques aimed at improving the quality of life of the patients suffering from dysphagia [21,28]

Summary

Introduction

Given these epidemiological data, we can consider PD as a pathological disease with an enormous impact, which is expected to increase in the coming years, making it necessary to search for new therapies for PD [4]. Langmore et al [8] found that dysphagia is an important risk factor for the development of aspiration pneumonia when combined with other factors (such as feeding, functional, medical, or dental status; gastroesophageal reflux; colonization of the oropharynx with bacterial pathogens). Many of these are applicable to patients with PD.

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Discussion

Conclusion