Impact of thermo-tactile stimulation on the speed and efficiency of swallowing: a systematic review.

BACKGROUND: A delayed or absent swallow reflex is common in dysphagia and can have a significant impact on swallow safety. Recent clinical practice survey data have supported the fact that clinicians continue to use thermo-tactile stimulation (TTS) as a strategy to stimulate key nerve pathways and evoke a swallow reflex for patients with a delayed or absent swallow reflex.

AIMS: To conduct a systematic review of the effectiveness of TTS as a compensatory and/or rehabilitative tool.

METHODS & PROCEDURES: A search performed on CINAHL, Medline and Speech Bite identified 599 articles. After removing duplicates, the titles and abstracts of 458 articles were assessed for eligibility; 426 articles were deemed to be clearly ineligible and the remaining 32 full-text articles were further screened for inclusion. Ten of these studies were included in this review.

MAIN CONTRIBUTION: The results of this review highlight the lack of available evidence in this area and give support to the view that there is only low-level evidence for use of TTS as a compensatory strategy immediately before a swallow.

CONCLUSIONS & IMPLICATIONS: There is low-level evidence to support the use of TTS. Current best practice would be to use TTS on a case-by-case basis, following detailed instrumental assessment and evaluation of its efficacy for an individual.