Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta-analyses

Renee Speyer, Reinie Cordier, Jae-Hyun Kim, Naomi Cocks, Emilia Michou, Sarah Wilkes-Gillan

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Aim: To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan.

Method: A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level.

Results: A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6–52.7) for drooling, 50.4% (95% CI 36.0–64.8) for swallowing problems, and 53.5% (95% CI 40.7–65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding.

Interpretation: Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. 

What this paper adds: Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP.

LanguageEnglish
Pages1249-1258
Number of pages10
JournalDevelopmental Medicine & Child Neurology
Volume61
Issue number11
Early online date22 Jul 2019
DOIs
Publication statusPublished - Nov 2019

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Sialorrhea
Cerebral Palsy
Deglutition
Meta-Analysis
Aspiration Pneumonia
Confidence Intervals
Dehydration
Malnutrition
Quality of Life
PubMed
MEDLINE
Research Personnel
Outcome Assessment (Health Care)
Databases
Guidelines

Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Cite this

Speyer, Renee ; Cordier, Reinie ; Kim, Jae-Hyun ; Cocks, Naomi ; Michou, Emilia ; Wilkes-Gillan, Sarah. / Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan : a systematic review and meta-analyses. In: Developmental Medicine & Child Neurology. 2019 ; Vol. 61, No. 11. pp. 1249-1258.
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Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan : a systematic review and meta-analyses. / Speyer, Renee; Cordier, Reinie; Kim, Jae-Hyun; Cocks, Naomi; Michou, Emilia; Wilkes-Gillan, Sarah.

In: Developmental Medicine & Child Neurology, Vol. 61, No. 11, 11.2019, p. 1249-1258.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan

T2 - Developmental Medicine and Child Neurology

AU - Speyer, Renee

AU - Cordier, Reinie

AU - Kim, Jae-Hyun

AU - Cocks, Naomi

AU - Michou, Emilia

AU - Wilkes-Gillan, Sarah

N1 - Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2019/11

Y1 - 2019/11

N2 - Aim: To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan.Method: A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level.Results: A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6–52.7) for drooling, 50.4% (95% CI 36.0–64.8) for swallowing problems, and 53.5% (95% CI 40.7–65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding.Interpretation: Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. What this paper adds: Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP.

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