Behavioural Interventions in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analysis of Randomised Clinical Trials

Speyer, Renée; Cordier, Reinie; Sutt, Anna‐Liisa; Remijn, Lianne; Heijnen, Bas J.; Balaguer, Mathieu; Pommée, Timothy; McInerney, Michelle; Bergström, Liza

doi:10.3390/jcm11030685

Cited by 21 publications

(18 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To our knowledge, this is the first systematic review and meta-analysis to examine the clinical effects of CTAR exercise in stroke survivors and confirm that CTAR exercise has superior effects than Shaker exercise in post-stroke dysphagia rehabilitation. The main results are consistent with a previous systematic review, which compared the effects of CTAR exercise in improving swallowing safety compared with no exercise intervention ( 47 ). But they did not compare oral intake ability and the effect of CTAR with Shaker exercise.…”

Section: Discussionsupporting

confidence: 90%

Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis

Liu¹,

Wang²,

Tian³

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

BackgroundChin tuck against resistance (CTAR) exercise was introduced to substitute for the commonly used Shaker exercise for dysphagia rehabilitation. The effects of CTAR exercise in stroke survivors needs to be validated.ObjectiveTo investigate the effects of Chin tuck against resistance (CTAR) exercise on the swallowing function and psychological condition in stroke survivors compared to no exercise intervention and the Shaker exercise.Materials and methodsThe Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL and four Chinese databases were searched for randomized controlled trails (RCTs) and quasi-RCTs from inception to February 2022.ResultsAfter screened and assessed the methodological quality of the studies, nine studies with 548 stroke survivors were included in the systematic review. 8 studies were included in the meta-analysis using RevMan 5.4 software. The mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated. The results revealed that CTAR exercise is effective in improving swallowing safety (MD, −1.43; 95% CI, −1.81 to −1.06; P < 0.0001) and oral intake ability (SMD, −1.82; 95% CI, −3.28 to −0.35; P = 0.01) compared with no exercise intervention, CTAR exercise is superior to Shaker exercise in improving swallowing safety (MD, −0.49; 95% CI, −0.83 to −0.16; P = 0.004). The psychological condition in CTAR group is significant better than the control group (MD, −5.72; 95% CI, −7.39 to −4.05; P < 0.00001) and Shaker group (MD, −2.20; 95% CI, −3.77 to −0.64; P = 0.006).ConclusionsOur findings support CTAR exercise as a superior therapeutic exercise for post-stroke dysphagia rehabilitation than Shaker exercise. More high-qualities RCTs from larger multicenter are needed to analysis the effects of CTAR exercise in patients with different type and phase of stroke and explore the optimal training dose.

show abstract

Section: Discussionsupporting

confidence: 90%

Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis

Liu¹,

Wang²,

Tian³

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…Nursing planning/intervention, identified by nursing diagnosis, is any treatment that a nurse performs to enhance patient outcomes. Behavioural interventions show promising effects in patients with PSD, which is in keeping with the results of a recent meta‐analysis (Speyer et al, 2022). Behavioural interventions, including bolus modification and management (Newman et al, 2016), motor behavioural techniques or oromotor exercises (Hwang et al, 2019), general body and head postural adjustments (Park et al, 2019), and swallowing manoeuvres (Mepani et al, 2009), may be the most widespread treatment approach for patients with PSD globally (Dziewas et al, 2021).…”

Section: Discussionsupporting

confidence: 86%

Clinical practice guideline appraisal and algorithm development to identify recommendations related to nursing practice for post‐stroke dysphagia

Jiang

Zhang

Lei

2023

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and ObjectivesTo assess the methodological quality of current clinical practice guidelines related to post‐stroke dysphagia and develop an algorithm using nursing process as a framework for clinical nursing.BackgroundDysphagia is a serious complication of stroke. Yet the recommendations related to nursing in guidelines have not been systematically sorted out, so they are difficult for nurses to use to guide clinical nursing practice.DesignSystematic review.MethodsA systematic review of literature was performed using the PRISMA Checklist. A systematic search for relevant guidelines published between 2017 and 2022 was conducted. Appraisal of Guidelines for Research and Evaluation II instrument was used to assess methodological quality. Recommendations related to nursing practice from high‐quality guidelines were summarised and developed into an algorithm to provide reference for the standardised construction of nursing practice scheme.Results991 records were initially identified from database searches and other sources. Finally, 10 guidelines were included, of which 5 were rated as high quality. A total of 27 recommendations from the 5 highest‐scoring guidelines were summarised and used to develop an algorithm.ConclusionsThis study indicated deficiencies and variability in current available guidelines. Based on five high‐quality guidelines, we developed an algorithm to facilitate nurses' adherence to guidelines and contribute to evidence‐based nursing. In the future, high‐quality guidelines, together with large‐sample and multi‐centre clinical researches are suggested to give more scientific and convincing evidence to nursing of post‐stroke dysphagia.Relevance to Clinical PracticeThe findings indicate that nursing process may provide a unified framework for standardised nursing of different diseases. Nursing leaders are recommended to adopt this algorithm in their units. In addition, nursing administrators and educators should promote the application of nursing diagnosis to help nurses foster nursing thinking mode.Patient or Public ContributionNo patient or public involvement in this review.

show abstract

“… 40 , 44 , 45 The meta-analysis evaluated the effects of 3 RCTs 40 , 41 , 43 and revealed a large pooled treatment effect. 46 However, it should be noted that the small number of published RCTs are heterogeneous with respect to their CTAR treatment regimens which makes comparisons between studies challenging and their amalgamation as part of a meta-analysis imperfect.…”

Section: Rehabilitative Exercisesmentioning

confidence: 99%

Advances in the Treatment of Dysphagia in Neurological Disorders: A Review of Current Evidence and Future Considerations

Cheng¹,

Hamad²,

Sasegbon³

et al. 2022

NDT

View full text Add to dashboard Cite

Dysphagia, which refers to difficult and/or disordered swallowing, is a common problem associated with various neurological diseases such as stroke, motor neuron diseases and neurodegenerative diseases. Traditionally, dysphagia treatments are either compensatory, which includes modifications of bolus texture or feeding posture, or rehabilitative, which includes behavioral exercises and sensory stimulation. Despite being widely adopted in clinical practice, recent views have challenged the clinical efficacy of these treatments due to the low level of evidence supported by mainly non-controlled studies. As such, with advancements in technology and scientific research methods, recent times have seen a surge in the development of novel dysphagia treatments and an increasing number of robust randomized controlled clinical trials. In this review, we will review the clinical evidence of several newly introduced treatments for dysphagia in the last two decades, including rehabilitative exercises, biofeedback, pharmacological treatments, neuromodulation treatments and soft robotics. Despite the recent improvements in the quality of evidence for the efficacy of dysphagia treatments, several critical issues, including heterogeneity in treatment regimens, long-term treatment effects, underlying mechanisms of some neuromodulation treatments, and the effects of these techniques in non-stroke dysphagia, remain to be addressed in future clinical trials.

show abstract

Behavioural Interventions in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analysis of Randomised Clinical Trials

Cited by 21 publications

References 61 publications

Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis

Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis

Clinical practice guideline appraisal and algorithm development to identify recommendations related to nursing practice for post‐stroke dysphagia

Advances in the Treatment of Dysphagia in Neurological Disorders: A Review of Current Evidence and Future Considerations

Contact Info

Product

Resources

About