Table 1 Characteristics of included studies and main findings
Source, country | Sample | Gender | Diagnosis | Intervention Group | Control group | Control/Comparison | Outcome measures | Main findings | Limitationsa |
|---|---|---|---|---|---|---|---|---|---|
Akaltun et al. [17] Turkey | n = 101 | Female =  41.6% Male =  58.4% | Cerebral palsy (n = 101) Drooling (n = 75) | n = 54 Mean age = 4.2 Drooling (n = 41) | n = 47 Mean age = 4 Drooling (n = 34) | I-shape ETT applied without stretching to the suprahyoid region and not including the origins of mylohyoid and digastric muscles | Rate of presence of drooling | Drooling was found to be significantly improved at six weeks in the ETT group and clinical improvements continued for 18 weeks | Unclear:—sequence generation -blinding of participants and personnel |
Awaad et al. [18] Egypt | n = 24 | Female =  29.2% Male =  70.8% | Spastic cerebral palsy (n = 24) Drooling (n = 24) | n = 12 Mean age = 6.32 | n = 12 Mean age = 5.9 | OMT exercises including perioral sensory stimulation, tapping, tongue pressure, jaw exercises, intraoral stimulation, and training with different sizes of straws | 5-min Drooling Quotient (DQ) test Drooling Severity and Frequency Scale (DSFS) | Comparison of pre- and post-treatment mean values of all measured variables showed significant improvement for children of both ETT and OMT groups. The post treatment results showed that OMT is more effective than ETT in decreasing drooling severity and frequency | Small sample size Unclear -sequence generation -allocation concealment -blinding of participants and personnel -blinding of outcome assessor |
Mokhlesin et al. [19] Iran | n = 18 | Female =  44% Male =  56% | Idiopathic intellectual disability (n = 8) Cerebral palsy (n = 7) Down Syndrome (n = 2) Microcephalic (n = 1) Drooling (n = 18) | n = 9 Mean age = 9.8 | n = 9 Mean age = 10.4 | OMT followed by sham taping (without stretching) OMT including brushing and icing of tongue, stroking and tapping of lips, resistance training of lips, tongue resistance training | 5-min DQ test Drooling Rating Scale (DRS) | 5-min DQ assessment revealed that using ETT plus OMT can produce greater improvement than sham taping plus OMT. However, there was not a statistically difference between the two groups based on parental reports using DRS. Within-group analysis showed that drooling reduced in both groups after the intervention both based on DRS and DQ assessments. Adding taping with and without stretch to OMT can be considered as a complementary method to mitigate drooling in children with intellectual disabilities | Small sample size |
Pervez et al. [20] Pakistan | n = 20 Mean age = 5.4 | Female =  30% Male =  70% | Cerebral palsy (n = 18) Childhood stroke (n = 2) Drooling (n = 20) | n = 10 | n = 10 | OMT including tapping, massage and rhythmic pressure | Modified Teachers’ Drooling Scale | Both ETT and OMT were effective in the management of drooling severity | Small sample size Unclear -sequence generation -allocation concealment -blinding of participants and personnel -blinding of outcome assessor |
Swati [21] India | n = 30 | Female =  43.3% Male =  56.7% | Non-spastic cerebral palsy (n = 10) Spastic cerebral palsy (n = 8) Seizure disorder (n = 1) Mental retardation /intellectual disability (n = 4) Autism (n = 4) Down syndrome (n = 1) Developmental delay (n = 1) Attention deficit hyperactivity disorder (n = 1) Drooling (n = 30) | n = 15 Mean age = 5.91 | n = 15 Mean age = 4.92 Lost to follow-up (n = 2) | OMT including manipulation, vibration, deep pressure and icing | Thomas-Stonell Drooling Scale (TSDS) Drooling Impact Scale (DIS) | Both groups showed significant improvement on drooling in DIS, TSDS, the lip closure measurement and aspect of social stigma. But OMT along with ETT showed more improvement | Small sample size Unclear -sequence generation -allocation concealment -blinding of participants and personnel High risk: blinding of outcome assessor |
de Freitas and Leite [22] Brazil | n = 37 | Female =  46% Male =  54% | Spastic cerebral palsy (n = 31) Non-spastic cerebral palsy (n = 6) Drooling (n = 37) | n = 18 Mean age = 8 | n = 19 Mean age = 7 | Rigid labial tapping with Micropore medical tape | TSDS Number of wipes used daily | Adhesive tapes fixed under the lower lip promoted a reduction in the number of the wipes used to dry saliva and an improvement in both the severity and frequency of drooling | Small sample size Unclear -sequence generation -allocation concealment -blinding of participants and personnel -blinding of outcome assessor |
Yilmaz et al. [23] Turkey | n = 48 Mean age = 9.28 | Female = 45.8% Male = 54.2% | Cerebral palsy (n = 48) Drooling (n = 48) | n = 16 Mean age = 9.28 | n = 32 Mean age = 9.32 | Group 1: no taping (n = 16) Group 2: Sham taping: I-tape of approximate 5 cm long applied on one cheek without any tension (n = 16) | DSFS 5-min DQ test | There was a significant improvement in patients assigned to the intervention group for the DSFS and 5-min DQ at 45 min (p < 0.05)_and 2 days (p < 0.01) after application. No improvement was observed in the control groups. However, there was no significant difference at the endpoint between the intervention and control groups | Small sample size Unclear -sequence generation -allocation concealment -blinding of outcome assessor High-risk: -blinding of participants and personnel |