The results of swallowing therapy in 58 patients with neurologic disorders are presented. All patients received tube feeding, either partially or exclusively, at admission, and successful outcomes, defined as exclusively oral feeding, were achieved in 67% of patients over a median treatment interval of 15 weeks. A subset of 11 patients who had experienced disease onset 25 weeks or more prior to admission nonetheless had a similar success rate of 64%. No other pretreatment variable, including age, localization of lesion, type or degree of aspiration, or cognitive status, correlated with successful outcome. Indirect therapy methods such as stimulation techniques and exercises to enhance the swallowing reflex, alter muscle tone, and improve voluntary function of the orofacial, lingual, and laryngeal musculature were utilized in all but 1 patient. Direct methods including compensatory strategies such as head and neck positioning, and techniques such as supraglottic swallowing and the Mendelsohn maneuver were additionally employed in nearly one-half of patients. Swallowing therapy is associated with successful outcome, as defined by exclusively oral feeding, among patients with neurogenic dysphagia, regardless of pretreatment variables including time since disease onset. Indirect treatment methods appear to be effective when used either alone or in combination with direct methods. Achievement of oral feeding is not associated with undue risk of pneumonia. Further rigorous scientific studies are needed.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Larsen G: Conservative management for incomplete dysphagia paralytica. Arch Phys Med Rehab 54:180–185, 1973
Griffin K: Swallowing training for dysphagic patients. Arch Phys Med Rehab 55:467–470, 1974
Buckley J, Addicks C, Maniglia J: Feeding patients with dysphagia. Nurs Forum 15:69–85, 1976
Dobie R: Rehabilitation of swallowing disorders. Am Fam Physician 17:84–95, 1978
Logemann J: Evaluation and Treatment of Swallowing Disorders. San Diego: College Hill Press, 1983
Logemann J: Treatment of aspiration related to dysphagia: an overview. Dysphagia 1:34–38, 1986
Logemann J: Neurogenic dysphagia. In: Bayless TM (ed.): Current Therapy in Gastroenterology and Liver Disease. Philadelphia: Mosby-Year Book, Inc, 1990
Logemann J, Kahrilas P, Kobara M, Vakil N: The benefit of head rotation on pharyngoesophageal dysphagia. Arch Phys Med Rehab 70:761–771, 1989
Groher ME: Dysphagia: Diagnosis and Management, 2nd ed. Boston: Butterworth-Heinemann, 1992
Siebens AA, Linden P: Neurogenic pharyngeal swallowing disorders. In: Bayless TM (ed.): Current Therapy in Gastroenterology and Liver Disease 1984–1985. Philadelphia: Mosby-Year Book, Inc, 1984
Tippett DC, Palmer J, Linden P: Management of dysphagia in a patient with closed head injury: a case report. Dysphagia 1:221–226, 1987
Linden P: Videofluoroscopy in the rehabilitation of swallowing dysfunction. Dysphagia 3:189–191, 1989
Linden P: Treatment strategies for adult neurogenic dysphagia. Semin Speech Language 12:255–261, 1991
Bartolome G, Buccholz DW, Hannig C, Neumann S, Prosiegel M, Schröter-Morasch H, Wuttge-Hannig A (eds): Diagnostik und Therapie neurologisch bedingter Schluckstörungen. Stuttgart: Gustav Fischer Verlag, 1993
Jenking WM, Merzenich MM, Ochs MT, Allard T, Guic-Robles E: Functional reorganization of primary somatosensory cortex in adult owl monkeys after behaviorally controlled tactile stimulation. J Neurophysiol 63:82–102, 1990
Wall JT, Kaas JT, Sur M, Nelson RJ, Fellman DJ, Merzenich MM: Functional reorganization in somatosensory cortical areas 3b and 1 of adult monkeys after median nerve repair: possible relationships to sensory recovery in humans. J Neurosci 6:218–233, 1986
Sullivan P, Markos P, Minor A: PNF-Ein Weg zum therapeutischen Üben. Propriozeptive neuromuskuläre Fazilitation: Therapie und klinische Anwendung. Stuttgart: Gustav Fischer Verlag, 1985
Voss D, Ionta M, Myers B: Propriozeptive neuromuskuläre Fazilitation: Bewegungsmuster und Techniken. Stuttgart: Gustav Fischer Verlag, 1988
Bobath B: Die Hemiplegie Erwachsener. Stuttgart: Georg Thieme Verlag, 1973
Crickmay MC: Sprachtherapie bei Kindern mit zerebralen Bewegunsstörungen auf der Grundlage der Behandlung nach Bobath. Berlin: Carl Marhold Verlag, 1978
Davis PM: Hemiplegie. Anleitung zu einer umfassenden Behandlung von Patienten mit Hemiplegie. Heidelberg: Springer Verlag, 1985
Feldkamp M, Danielcik I: Krankengymnastische Behandlung der zerebralen Bewegunsstörung—im Kindesalter—. München: Richard Pflaum Verlag, 1982
Bartolome G, Neumann S: Swallowing therapy in patients with neurologic disorders causing cricopharyngeal dysfunction. Dysphagia 8:146–149, 1993
Hannig C, Wuttge-Hannig A, Hörmann M, Hermann F: Kinematographische Untersvchung des Pathomechanismus der Aspirationspneumonie. Fortsch Röntgenstr 150:260–267, 1989
Kaprisen AT, Clumeck A, Nino-Murcia M: The efficacy of rehabilitative management of dysphagia. Dysphagia 4:48–52, 1989
Neumann S: Swallowing therapy with neurologic patients: results of direct and indirect therapy methods in 66 patients suffering from neurologic disorders. Dysphagia 8:150–153, 1993
About this article
Cite this article
Neumann, S., Bartolome, G., Buchholz, D. et al. Swallowing therapy of neurologic patients: Correlation of outcome with pretreatment variables and therapeutic methods. Dysphagia 10, 1–5 (1995). https://doi.org/10.1007/BF00261272
- Swallowing therapy
- Swallowing rehabilitation
- Deglutition disorders