Associations between the completion rate of the unsupervised community swallowing training and swallowing function in older adults with mild dysphagia: a quasi-experimental pre-post study without control.

BACKGROUND

This study aimed to explore the associations between the unsupervised Simple Swallowing Training Program (SSTP) and swallowing function, and factors influencing the completion rate and functional improvement.

METHODS

This quasi-experimental pre-post study included community-dwelling older adults with mild dysphagia in China between 2024 and 2025. Each participant performed the SSTP twice daily without supervision for 15 consecutive days and provided online feedback on their progress. Pre- and post-study swallowing function and quality of life were assessed using the Modified Barium Swallow Impairment Profile (MBSImP) and Dysphagia Handicap Index (DHI). Participants were divided into 31 groups according to their SSTP completion status. Wilcoxon Signed-Rank tests were used to explore the minimum training frequency of the SSTP. Univariate and multivariate linear regression models were used to explore the factors influencing the MBSImP improvement and the unsupervised SSTP completion rate.

RESULTS

There were 741 participants. The pre- and post-study MBSImP differences were statistically significant when the SSTP completion sessions were ≥20. Therefore, and the recommended minimum SSTP training frequency was 20 sessions. There was significant improvement in the oral, pharyngeal, and total MBSImP and DHI (p < 0.001), whereas no significant differences were observed in the esophageal MBSImP (p > 0.05). Age, previous stroke, neurodegenerative diseases, and previous head and neck cancer were factors only influencing the MBSImP improvement (p < 0.05).

CONCLUSIONS

Completing ≥20 SSTP sessions was associated with significant improvements in oropharyngeal swallowing and quality of life. Age and swallowing-related medical history were associated with functional improvement, but not with the completion rate of the SSTP.