Disability and rehabilitation · 2025
Effectiveness of swallowing rehabilitation exercises in older adults with swallowing disorders: systematic review and network meta-analysis of randomized controlled trials.
СтатьяСистематический обзорNetwork Meta-AnalysisНазвание и аннотация: Перевод в очереди
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Chen Nai-Ching, Pu Lihui, Chen Kuei-Min
Аннотация
PURPOSE: This study aimed to evaluate the comparative effectiveness of swallowing rehabilitation exercises in older adults with dysphagia to identify the most beneficial interventions.
MATERIALS AND METHODS: A systematic review and network meta-analysis were conducted using six databases (PubMed, Embase, CINAHL, Cochrane Library, PsycINFO, and Airiti Library) searched on 15 August 2024. Randomized controlled trials involving adults aged ≥65 years with dysphagia were included. Study characteristics, interventions, and outcomes were extracted, and the Risk of Bias 2.0 tool was used for quality assessment.
RESULTS: The Masako maneuver showed the greatest improvement in dysphagia severity (SMD = 1.57, 95% CI: 1.16-1.98). Expiratory muscle strength training (EMST) significantly reduced aspiration risk (SMD = 0.71, 95% CI: 0.35-1.06). Tongue resistance exercises improved anterior (MD = 4.24) and posterior tongue strength (MD = 4.45). No significant effects were found for upper esophageal sphincter opening, laryngeal closure, or swallowing-related quality of life.
CONCLUSIONS: Swallowing rehabilitation exercises offer functional benefits for older adults with dysphagia. Specific exercises target different aspects of swallowing physiology. Further studies are needed to examine long-term efficacy and optimal training combinations.
SYSTEMATIC REVIEW REGISTRATION: This review has been registered in the PROSPERO (CRD42023409297).
MATERIALS AND METHODS: A systematic review and network meta-analysis were conducted using six databases (PubMed, Embase, CINAHL, Cochrane Library, PsycINFO, and Airiti Library) searched on 15 August 2024. Randomized controlled trials involving adults aged ≥65 years with dysphagia were included. Study characteristics, interventions, and outcomes were extracted, and the Risk of Bias 2.0 tool was used for quality assessment.
RESULTS: The Masako maneuver showed the greatest improvement in dysphagia severity (SMD = 1.57, 95% CI: 1.16-1.98). Expiratory muscle strength training (EMST) significantly reduced aspiration risk (SMD = 0.71, 95% CI: 0.35-1.06). Tongue resistance exercises improved anterior (MD = 4.24) and posterior tongue strength (MD = 4.45). No significant effects were found for upper esophageal sphincter opening, laryngeal closure, or swallowing-related quality of life.
CONCLUSIONS: Swallowing rehabilitation exercises offer functional benefits for older adults with dysphagia. Specific exercises target different aspects of swallowing physiology. Further studies are needed to examine long-term efficacy and optimal training combinations.
SYSTEMATIC REVIEW REGISTRATION: This review has been registered in the PROSPERO (CRD42023409297).