Dysphagia Rehabilitation intervention Strategies in Moderate-Severe Acquired Brain injury : a Scoping Review
Bibliographic record
Abstract
Objectives: To conduct a scoping review of all available literature on interventions for dysphagia rehabilitation among individuals with acquired brain injury (ABI), to answer the research question: What literature is available investigating dysphagia-specific interventions for moderate-severe non-stroke ABI?Methods: A literature search was conducted using PubMed, MEDLINE, Embase, and CINAHL for studies published in English up to July 2018. Studies were included if: (1) a dysphagia rehabilitation intervention was provided to participants, (2) any of the participants had moderate to severe non-stroke ABI, and (3) there were nu22651 adult (u226518 years) participants. For each study meeting inclusion criteria, data on author(s), year, country of publication, study design, sample size, demographic information (age, gender, injury etiology), intervention type, comparators, and outcome measures were extracted. Levels of evidence were assigned to each study using the modified Sackett scale. Results: Among the 16 studies which met our inclusion criteria, eight studies had a population of <50% ABI, three had >50% ABI, and five included an unspecified percentage of ABI. Eleven studies (68.75%) were published in the last six years (2012-2018), with the five remaining studies (31.25%) published more than ten years ago (1990-2007). Fourteen studies were published as journal articles, and two were conference abstracts. Four studies originated in the United States, three from Spain, two from each of the following countries, Canada, Korea, and Japan, and one each from South Africa, Germany, and Italy. Two randomized controlled trials (RCTs) provided level 1b evidence, six studies (3 RCTs, 3 prospective controlled trials) were level 2 evidence, six (3 post-test, 3 pre-post) were level 4 evidence, and two case studies provided level 5 evidence. Nine different interventions were investigated for dysphagia rehabilitation, with electrical stimulation, individualized management programs, and diet manipulation being the most common interventions. Eleven unique outcome measures were used overall, which crossed several domains and evaluated various outcomes including swallowing function, nutritional status, and aspiration. Conclusions: The literature investigating dysphagia rehabilitation interventions for non-stroke ABI is limited, with wide variability in terms of intervention types, interventional study designs, study population injury etiology, and outcome assessment across studies. Although a growth in the number of dysphagia studies has been observed within recent years, there remains an important gap in the literature pertaining to dysphagia rehabilitation in non-stroke ABI populations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.016 |
| Open science | 0.005 | 0.004 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.014 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".