Behavioural Swallowing Interventions for Persons with Ataxic Etiologies: A Systematic Review

Oropharyngeal dysphagia is common in persons with ataxic etiologies. However, physiological impacts and avenues to remediate them remain poorly described in the scientific literature. Behavioural swallowing interventions may confer benefit, but evidence-based practices for persons with ataxic etiologies remain understudied. We undertook a systematic review to identify and synthesize existing literature on the use and effectiveness of behavioural swallowing interventions for individuals with dysphagia secondary to ataxic etiologies. We conducted a comprehensive literature search in seven databases and multiple grey literature sources to identify studies reporting behavioural swallowing interventions in adults with primary ataxic etiologies. Of 933 retrieved citations, 44 full texts were accepted for review. A final three studies met the inclusion criteria, one pre-post design, one case report and one case series involving six patients with degenerative ataxias and one with acute cerebellar stroke. Individual-level data for the seven patients revealed improvement in penetration aspiration scores with use of chin tuck positioning, supraglottic swallow, and tongue strengthening exercises in five patients. Although limited, this emerging evidence will help guide researchers to continue efforts to establish the effectiveness of behavioural swallowing interventions that uniquely address coordination difficulties in persons with ataxic etiologies.