Table 1.
Single swallowing interventions in included studies (including participants, exercise descriptions and dosages, outcome measures and pre–post Hedges g effect sizes in exercise-based intervention group) grouped by exercise type
| Study | Number of participants (mean age in years ± SD) | Mean time post CVA ± SD | Description of exercise | Intensity | Frequency (per day/week) | Duration | Outcome measures | Effect sizes (if p < 0.05) |
|---|---|---|---|---|---|---|---|---|
| Cervical isometric strength training | ||||||||
| Ploumis et al. (2018) [70] |
T: 70 (52 ± 15) Expa: 37 Con: 33 |
2.5 ± 1.1 d | Contract neck muscles forwards–backwards–sidewards against resistance | 4 reps in all 4 directions for 10 min | 3x/day | 12 weeks |
Change of sagittal and coronal C2–C7 Cobb angle VFSS score |
NR |
| Chin tuck against resistance | ||||||||
| Gao and Zhang (2017) [31] |
T: 90 CTARa: 30 (70.88 ± 6.6) Shaker: 30 (71.12 ± 7.07) Con: 30 (71.14 ± 6.41) |
CTAR: 12.95 ± 1.60 d Shaker: 13 ± 1.41 d Con: 12.15 ± 1.35 d |
Chin tuck against an inflatable rubber ball as far as possible while seated | 30 reps | 3x/day, 7x/week | 6 weeks | PAS | g = 1.33 |
| Kim and Park (2019) [71] |
CTARa: 12 (63.5 ± 5.5) Con: 13 (65.2 ± 6.2) |
< 6 mos | PhagiaFlex-HF device fixed to the desk and height adjusted so device was under the chin. Chin down exercises performed against device |
Isometric: 10 s hold × 3 Isotonic: 30 reps |
5x/wk | 6 wks |
PAS FOIS |
g = 1.99 g = 1.60 |
| Park et al. (2018) [52] |
CTARa: 11 (62.16 ± 17.27) Con: 11 (58.43 ± 12.51) |
Exp: 37.24 ± 8.54 wks Con: 32.14 ± 14.38 |
Isometric and isokinetic chin tucks against CTAR device as strongly as possible in sitting position | Isometric: 60 s hold × 3 Isokinetic: 30 reps | 5x/wk | 4 wks |
FDS PAS |
g = 1.02 g = 1.69 |
| Park et al. (2019) [72] |
CTARa: 19 (60.95 ± 11.19) Shaker: 18 (59.45 ± 9.34) |
CTAR: 3.6 ± 1.19 Shaker: 3.85 ± 1.18 |
LES 100 CTAR device was used with a resistance bar placed beneath the chin. 1-RM was determined. A tablet PC was used to display targets |
70% of 1-RM. Isometric: 60 s chin tuck × 3 Isotonic: 30 consecutive reps |
5x/day | 4 wks |
VDS oral phase VDS pharyngeal phase VDS total PAS FOIS |
g = 0.92 g = 2.16 g = 2.34 g = 1.54 g = 1.16 |
| Effortful swallowing | ||||||||
| Cho et al. (2017) [73] | 9 (age NR) | NR | Press tongue firmly against the palate while swallowing as hard as possible | 30 reps | 5x/wk | 4 wks |
VDS oral phase VDS pharyngeal phase |
g = 0.74 g = 0.32 |
| Park et al. (2019) [62] |
Expa: 12 (66.5 ± 9.5) Con: 12 (64.8 ± 11.2) |
Exp: 24.39 ± 8.65 wks Con: 25.74 ± 6.27 wks |
Push tongue firmly onto palate while squeezing neck muscles and swallow as forcefully as possible | 10 reps | 3x/day, 5x/wk | 4 wks |
Ant. tongue strength Post. tongue strength VDS |
g = 1.51 g = 1.23 g = 1.32 |
| Wei et al. (2017) [63] |
Cona: 15 (57.9 ± 9.3) Exp: 15 (57.7 ± 8.8) |
Con:4.5 ± 2.3 mos Exp:4.3 ± 2.6 mos |
Swallow as hard as possible using mouth muscles without recruiting abdominal/stomach muscles | 10 reps per day | 2x/day, 5x/wk | 3 wks (or if no longer tube fed) |
Motor evoked potentials UES displacement Max UES opening FOIS |
NR |
| Expiratory muscle strength training (EMST)/Respiratory training | ||||||||
| Arnold et al. (2020) [45] |
Expa: 10 (70.5 ± NR) Con: 10 (66.1 ± NR) |
NR | Forcefully inhale and exhale through Breather device using diaphragmatic breathing technique with nose clip in place | 5 min × 3 sets at highest tolerated settings on device | 3x/day, 7x/wk | 4 wks |
PEFR PAS FOIS VAS MASA |
g = 3.04 g = 2.19 g = 1.63 g = 2.15 g = 2.32 |
| Eom et al. (2015) [64] |
Expa: 13 (69.2 ± 4.1) Con: 13 (70.2 ± 3.6) |
< 3 mos | Blow strongly and rapidly into EMST device until pressure release valve opens (at > 70% of MEP) | 5 breaths (< 1 min break between sessions) | 5x/day, 5x/wk | 4 wks |
VDS PAS |
g = 1.68 g = 1.49 |
| Guillen-Sola et al. (2017) [37] |
IEMTa: 21 (67.9 ± 10.6) NMES: 20 (70.3 ± 8.4) Con: 21 (68.9 ± 7) |
IEMT:10.8 ± 8.7 d NMES: 11 ± 5.5 d Con: 9.3 ± 5.1 d |
Respirations at 30% of max inspiratory and expiratory pressures and increased by 10cmH2O each week. 1 min of recovery breathing off the device | 5 sets of 10 reps | 2x/day, 5x/wk | 3 wks |
PAS FOIS DOSS Max. inspiratory pressure MEP |
NR |
| Hegland et al. (2016) [65] | 14 (64.5 ± 7.4) | 11.9 ± 7.9 mos | With noseclips on, exhale quickly and forcefully into EMST device until valve opens (at 60% of MEP) | 5 reps | 5x/day, 5x/wk | 5 wks |
MEP PEPR vol. cough PEPR cough reflex VA vol. cough VA cough reflex MBSImp PAS |
g = 0.85 n/s g = 1.41 n/s g = 0.67 g = 1.55 NR |
| Liaw et al. (2020) [55] | Expa: 11 (65.4 ± 11.54) Con: 10 (60.44 ± 10.65) | ≥ 6 mos | Inspiratory muscle training (IMT): inhale deep and forceful breaths sufficient for opening the valve. Expiratory muscle training (EMT): blow fast and forcefully to open the valve |
IMT: 30–60% of max pressure EMT: 15–75% of MEP × 5 reps for 5 sets each |
1–2x/day (1–2 min rest), 5x/wk | 6 wks |
Change in max. inspiratory pressure Change in MEP FVC FEV1 FOIS |
g = 1.33 g = 1.10 n/s n/s g = 1.11 |
| Moon et al. (2017) [50] |
Expa: 9 (63 ± 5.8) Con: 9 (63.1 ± 5.2) |
Exp: 21.4 ± 5.1 d Con: 21.1 ± 4 d |
Take a deep breath and bite the EMST mouthpiece. Close nostrils and blow fast and strong into device (set at 70% of MEP) | 7 reps | 5x/wk | 4 wks |
FDS PAS Vallecular residue Pyriform sinus residue |
g = 1.70 g = 1.79 g = 2.05 g = 0.93 |
| Park et al. (2016) [67] |
Expa: 14 (64.3 ± 10.7) Con: 13 (65.8 ± 11.3) |
Exp:27.4 ± 6.3 wks Con:26.6 ± 6.8 wks |
After max inhalation, blow strong and fast into EMST device between lips until pressure release valve opens (at 70% MEP) | 5 reps (< 1 min break after each session) | 5x/day, 5x/wk | 4 wks |
Suprahyoid muscle activity PAS (liquids) PAS (semisolids) FOIS |
g = 1.14 g = 1.93 g = 1.02 g = 1.47 |
| Game-based biofeedback | ||||||||
| Stepp et al. (2011) [28] | 1 (18) | 6 yrs | Swallow at target strength/length (33%, 66% and 100% of max swallow strength for 2.8, 3.5 or 4.7 s) to “eat” the 7 swallow targets (depicted as fish on sEMG machine) | 7 reps for 10 sets of 2 min (1–2 min breaks and > 5 min between sets 5–6) | 3x/wk | 3 wks |
Number of targets per session Neck intermuscular beta coherence |
NR |
| Jaw opening exercise | ||||||||
| Choi et al. (2020) [58] |
Jaw openinga: 11 (63.5 ± 7.7) Head lift: 10 (61.2 ± 9.7) |
Jaw opening: 12.1 ± 2.2wks Head lift: 13.4 ± 2.2wks |
Hold jaw open against resistance bar (isometric). Open jaw against resistance bar (isotonic) |
Isometric: 10 s hold × 3 reps Isotonic: 3 sets of 30 reps |
5x/wk | 6 wks |
Muscle thickness: Digastric Mylohyoid Hyoid movement: Anterior Superior BRPES |
g = 0.62 g = 1.06 g = 1.1 g = 0.89 NR |
| Koyama et al. (2017) [66] |
Expa: 6 (66.0 ± 9.3) Con: 6 (71.8 ± 7.6) |
Exp: 6.7 ± 2.1 mos Con: 9.2 ± 4 mos |
Press tongue against hard palate. Open mouth against resistance (trainer’s hand pushing chin up). Muscle contraction measured with surface electrodes | 80% MVC 6 s hold × 5 reps | 4x/day, 5x/wk | 6 wks |
Distance between mental spine and hyoid bone Hyoid displacement: Superior Anterior |
g = 0.41 n/s g = 1.26 |
| Oh et al. (2017) [74] | 3 (age NR) | < 12mos | Open mouth against external resistance (38 cm circumference ball) |
Isometric: hold for 60 s, Isotonic: 30 reps |
5x/wk | 4 wks | PAS (liquids) | g = 2.04b |
| Park et al. (2020) [54] |
Expa: 20 (62.1 ± 10.1) Con: 20 (61.8 ± 12.1) |
< 6mos | Resistive jaw opening device affixed to the sternum and resistive portion placed below chin. Depress the resistive jaw opening device |
Isometric: hold for 30 s × 3 reps Isotonic: 2–3 s × 10 reps (30 s rest) |
3x/day, 5x/wk | 4 wks |
Hyoid movement: Anterior Superior PAS (semisolids) PAS (liquids) FOIS |
g = 0.9 g = 0.7 g = 0.6 g = 0.6 g = 1.1 |
| Wada et al. (2012) [35] | 8 (70.5 ± 11.3) | Chronic | Open jaw to max extent | 10 s hold × 5 reps (10 s rest between reps) | 2x/day, daily | 4 wks |
Movement of hyoid: Upward Forward UES opening width Time for pharynx passage |
g = 0.99 n/s g = 0.36 g = 0.90 |
| Lip muscle training | ||||||||
| Hagg and Anniko (2008) [75] | 30 (70 ± 9.75) | 1 mos (2 days–10 yrs) | Hold an oral screen predentally between closed lips as screen is gradually pulled away | 5–10 s hold × 3 reps | 3x/day, 7x/wk | At least 5 wks |
Lip force meter Swallowing capacity test |
g = 1.40 g = 1.79 |
| Hagglund et al. (2020) [59] |
Expa: 18 (75, range: 56–90) Con: 14 (75, range: 60–85) |
NR | Hold oral device (Muppy) predentally behind closed lips against a gradually increasing horizontal pulling force | 5–10 s hold × 3 reps |
3x/day, daily |
5 wks |
TWST Lip force PAS |
NR NR NR |
| Park et al. (2018) [76] | 10 (age NR) | ≤ 6 mos | Press IOPI bulb between lips | 70% of 1–RM × 30 reps/wk | 5x/wk | 4 wks |
Lip strength Lip closure on VFSS |
g = 0.98 g = 1.05 |
| Masako maneuver | ||||||||
| Kumaresan et al. (2018) [77] | 30 (age NR) | NR | Protrude tongue and gently bite down on the anterior part of the tongue while swallowing saliva | 10 reps × 3 | 3x/day | 2 wks | EAT-10 | g = 9.86 |
| Mendelsohn maneuver | ||||||||
| Bogaardt et al. (2009) [36] | 11 (61.1 ± 7.6) | 30.6 ± 42.4mos | Modified maneuver: prolong laryngeal excursion for 8–10 s with sEMG feedback | Instructed to practise without sEMG 2–3x/day (40–60 reps) | 1x/wk (or 1x/fort-night) | 6.4 sessions and 76.1 days (mean) | FOIS | g = 1.46 |
| McCullough and Kim (2013) [78] | Crossover group: 18 (70.2 ± 11.5; range: 42–88) | 9.5 ± 4; range: 6–22mos | Swallow “long and strong” with a squeeze at the peak of the swallow for 3–4 s with sEMG feedback |
Target set at 5 μV above mean 30–40 swallows, 45–60 min |
2x/day (2–3 h breaks) | 2 wks |
Max hyoid: Anterior excursion Elevation UES opening width Duration of: Hyoid elevation UES opening DOSS |
n/s n/s n/s n/s n/s n/s |
| Wei et al. (2017) [63] |
Cona: 15 (57.9 ± 9.3) Exp: 15 (57.7 ± 8.8) |
Con: 4.5 ± 2.3 mos Exp: 4.3 ± 2.6 mos |
Swallow the bolus by pressing tongue against hard palate and squeezing the throat muscles. Maintain swallow for 2 s | 10 reps | 2x/day, 5x/wk | 3 wks (or if no longer tube fed) |
Motor evoked potentials UES displacement Max UES opening FOIS |
NR |
| Proprioceptive Neuromuscular Facilitation (PNF)-based short neck flexion exercises | ||||||||
| Kim et al. (2015) [79] |
Expa: 13 (63.2 ± 10.2) Con: 13 (63.6 ± 8.1) |
Exp:15.6 ± 2.9 mos Con:16.15 ± 3.1 mos |
While supine with head/neck off the bed, look at target object 15° diagonally to the right, while the tester moves the participant’s neck in the opposite direction. Repeat in the opposite direction | 30 min | 3x/wk | 6 wks |
New VFSS scale ASHA NOMS |
g = 1.97 g = 0.67 |
| Shaker head lift | ||||||||
| Cho et al. (2017) [73] | 9 (age NR) | NR | Lift the head while in lying position (isometric and isokinetic) |
Isometric: 60 s hold Isokinetic: 30 reps |
5x/wk | 4 wks |
VDS oral phase VDS pharyngeal phase |
g = 0.74 g = 0.32 |
| Choi et al. (2017) [47] |
Expa: 16 (60.81 ± 10.85) Con: 15 (60.4 ± 10.5) |
Exp:3.44 ± 1.15mos Con: 4.13 ± 0.99mos |
Head lift high enough to observe toes in supine position (isometric and isokinetic) | Isometric: 60 s hold × 3 reps (60 s rest) Isokinetic: 30 reps | 5x/wk | 4 wks |
PAS FOIS |
g = 2.06 g = 1.57 |
| Choi et al. (2020) [58] |
Head lifta: 10 (61.2 ± 9.7) Jaw opening: 11 (63.5 ± 7.7) |
Head lift: 13.4 ± 2.2wks Jaw opening: 12.1 ± 2.2wks | Lift head and hold (isometric). Lift head and lower (isotonic) |
Isometric: 10 s hold × 3 reps Isotonic: 3 sets of 30 reps |
5x/wk | 6 wks |
Muscle thickness: Digastric Mylohyoid Hyoid movement: Anterior Superior BRPES |
g = 0.91 g = 1.28 g = 1.29 g = 0.91 NR |
| Gao and Zhang (2017) [31] |
Shakera: 30 (71.1 ± 7.07) CTAR:30 (70.88 ± 6.6) Con:30 (71.14 ± 6.41) |
Shaker: 13 ± 1.41 d CTAR:12.95 ± 1.6 d Con:12.15 ± 1.35 d |
Raise head and neck to look at feet from supine position (isokinetic only) | 30 reps | 3x/day, 7x/wk | 6 wks | PAS | g = 1.33 |
| Kim et al. (2015) [79] |
Cona: 13 (63.6 ± 8.1) Exp: 13 (63.2 ± 10.2) |
Con:16.15 ± 3.1 mos Exp:15.6 ± 2.9 mos |
Lie on bed and raise head without moving shoulders to look at feet and hold (isometric and isokinetic) |
Isometric: 60 s × 3 (60 s rest) Isokinetic: 30 reps 30 min |
3x/wk | 6 wks |
New VFSS scale ASHA NOMS |
g = 1.48 g = 2.33 |
| Logemann et al. (2009) [32] |
Expa: 8 (63.1 ± 22.8) Con: 11 (70.9 ± 9.5) |
> 3mos | Isometric head lifts in supine position (with rest between lifts) followed by consecutive isokinetic reps |
Isometric: 60 s × 3 Isokinetic: 30 reps |
Practice 3x/day, 2x/wk | 6 wks |
Hyoid movement: Anterior Superior |
n/s n/s |
|
Laryngeal movement: Anterior Superior Max UES opening |
n/s n/s n/s |
|||||||
| Mepani et al. (2009) [34] |
Expa: 5 (64 ± 22.8) Con: 6 (70.5 ± 9.5) |
> 3 mos | Raise head high and forward enough to observe toes while in supine position. Isometric head lifts with rest period followed by consecutive head lifts at constant velocity without rest (isokinetic) |
Isometric: 60 s hold × 3 (60 s rest) Isokinetic: 30 reps. 45 min |
2x/wk | 6 wks | Thyrohyoid muscle shortening | g = 1.08 |
| Park et al. (2017) [53] |
Expa: 13 (59.26 ± 11.94) Con: 14 (61.59 ± 13.61) |
Exp: 21.29 ± 8.92 wks Con: 19.2 ± 5.65 wks |
Raise head to look at toes and hold (isometric) without lifting shoulders in supine position (rest period between lifts) followed by × 30 isokinetic consecutive reps |
Isometric: 60 s hold × 3 (60 s rest) Isokinetic: 30 reps |
5x/wk | 4 wks |
PAS (liquids) PAS (semisolids) Hyoid displacement: Horizontal Vertical Larynx displacement: Horizontal Vertical |
g = 1.78 g = 0.97 g = 1.01 g = 1.25 g = 0.48 g = 0.57 |
| Park et al. (2019) [72] | Shakera: 18 (59.45 ± 9.34) CTAR: 19 (60.95 ± 11.19) |
Shaker: 3.85 ± 1.18 CTAR: 3.6 ± 1.19 |
Raise head to look at toes and hold (isometric) without lifting shoulders in supine position, followed by isokinetic consecutive reps |
Isometric: 60 s hold × 3 Isotonic: 30 consecutive reps |
5x/day | 4 wks |
VDS oral phase VDS pharyngeal phase VDS total PAS FOIS |
g = 0.98 g = 1.71 g = 1.87 g = 0.95 g = 0.74 |
| Shaker et al. (2002) [38] | 27 (73.37 ± 6.21) | 8.63 ± 18.54 mos | Lie flat and perform sustained head raisings (isometric) with rest periods, followed by consecutive isokinetic head raisings (high and forward enough to observe toes) |
Isometric: 60 s hold × 3 (60 s rest) Isokinetic: 30 reps |
3x/day | 6 wks |
UES opening Laryngeal excursion Anterior Superior Hyoid excursion FOAMS |
g = 3.48 g = 1.91 n/s n/s g = 6.66 |
| Swallowing with kinesiology taping | ||||||||
| Jung et al. (2020) [60] |
Expa: 13 (71.3 ± 6.5) Con: 14 (70.5 ± 8.2) |
Exp: 16.2 ± 5.2 wks Con: 15.1 ± 6.4 wks |
Voluntary swallow with kinesiology tape attached to the hyolaryngeal complex, pulled downward with approx. 70% tension and attached to the sternum and clavicle bilaterally | 5 sets of 10 swallows against kinesiology tape tension | 10x/day, daily | 4 wks |
Muscle thickness: Tongue Mylohyoid Anterior belly of digastric |
g = 0.55 g = 1.24 g = 0.83 |
| Supraglottic swallow | ||||||||
| Wei et al. (2017) [63] |
Cona: 15 (57.9 ± 9.3) Exp: 15 (57.7 ± 8.8) |
Con:4.5 ± 2.3 mos Exp:4.3 ± 2.6 mos |
Hold breath before and during swallow, and cough/clear throat after swallow before breathing | 10 reps | 2x/day, 5x/wk | 3 wks (or if no longer tube fed) |
Motor evoked potentials UES displacement Max UES opening FOIS |
NR |
| Tongue strengthening exercises | ||||||||
| Cho et al. (2017) [73] | 9 | NR | Press tongue strongly against hard palate | 30 reps | 5x/wk | 4 wks |
VDS oral phase VDS pharyngeal phase |
g = 0.74 g = 0.32 |
| Juan et al. (2013) [27] | 1 (56) | 27 mos | Press tongue against bulb placed between hard palate and either anterior or posterior tongue | 60% of 1-RM for 1st wk; 80% of 1-RM onwards × 10 reps | Therapy: 3x/day, 3x/wk | 8 wks therapy |
Lingual pressures Ant Post Lingual volume SWAL–QOL |
N/A |
| Kim et al. (2017) [61] |
Expa: 18 (62.17 ± 11.01) Con: 17 (59.29 ± 10.19) |
Exp: 4.94 ± 5.52 mos Con: 5.29 ± 5.62 mos |
Press tongue strongly against palate for anterior and posterior tongue regions in a random sequence | 30 reps | 5x/wk | 4 wks |
Ant. tongue strength Post. tongue strength VDS oral phase VDS pharyngeal phase PAS |
g = 0.89 g = 1.41 g = 1.06 g = 0.91 g = 2.26 |
| Moon et al. (2018) [51] |
Expa: 8 (62 ± 4.17) Con: 8 (63.50 ± 6.05) |
Exp: 56 ± 17.35 d Con: 59.88 ± 20.04 d |
Ex1: Press tongue tip on bulb at posterior alveolar arch and press middle portion of tongue on bulb at middle of the hard palate Ex2: generate precise pressures (± 10 kPa of target) |
Ex1: 6 reps × 5 Ex2: Targets at 50, 75 and 100% of max pressure 30 min |
5x/wk | 8 wks |
Ant. MIPs Post. MIPs MASA SWAL–QOL |
g = 3.17 g = 4.50 g = 5.73 g = 3.40 |
| Park et al. (2015) [49] |
Expa: 15 (67.3 ± 10.6) Con: 14 (65.8 ± 11.5) |
Exp: 25.37 ± 7.43 wks Con: 26.38 ± 6.81 wks |
Press IOPI bulb toward hard palate with tongue as hard as possible in anterior and posterior positions | 2 s hold at 80% of 1-RM × 10 reps | 5x/day (min. 30 s rest), 5x/wk | 6 wks |
Ant. MIPs Post. MIPs VDS |
g = 0.26 g = 0.50 g = 0.36 |
| Robbins et al. (2007) [68] | 10 (69.7 ± 13.66) |
1 mos (n = 6), 5 to > 48 mos (n = 4) |
Compress IOPI bulb between tongue and hard palate for anterior and posterior tongue | 60% of 1-RM for 1st wk and 80% of 1-RM onwards × 10 reps | 3x/day, 3x/wk | 8 wks |
Change in MIPs (IOPI) Swallowing pressure Oropharyngeal residue PAS Durational measures MRI SWAL–QOL Dietary questionnaires |
NR |
| Steele et al. (2016) [69] | 14 (71 ± 13.43) | 70.29 ± 42.21 d |
Strength training: Ex1: post. MIPs, regular and effortful saliva swallows Ex2: post. MIPs with slow-release trials Ex3-4: effortful and regular saliva swallows with slow-release trials Ex5: nectar-thick liquid swallows with slow-release Accuracy training: Ex1: ant. and post. MIPs Ex2-3: ant. and post. tongue MIP trials Ex4-5: ant. and post. tongue target accuracy trials |
Strength: Ex1: 5 reps each Ex2: 20 reps Ex3-4: 10 reps each Ex5: 5 reps Accuracy: Ex1: 5 reps Ex2-3: 10 reps Ex4-5: 15 reps each (25–85% of MIP) |
2–3x/wk | 8–12 wks |
Post. MIPs Stage transition duration (from VFSS) PAS Normalised Residue Ratio Scale |
NR n/s n/s NR NR |
| Yeates et al. (2008) [29] | 1 (72) | 7 mos |
Ant. and post. tongue-to-palate presses (half isometric strength, half accuracy) Strength: press bulb to roof of mouth as hard as possible. 1 set of tongue presses in ant. position coupled with a swallow Accuracy: generate precise pressures in ant. or post. tongue positions |
6 reps × 10 sets in total Strength: at max pressure Accuracy: 50, 75, 100% of MEP |
10 sets per day, 2–3x/wk | 24 sessions |
Ant. and post. tongue bulb pressure (average, accuracy, accuracy relative to strength) Stage transition duration (from VFSS) |
N/A |
1-RM 1 repetition maximum, ant. anterior, ASHA NOMS American Speech–Language Hearing Association’s National Outcomes Measurement System, BRPES Borg rating of perceived exertion, C2–C7 cervical vertebrae 2–7, Con control group, CTAR chin tuck against resistance, CVA cerebrovascular accident, d days, DOSS Dysphagia Outcome and Swallow Scale, EAT-10 Eating Assessment Tool-10, EMST expiratory muscle strength training, Ex1,2 exercise 1, 2 etc., Exp experimental group, FDS Functional Dysphagia Scale, FEV1 forced expiratory volume per second, FOAMS Functional Outcome Assessment of Swallowing, FOIS Functional Oral Intake Scale, FVC forced vital capacity, g Hedges’ g, h hour/s, H2O water, IEMT Inspiratory/Expiratory Muscle Training, IOPI Iowa Oral Performance Instrument, kPa kilopascals, LEDT laryngeal elevation delay time, MASA Mann Assessment of Swallowing Ability, max maximum, MBSImp Modified Barium Swallow Impairment Profile, min minute/s, min. minimum, MEP maximum expiratory pressure, MIP maximum isometric pressure, mos months, MRI magnetic resonance imaging, MVC maximum voluntary contraction, NMES neuromuscular electrical stimulation, NR not reported or not calculable, n/s not significant, PAS Penetration–Aspiration Scale, PEFR peak expiratory flow rate, post. posterior, reps repetitions, RSST Repetitive Saliva Swallowing Test, s seconds, sEMG surface electromyography, SD standard deviation, SWAL–QOL Swallowing Quality-of-Life questionnaire, T total, TWST Timed Water Swallow Test, μV microvolts, UES upper oesophageal sphincter, VA volume acceleration, VAS visual analogue scale, VDS Videofluoroscopic Dysphagia Scale, vol voluntary, VFSS Videofluoroscopic Swallow Study, vs versus, wk/s week/s, WST Water Swallowing Test (WST), x/times per, yrs years
aIntervention, dosage and effect sizes reported for the first listed group (with studies containing > 1 group)
bNot reported whether results were significant or not