Objectives Dysphagia is a common debilitating clinical feature of inclusion body myositis (IBM). However, the impact of dysphagia in IBM has been historically overlooked. This study aimed to identify, evaluate, and summarize the evidence regarding assessment and management of dysphagia in persons with IBM undergoing treatment. Methods A systematic review was conducted using a multi-engine search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Eligible studies had to employ an intervention for persons with IBM, report a swallowing outcome, and be published in English. Quality assessments of the eligible studies were performed. Results Of 239 studies found, 19 met inclusion criteria. One study was rated as “fair” and the rest as “poor” quality, particularly due to the lack of published and validated swallowing assessment procedures and outcome measures. Cricopharyngeal (CP) dysfunction (12/19) was the most commonly reported swallowing abnormality. Interventions for disease management included pharmacological agents (10/19), followed by surgical (3/19), behavioral (1/19), and combined approaches (5/19). Interventions with immunosuppressants, Botox injection, balloon dilation, and/or CP myotomy led to mixed and transient benefit. Few studies examining statins or behavioral therapies (primarily focused on respiratory function) showed no effects for dysphagia. Conclusion Various interventions have been reported to temporarily improve dysphagia in persons with IBM. However, these findings are based on limited and overall low-quality evidence. This study cautions the generalization of these findings and emphasizes the need for further systematic research to improve diagnosis and management of dysphagia in IBM.

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Purpose: Swallow onset is commonly characterized by bolus location. Quantifying this swallow event using swallow reaction time (SRT) may further inform swallow assessment, but few studies have established normative reference values for SRT using a large sample size and well-tested, standardized, and validated videofluoroscopic swallow study (VFSS) approach. The purpose of this study was to investigate SRT in a large cohort of healthy adults and the effects of demographic (age, sex) and bolus (viscosity, volume) characteristics on SRT using the Modified Barium Swallow Impairment Profile approach. Method: Archival VFSSs of 195 healthy adults (21–89 years) were analyzed to obtain SRT across seven standardized swallow tasks ranging from thin to extremely thick liquid and a solid. Descriptive statistics were generated for age, sex, viscosity, and volume. Generalized estimating equation models were computed to explore the effects of demographic and bolus characteristics on SRT. Results: Variability in SRT was observed among healthy adults across all swallow tasks. Only viscosity significantly influenced SRT. Specifically, thicker viscosities resulted in longer SRT. Conclusions: Wide variability in SRT was observed in this large cohort of healthy adults across various liquid swallow tasks and a solid task. Thicker viscosities, in particular, yielded longer SRT and should be considered a normal variant. This study further provides normative SRT data related to a commonly used VFSS approach, which clinicians can use as reference values for their patient data.

Purpose: Marginalized communities have an increased predisposition to disease where dysphagia is often associated. While commonly used as paradigms in health care and dysphagia management, the biomedical model and forward design do not adequately support equitable, inclusive, and quality care for individuals of culturally and linguistically diverse (CLD) backgrounds. A more-narrow focus on curative and impairment-based management may actually be detrimental to patients' personal and cultural identities. Therefore, it is crucial to broaden the focus of service delivery to provide culturally responsive, patient-centered care. This tutorial describes the application of backward design to dysphagia management, with practical strategies and tools offered to increase the quality of care for persons of CLD backgrounds. Conclusion: Clinicians need to prioritize the individual cultural dynamics of each patient. Personalized ethnocentric care requires clinicians to become aware of their own worldviews and biases while understanding better their patients' identities. Clinicians should consider adopting a more holistic lens and beginning the dysphagia management process with the patient's end goal in mind. Through this critical first step, clinicians will be better equipped to inform appropriate assessment and intervention selections that leverage all aspects of the biopsychosocial framework, helping to reduce health disparities in CLD populations.