Methods of diagnosis and rehabilitation of dysphagia in patients with spinal cord injury: a systematic review

European Journal of Physical and Rehabilitation Medicine, 2025 · DOI: 10.23736/S1973-9087.24.08614-3 · Published: February 1, 2025

Spinal Cord Injury Rehabilitation

Simple Explanation

This systematic review examines methods for diagnosing and treating dysphagia (swallowing difficulties) in people with spinal cord injuries (SCI). The review analyzes 43 studies to identify common assessment tools and rehabilitation approaches used for dysphagia in SCI patients. The goal is to summarize current practices and highlight areas where more research is needed to improve patient care and reduce healthcare costs.

Study Duration

Not specified

Participants

9815 subjects

Evidence Level

Systematic Review

Key Findings

1
The most common assessment tools are the Bedside Swallow Evaluation (BSE), Bazaz score, Eating Assessment Tool-10 (EAT-10), and Videofluoroscopic Study of Swallowing (VFSS).
2
Rehabilitation protocols include early oral feeding exclusion or consistency-modified oral intake, postural adaptations, oxygen therapy, specific exercises, and neuromuscular electrical stimulation.
3
There is inconsistency in the methods of diagnosis and rehabilitation protocols for dysphagia in SCI patients.

Research Summary

This systematic review evaluated diagnostic and rehabilitation methods for dysphagia in spinal cord injury (SCI) patients. The review identified a range of assessment tools, including clinical evaluations, rating scales, questionnaires, and instrumental assessments, with the BSE, Bazaz score, EAT-10, and VFSS being the most common. Rehabilitation protocols vary, including dietary modifications, compensatory strategies, and specific exercises, but a lack of standardization highlights the need for further research.

Practical Implications

Standardized Protocols

Establish clear, reproducible diagnostic and rehabilitation procedures based on current knowledge.

Further Research

Conduct rigorous studies to validate shared protocols for dysphagia management in SCI patients.

Personalized Treatment

Tailor rehabilitation programs considering factors such as cognitive impairments, pain, and respiratory problems.

Study Limitations

1
Heterogeneity in study settings and designs.
2
Studies with lower quality assessment scores failing to provide important patient information.
3
Aggregate information related to the etiology of dysphagia, not allowing clean data extraction for the SCI population.

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