Rehabilitation or compensation: time for a fresh perspective on speech and language therapy for dysphagia and Parkinson's disease?

BACKGROUND: Dysphagia is a common symptom of Parkinson's disease and can have negative consequences for physical health and quality of life. A variety of treatment options are available to clinicians working with people who have dysphagia and Parkinson's disease. These options can be broadly categorized as being compensatory or rehabilitative in nature. AIMS: To explore the evidence behind treatment options available to clinicians working with dysphagia and Parkinson's disease and to draw conclusions about whether compensatory or rehabilitative approaches are likely to provide the best outcomes for our patients. METHODS & PROCEDURES: A critical literature review of compensatory and rehabilitative interventions for dysphagia in Parkinson's disease was undertaken. Relevant studies were analysed for their robustness and potential clinical applications. General conclusions were drawn based on the evidence base identified in this review. MAIN CONTRIBUTION: This review outlines the lack of evidence supporting both compensatory and rehabilitative methods of treating dysphagia in Parkinson's disease. It directs clinicians and researchers towards areas that require further investigation. CONCLUSIONS & IMPLICATIONS: To date, compensatory methods of treating dysphagia in Parkinson's disease have received more research attention than rehabilitative methods and yet neither approach has a strong evidence base. This review argues that rehabilitative methods could possibly have greater potential to increase swallowing safety and improve quality of life in the long-term than compensatory methods alone. However, at present there is a lack of research in this area.