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EBP Compendium: Summary of Systematic Review

The Cochrane Collaboration
Enteral Tube Feeding for Amyotrophic Lateral Sclerosis/Motor Neuron Disease

Katzberg, H. D., & Benatar, M. (2011).
Cochrane Database of Systematic Reviews (1).

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes*
Quality assessments are reproducible Yes*

Description: This is a review of randomized controlled trials investigating the efficacy of enteral tube feeding in individuals with amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND). One aspect of the review which may be of interest to speech-language pathologists was the examination of studies assessing patient and caregiver quality of life with tube feeding versus oral feeding.

Question(s) Addressed:

What is the efficacy of percutaneous endoscopic gastrostomy placement or other tube feeding placement on the survival, nutritional status and quality of life for individuals with amyotrophic lateral sclerosis?

Population: Individuals diagnosed with definite, possible, or probable ALS, according to the El Escorial criteria or the revised criteria.

Intervention/Assessment: “The primary intervention of interest was placement of PEG or other form of feeding tube at any time during the course of ALS/MND, in comparison with other patients with ALS/MND who had no feeding tube and continued oral intake. Patients who received a PEG could still continue to eat some food or liquid orally. Other studies of interest were those that compared the safety of different types or methods of feeding tubes placed in patients with ALS/MND” (p. 3).

Number of Studies Included: 0

Years Included: Through 2005



  • Treatment
    • Swallowing
      • Oral vs Tube Feeding
        • No controlled trials were found comparing tube feeding to oral feeding in individuals with ALS.
        • Results of retrospective and prospective case controlled studies suggest a benefit from enteral feeding on nutrition and survival. However, no conclusions could be drawn regarding the effect of tube feeding versus continued oral feeding on reported quality of life. The authors note that "quality of life has only been addressed by a few researchers and needs more serious attention” (p. 2).

Keywords: Amyotrophic Lateral Sclerosis, Tube Feeding

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*Authors describe plans for quality assessment, but no articles where found in the search that met the inclusion criteria.  

Added to Compendium: December 2011

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