Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction

Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction

Blog Article

Introduction Inducible laryngeal obstruction (ILO) describes transient laryngeal closure during respiration and can cause significant morbidity.Non-pharmacological behavioural therapy is the commonly cited Hand Grip treatment but efficacy is largely unknown.Aim To synthesise the current evidence base on the effectiveness of non-pharmacological interventions used to treat adults with ILO.

Methods Electronic databases (Medline/Embase/CINAHL/PsycINFO/AMED/CENTRAL) were systematically searched, informed by a population, intervention, comparison, outcome framework.Two reviewers independently screened a representative sample, with lead-author completion due to excellent inter-rater reliability.Data was extracted using a predefined piloted form.

Methodological quality was appraised (blindly by two reviewers) using the Joanna Briggs Institute Critical Appraisal Tools.A narrative synthesis was performed due to heterogeneity of studies (PROSPERO registration number: CRD42020213187).Results Initial searching identified 3359 records.

Full-text screening occurred in 92 records and 14 studies, comprising 527 participants, were deemed eligible.All studies were low-level evidence (observational by design, with four case reports), with a high risk of bias; none contained control arms for comparison.Intervention description was inconsistently and poorly described but direction of effect was positive Nylon/Synthetic Headstalls in 76% of outcomes measured.

The majority of studies showed a reduction in symptom scores and improved direct laryngeal imaging post intervention; there was an overall reduction, 59.5%, in healthcare utilisation.Discussion The literature is in an embryonic state and lacks robust data to truly inform on the effectiveness of non-pharmacological interventions used to treat adults with ILO.

However, positive signals in the synthesis performed support non-pharmacological treatment approaches and further development is warranted.