Critical Review: The Effects of Cervical Bracing on Swallowing Branco, C. M.Cl.Sc. (SLP) Candidate School of Communication Sciences and Disorders, U.W.O. This critical review focused on examining the effects of cervical bracing on swallowing

Cervical orthoses are used to immobilize the cervical spine (Schneider et al., 2007) while treating a range of neck impairments from muscle spasm to serious instability (Johnson et al., 1977; Johnson et al., 1981), such as after cervical spine surgery (Schneider et al., 2007) and spinal cord injury (Johnson et al., 1981; Stambolis et al., 2003). There are many different cervical orthoses available that can be divided into four general categories of support (Johnson et al., 1981; Stambolis et al., 2003). The first is the collar, which extends from the head to upper part of the thorax. An example is the Philadelphia collar (Johnson et al., 1977; Johnson et al., 1981; Stambolis et al., 2003). The second type is the poster brace, which is more rigid than the collar, and has padded mandibular and occipital supports (Johnson et al., 1977; Johnson et al., 1981; Logemann, 1998). The third category is the cervicothoracic brace, which extends further down the trunk than the poster brace (Johnson et al., 1977; Johnson et al., 1981; Schneider et al., 2007; Stambolis et al., 2003). Examples of this include the sternal occipital mandibular immobilizer (SOMI) (Johnson et al., 1981; Schneider et al., 2007; Stambolis et al., 2003) and the Minerva cervicothoracic orthosis (Schneider et al., 2007; Odderson & Lietzow, 1997). The final category is the halo ring, which is the ultimate orthoses, providing rigid fixation of the head (Johnson et al., 1977; Johnson et al., 1981; Stambolis et al., 2003). The effectiveness of cervical orthoses is generally based on their ability to restrict cervical motion (i.e., flexion, extension, lateral bending and rotation) (Johnson et al., 1981), patient comfort, and potential patient compliance (Schneider et al., 2007), with no consideration given to their effect on one’s ability to eat and/or swallow. Cervical orthoses would appear to hinder one’s oral and laryngeal mobility, but a review of the literature needs to be completed to determine the effects cervical bracing can have on the normal swallow. In addition, it would be important to establish the possible effects of cervical orthoses on those who already have swallowing difficulties. Understanding the potential effects of cervical orthoses on swallowing is important because decisions about bracing and modifications during eating, especially for those who are already at risk of developing dysphagia, can be informed by this knowledge.