Dosages of swallowing exercises in stroke rehabilitation: a systematic review.

Eur Arch Otorhinolaryngol

Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

Published: March 2023

AI Article Synopsis

  • The study aimed to systematically review the dosage of swallowing exercises used in post-stroke dysphagia intervention studies.
  • Researchers reviewed 54 studies involving 1,501 participants and found inconsistencies in reporting exercise dosages, especially regarding intensity, while the most common regimen was five times per week for four weeks.
  • The findings highlighted the need for improved and consistent reporting of swallowing exercise dosages in future research to better inform evidence-based practices.

Article Abstract

Purpose: To investigate the dosages of swallowing exercises reported in intervention studies on post-stroke dysphagia through systematic review.

Methods: Five electronic databases were searched from inception until February 2022 with reference tracing of included studies. Studies were included, where adults with post-stroke dysphagia received rehabilitative, behavioural swallowing exercises, pre/post outcomes were reported, and intervention dosage was described in detail, including frequency, intensity, time, and type of exercise. Two reviewers independently screened studies and rated quality using ASHA Levels of Evidence tool. Data was tabulated and narratively described.

Results: 54 studies were included with a total 1501 participants. Studies included 28 randomised controlled trials, 8 non-randomised controlled trials, 12 pre/post studies, 3 retrospective case controls and 3 case studies. Results showed inconsistent reporting of intervention dosage, with intensity the least consistently reported dosage component. While swallowing intervention was most commonly provided five times per week for four weeks, there was a wide breadth of type, frequency, intensity and duration of swallowing exercises reported. Dosage under-reporting and variation was particularly observed in "standard care" co-interventions or control groups. Study strengths included following PRISMA guidelines, providing a comprehensive review of swallowing exercise methodology and dosages, and including non-English studies. The limitation was lack of meta-analysis due to the heterogeneity of included studies.

Conclusions: Dosages of swallowing exercises are inconsistently reported and vary significantly in post-stroke dysphagia studies. Results indicate the need for consistent and comprehensive dosage reporting in dysphagia studies, and for further research into evidence-based principles to optimise swallowing exercise dosages.

Systematic Review Registration Number: 131294.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9899761PMC
http://dx.doi.org/10.1007/s00405-022-07735-7DOI Listing

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