Non-pharmacologic Approaches to Dysphagia in Patients with Multiple Sclerosis: A Systematic Review

Abstract

Dysphagia, which is frequently seen in patients with multiple sclerosis (MS) and defined as difficulty in swallowing, can lead to serious complications such as aspiration pneumonia, dehydration, malnutrition, and increases morbidity and mortality rates and decreases quality of life. In patients with MS, dysphagia can be intervened by pharmacologic or surgical methods; this symptom can also be controlled by nonpharmacologic and non-invasive methods such as sensory stimulation techniques, swallowing maneuvers, dietary modifications, and positional swallowing techniques. No previous systematic reviews on the effects of non-pharmacologic or non-invasive methods on dysphagia in MS have been published. The main objective of this study was to summarize and qualitatively analyze published studies on non-pharmacologic or non-invasive methods effects for dysphagia in MS. Within the scope of the study, a detailed literature review was performed and four studies were examined considering the inclusion criteria. The non-pharmacologic applications in the studies are as follows: Traditional dysphagia rehabilitation methods, which include methods such as oral motor exercises and swallowing maneuvers; electrical stimulation, and respiratory muscle exercises. In these studies, dysphagia and/or swallowing-related quality of life were measured with similar scales. It is seen that all of the related interventions have a significant effect on dysphagia and/or swallowing-related quality of life in patients with MS. In conclusion, in light of the information in the literature, non-pharmacologic methods can be said to be effective in the control of dysphagia in patients with MS. In addition, it may be suggested to conduct experimental and more comprehensive studies in this field.

Keywords

• dysphagia
• nursing care
• multiple sclerosis
• non-pharmacologic approaches
• systematic review