Effects of Non-Pharmacological Interventions on the Swallowing Function of Patients With Post-Stroke Dysphagia: A Systematic Review and Network Meta-Analysis.

IF 3.1 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of oral rehabilitation Pub Date : 2024-11-12 DOI:10.1111/joor.13901
Bohan Zhang, Ka Po Wong, Cai Guo, Shu-Cheng Chen, Shuojin Fu, Ruifu Kang, Qian Xiao, Jing Qin
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Abstract

Background: Post-stroke dysphagia can lead to serious complications and appropriate rehabilitation can significantly improve swallowing function. However, the best rehabilitation method for post-stroke dysphagia patients is not clear at the present stage, so it is necessary to conduct a comprehensive network meta-analysis and systematic review of different interventions for dysphagia.

Objective: To compare the effectiveness and ranking of different interventions for improving swallowing function, and feeding and daily function in patients with post-stroke dysphagia.

Methods: Seven databases were searched from the date of inception to September 1, 2022. Two investigators independently conducted literature searches, selected randomized controlled trials on dysphagia interventions, and assessed study quality. Network meta-analysis was conducted by using Stata software.

Results: A total of 33 studies involving 1,341 patients were included. According to the ranking probabilities, acupuncture was rated as the most effective of all interventions to enhance patients' swallowing function (surface under cumulative ranking curve values [SUCRCV]: 99.0%, standardized mean difference [SMD]: -2.40, 95% confidence interval [CI]: -3.38 to -1.43), followed by the chin tuck against resistance exercise (CTAR, SUCRA: 89.9%, SMD: -1.83, 95% CI: -2.69 to -0.97). Among all the interventions, acupuncture was the most effective for feeding and daily function (SUCRCV: 88.4%, SMD: -1.62, 95% CI: -2.94 to -0.30).

Conclusions: The results showed that acupuncture was the most effective in the rehabilitation of patients with post-stroke dysphagia, followed by CTAR. Considering that CTAR is a low-cost and highly feasible intervention, we suggest that CTAR should be selected as a rehabilitation measure for patients with post-stroke dysphagia to improve their swallowing function.

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非药物干预对脑卒中后吞咽困难患者吞咽功能的影响:系统综述和网络元分析。
背景:脑卒中后吞咽困难可导致严重的并发症,适当的康复治疗可显著改善吞咽功能。然而,现阶段针对脑卒中后吞咽困难患者的最佳康复方法尚不明确,因此有必要对不同的吞咽困难干预措施进行全面的网络荟萃分析和系统综述:比较不同干预措施在改善卒中后吞咽困难患者吞咽功能、进食和日常生活功能方面的有效性和排名:方法:检索了从开始到 2022 年 9 月 1 日的七个数据库。两名研究人员独立进行文献检索,选择有关吞咽困难干预措施的随机对照试验,并评估研究质量。使用Stata软件进行网络荟萃分析:结果:共纳入 33 项研究,涉及 1 341 名患者。根据排序概率,针灸被评为所有干预措施中对增强患者吞咽功能最有效的(累积排序曲线下表面值[SUCRCV]:99.0%,标准化平均差[SMD]:-2.40,95%置信区间[CI]:-3.38至-1.43),其次是托腮抗阻运动(CTAR,SUCRA:89.9%,SMD:-1.83,95%CI:-2.69至-0.97)。在所有干预措施中,针灸对喂养和日常功能最有效(SUCRCV:88.4%,SMD:-1.62,95% CI:-2.94 至 -0.30):结果表明,针灸对中风后吞咽困难患者的康复最有效,其次是 CTAR。考虑到CTAR是一种成本低、可行性高的干预措施,我们建议选择CTAR作为脑卒中后吞咽困难患者的康复措施,以改善其吞咽功能。
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来源期刊
Journal of oral rehabilitation
Journal of oral rehabilitation 医学-牙科与口腔外科
CiteScore
5.60
自引率
10.30%
发文量
116
审稿时长
4-8 weeks
期刊介绍: Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.
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