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25-04-2024 | Dysphagia | Original Article

Dysphagia Rehabilitation in Dysphagic Patients with Acute or Critical Illness: A Systematic Review and Meta-Analysis

Authors: Akira Kuriyama, Shinichi Watanabe, Yukiko Katayama, Taisuke Yasaka, Akira Ouchi, Yuki Iida, Fumihito Kasai

Published in: Dysphagia

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Abstract

Dysphagia or swallowing dysfunction is common in patients with acute or critical illness, and diverse methods of dysphagia rehabilitation are provided worldwide. We aimed to examine the efficacy of rehabilitation to treat dysphagia in patients with acute or critical illness. We searched PubMed, ICHUSHI, and Cochrane Central Register of Controlled Trials databases from inception to November 22, 2023 for relevant randomized controlled trials. We focused on dysphagic patients with acute or critical illness who were not orotracheally intubated. Our target intervention included conventional rehabilitation and nerve stimulation/neuromodulation techniques as dysphagia rehabilitation. Comparators were conventional or standard care or no dysphagia interventions. Primary outcomes included mortality, incidence of pneumonia during the study period, and health-related quality of life (HRQoL) scores within 90 days of hospital discharge. We pooled the data using a random-effects model, and classified the certainty of evidence based on the Grading of Recommendations, Assessment, Development, and Evaluation system. Nineteen randomized controlled trials involving 1,096 participants were included. Dysphagia rehabilitation was associated with a reduced incidence of pneumonia (risk ratio [RR], 0.66; 95% confidence interval [CI], 0.54–0.81; moderate certainty), but not with reduced mortality (RR, 0.92; 95% CI, 0.61–1.39; very low certainty) or improved HRQoL scores (mean difference, -0.20; 95% CI, -20.34 to 19.94; very low certainty). Based on the available moderate- or very low- quality evidence, while dysphagia rehabilitation had no impact on mortality or HRQoL, they might reduce the incidence of pneumonia in dysphagic patients with acute or critical illness.
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Literature
1.
go back to reference Zuercher P, Moret CS, Dziewas R, Schefold JC. Dysphagia in the intensive care unit: epidemiology, mechanisms, and clinical management. Crit Care (London England). 2019;23(1):103.CrossRef Zuercher P, Moret CS, Dziewas R, Schefold JC. Dysphagia in the intensive care unit: epidemiology, mechanisms, and clinical management. Crit Care (London England). 2019;23(1):103.CrossRef
2.
go back to reference Macht M, Wimbish T, Bodine C, Moss M. ICU-acquired swallowing disorders. Crit Care Med. 2013;41(10):2396–405.PubMedCrossRef Macht M, Wimbish T, Bodine C, Moss M. ICU-acquired swallowing disorders. Crit Care Med. 2013;41(10):2396–405.PubMedCrossRef
3.
go back to reference Skoretz SA, Flowers HL, Martino R. The incidence of dysphagia following endotracheal intubation: a systematic review. Chest. 2010;137(3):665–73.PubMedCrossRef Skoretz SA, Flowers HL, Martino R. The incidence of dysphagia following endotracheal intubation: a systematic review. Chest. 2010;137(3):665–73.PubMedCrossRef
4.
go back to reference McIntyre M, Doeltgen S, Dalton N, Koppa M, Chimunda T. Post-extubation dysphagia incidence in critically ill patients: a systematic review and meta-analysis. Australian Crit care: Official J Confederation Australian Crit Care Nurses. 2021;34(1):67–75.CrossRef McIntyre M, Doeltgen S, Dalton N, Koppa M, Chimunda T. Post-extubation dysphagia incidence in critically ill patients: a systematic review and meta-analysis. Australian Crit care: Official J Confederation Australian Crit Care Nurses. 2021;34(1):67–75.CrossRef
5.
go back to reference Schefold JC, Berger D, Zurcher P, Lensch M, Perren A, Jakob SM, et al. Dysphagia in mechanically ventilated ICU patients (DYnAMICS): a prospective observational trial. Crit Care Med. 2017;45(12):2061–9.PubMedCrossRef Schefold JC, Berger D, Zurcher P, Lensch M, Perren A, Jakob SM, et al. Dysphagia in mechanically ventilated ICU patients (DYnAMICS): a prospective observational trial. Crit Care Med. 2017;45(12):2061–9.PubMedCrossRef
6.
go back to reference Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A, et al. Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care (London England). 2011;15(5):R231.CrossRef Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A, et al. Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care (London England). 2011;15(5):R231.CrossRef
7.
go back to reference Altman KW, Yu GP, Schaefer SD. Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources. Archives otolaryngology–head neck Surg. 2010;136(8):784–9.CrossRef Altman KW, Yu GP, Schaefer SD. Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources. Archives otolaryngology–head neck Surg. 2010;136(8):784–9.CrossRef
8.
go back to reference Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139–46.PubMedCrossRef Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139–46.PubMedCrossRef
9.
go back to reference Evancho A, Tyler WJ, McGregor K. A review of combined neuromodulation and physical therapy interventions for enhanced neurorehabilitation. Front Hum Neurosci. 2023;17:1151218.PubMedPubMedCentralCrossRef Evancho A, Tyler WJ, McGregor K. A review of combined neuromodulation and physical therapy interventions for enhanced neurorehabilitation. Front Hum Neurosci. 2023;17:1151218.PubMedPubMedCentralCrossRef
10.
go back to reference Spronk PE, Spronk LEJ, Egerod I, McGaughey J, McRae J, Rose L, et al. Dysphagia in Intensive Care evaluation (DICE): an International Cross-sectional Survey. Dysphagia. 2022;37(6):1451–60.PubMedCrossRef Spronk PE, Spronk LEJ, Egerod I, McGaughey J, McRae J, Rose L, et al. Dysphagia in Intensive Care evaluation (DICE): an International Cross-sectional Survey. Dysphagia. 2022;37(6):1451–60.PubMedCrossRef
11.
go back to reference Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical Res ed). 2021;372:n71. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical Res ed). 2021;372:n71.
13.
go back to reference Jackson JL, Kuriyama A, Anton A, Choi A, Fournier JP, Geier AK, et al. The Accuracy of Google Translate for Abstracting Data from Non-english-language trials for systematic reviews. Ann Intern Med. 2019;171(9):677–9.PubMedCrossRef Jackson JL, Kuriyama A, Anton A, Choi A, Fournier JP, Geier AK, et al. The Accuracy of Google Translate for Abstracting Data from Non-english-language trials for systematic reviews. Ann Intern Med. 2019;171(9):677–9.PubMedCrossRef
14.
go back to reference Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical Res ed). 2011;343:d5928.CrossRef Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical Res ed). 2011;343:d5928.CrossRef
15.
go back to reference Higgins JP, Green. S. editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester (UK): Wiley; 2008.CrossRef Higgins JP, Green. S. editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester (UK): Wiley; 2008.CrossRef
16.
go back to reference Sweeting MJ, Sutton AJ, Lambert PC. What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data. Stat Med. 2004;23(9):1351–75.PubMedCrossRef Sweeting MJ, Sutton AJ, Lambert PC. What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data. Stat Med. 2004;23(9):1351–75.PubMedCrossRef
17.
18.
go back to reference Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clinical Res ed). 2003;327(7414):557–60.CrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clinical Res ed). 2003;327(7414):557–60.CrossRef
19.
go back to reference Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical Res ed). 1997;315(7109):629–34.CrossRef Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical Res ed). 1997;315(7109):629–34.CrossRef
20.
go back to reference Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ (Clinical Res ed). 2008;336(7650):924–6.CrossRef Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ (Clinical Res ed). 2008;336(7650):924–6.CrossRef
21.
go back to reference Furukawa TA, Miura T, Chaimani A, Leucht S, Cipriani A, Noma H, et al. Using the contribution matrix to evaluate complex study limitations in a network meta-analysis: a case study of bipolar maintenance pharmacotherapy review. BMC Res Notes. 2016;9:218.PubMedPubMedCentralCrossRef Furukawa TA, Miura T, Chaimani A, Leucht S, Cipriani A, Noma H, et al. Using the contribution matrix to evaluate complex study limitations in a network meta-analysis: a case study of bipolar maintenance pharmacotherapy review. BMC Res Notes. 2016;9:218.PubMedPubMedCentralCrossRef
22.
go back to reference Guyatt GH, Oxman AD, Kunz R, Brozek J, Alonso-Coello P, Rind D, et al. GRADE guidelines 6. Rating the quality of evidence–imprecision. J Clin Epidemiol. 2011;64(12):1283–93.PubMedCrossRef Guyatt GH, Oxman AD, Kunz R, Brozek J, Alonso-Coello P, Rind D, et al. GRADE guidelines 6. Rating the quality of evidence–imprecision. J Clin Epidemiol. 2011;64(12):1283–93.PubMedCrossRef
23.
24.
go back to reference Carnaby G, Hankey GJ, Pizzi J. Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial. Lancet Neurol. 2006;5(1):31–7.PubMedCrossRef Carnaby G, Hankey GJ, Pizzi J. Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial. Lancet Neurol. 2006;5(1):31–7.PubMedCrossRef
25.
go back to reference Du J, Yang F, Liu L, Hu J, Cai B, Liu W, et al. Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia: a randomized, double-blind clinical trial. Clin Neurophysiology: Official J Int Federation Clin Neurophysiol. 2016;127(3):1907–13.CrossRef Du J, Yang F, Liu L, Hu J, Cai B, Liu W, et al. Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia: a randomized, double-blind clinical trial. Clin Neurophysiology: Official J Int Federation Clin Neurophysiol. 2016;127(3):1907–13.CrossRef
26.
go back to reference Dziewas R, Stellato R, van der Tweel I, Walther E, Werner CJ, Braun T, et al. Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomised trial. Lancet Neurol. 2018;17(10):849–59.PubMedCrossRef Dziewas R, Stellato R, van der Tweel I, Walther E, Werner CJ, Braun T, et al. Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomised trial. Lancet Neurol. 2018;17(10):849–59.PubMedCrossRef
27.
go back to reference Khedr EM, Abo-Elfetoh N. Therapeutic role of rTMS on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction. J Neurol Neurosurg Psychiatry. 2010;81(5):495–9.PubMedCrossRef Khedr EM, Abo-Elfetoh N. Therapeutic role of rTMS on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction. J Neurol Neurosurg Psychiatry. 2010;81(5):495–9.PubMedCrossRef
28.
go back to reference Khedr EM, Abo-Elfetoh N, Rothwell JC. Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation. Acta Neurol Scand. 2009;119(3):155–61.PubMedCrossRef Khedr EM, Abo-Elfetoh N, Rothwell JC. Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation. Acta Neurol Scand. 2009;119(3):155–61.PubMedCrossRef
29.
go back to reference Kumar S, Wagner CW, Frayne C, Zhu L, Selim M, Feng W, et al. Noninvasive brain stimulation may improve stroke-related dysphagia: a pilot study. Stroke. 2011;42(4):1035–40.PubMedPubMedCentralCrossRef Kumar S, Wagner CW, Frayne C, Zhu L, Selim M, Feng W, et al. Noninvasive brain stimulation may improve stroke-related dysphagia: a pilot study. Stroke. 2011;42(4):1035–40.PubMedPubMedCentralCrossRef
30.
go back to reference Suntrup S, Marian T, Schroder JB, Suttrup I, Muhle P, Oelenberg S, et al. Electrical pharyngeal stimulation for dysphagia treatment in tracheotomized stroke patients: a randomized controlled trial. Intensive Care Med. 2015;41(9):1629–37.PubMedCrossRef Suntrup S, Marian T, Schroder JB, Suttrup I, Muhle P, Oelenberg S, et al. Electrical pharyngeal stimulation for dysphagia treatment in tracheotomized stroke patients: a randomized controlled trial. Intensive Care Med. 2015;41(9):1629–37.PubMedCrossRef
31.
go back to reference Suntrup-Krueger S, Ringmaier C, Muhle P, Wollbrink A, Kemmling A, Hanning U, et al. Randomized trial of transcranial direct current stimulation for poststroke dysphagia. Ann Neurol. 2018;83(2):328–40.PubMedCrossRef Suntrup-Krueger S, Ringmaier C, Muhle P, Wollbrink A, Kemmling A, Hanning U, et al. Randomized trial of transcranial direct current stimulation for poststroke dysphagia. Ann Neurol. 2018;83(2):328–40.PubMedCrossRef
32.
go back to reference Turra GS, Schwartz IVD, Almeida ST, Martinez CC, Bridi M, Barreto SSM. Efficacy of speech therapy in post-intubation patients with oropharyngeal dysphagia: a randomized controlled trial. CoDAS. 2021;33(2):e20190246.PubMedCrossRef Turra GS, Schwartz IVD, Almeida ST, Martinez CC, Bridi M, Barreto SSM. Efficacy of speech therapy in post-intubation patients with oropharyngeal dysphagia: a randomized controlled trial. CoDAS. 2021;33(2):e20190246.PubMedCrossRef
33.
go back to reference Vasant DH, Michou E, O’Leary N, Vail A, Mistry S, Hamdy S, et al. Pharyngeal electrical stimulation in Dysphagia Poststroke: a prospective, randomized single-blinded interventional study. Neurorehabilit Neural Repair. 2016;30(9):866–75.CrossRef Vasant DH, Michou E, O’Leary N, Vail A, Mistry S, Hamdy S, et al. Pharyngeal electrical stimulation in Dysphagia Poststroke: a prospective, randomized single-blinded interventional study. Neurorehabilit Neural Repair. 2016;30(9):866–75.CrossRef
34.
go back to reference Benfield JK, Hedstrom A, Everton LF, Bath PM, England TJ. Randomized controlled feasibility trial of swallow strength and skill training with surface electromyographic biofeedback in acute stroke patients with dysphagia. J Oral Rehabil. 2023;50(6):440–51.PubMedCrossRef Benfield JK, Hedstrom A, Everton LF, Bath PM, England TJ. Randomized controlled feasibility trial of swallow strength and skill training with surface electromyographic biofeedback in acute stroke patients with dysphagia. J Oral Rehabil. 2023;50(6):440–51.PubMedCrossRef
35.
go back to reference Jiao Y, Peng W, Yang J, Li C. Effect of Repetitive Transcranial Magnetic Stimulation on the Nutritional Status and neurological function of patients with Postischemic Stroke Dysphagia. Neurologist. 2023;28(2):69–72.PubMedCrossRef Jiao Y, Peng W, Yang J, Li C. Effect of Repetitive Transcranial Magnetic Stimulation on the Nutritional Status and neurological function of patients with Postischemic Stroke Dysphagia. Neurologist. 2023;28(2):69–72.PubMedCrossRef
36.
go back to reference Kumar S, Marchina S, Langmore S, Massaro J, Palmisano J, Wang N, et al. Fostering eating after stroke (FEASt) trial for improving post-stroke dysphagia with non-invasive brain stimulation. Sci Rep. 2022;12(1):9607.PubMedPubMedCentralCrossRef Kumar S, Marchina S, Langmore S, Massaro J, Palmisano J, Wang N, et al. Fostering eating after stroke (FEASt) trial for improving post-stroke dysphagia with non-invasive brain stimulation. Sci Rep. 2022;12(1):9607.PubMedPubMedCentralCrossRef
37.
go back to reference Matos KC, de Oliveira VF, de Oliveira PLC, Carvalho FA, de Mesquita MRM, da Silva Queiroz CG, et al. Combined conventional speech therapy and functional electrical stimulation in acute stroke patients with dyphagia: a randomized controlled trial. BMC Neurol. 2022;22(1):231.PubMedPubMedCentralCrossRef Matos KC, de Oliveira VF, de Oliveira PLC, Carvalho FA, de Mesquita MRM, da Silva Queiroz CG, et al. Combined conventional speech therapy and functional electrical stimulation in acute stroke patients with dyphagia: a randomized controlled trial. BMC Neurol. 2022;22(1):231.PubMedPubMedCentralCrossRef
38.
go back to reference Suntrup-Krueger S, Labeit B, Marian T, Schröder J, Claus I, Ahring S, et al. Pharyngeal electrical stimulation for postextubation dysphagia in acute stroke: a randomized controlled pilot trial. Crit Care (London England). 2023;27(1):383.CrossRef Suntrup-Krueger S, Labeit B, Marian T, Schröder J, Claus I, Ahring S, et al. Pharyngeal electrical stimulation for postextubation dysphagia in acute stroke: a randomized controlled pilot trial. Crit Care (London England). 2023;27(1):383.CrossRef
39.
go back to reference Zhong L, Wen X, Liu Z, Li F, Ma X, Liu H, et al. Effects of bilateral cerebellar repetitive transcranial magnetic stimulation in poststroke dysphagia: a randomized sham-controlled trial. NeuroRehabilitation. 2023;52(2):227–34.PubMedCrossRef Zhong L, Wen X, Liu Z, Li F, Ma X, Liu H, et al. Effects of bilateral cerebellar repetitive transcranial magnetic stimulation in poststroke dysphagia: a randomized sham-controlled trial. NeuroRehabilitation. 2023;52(2):227–34.PubMedCrossRef
40.
go back to reference Zou F, Chen X, Niu L, Wang Y, Chen J, Li C, et al. Effect of Repetitive Transcranial Magnetic Stimulation on post-stroke Dysphagia in Acute Stage. Dysphagia. 2023;38(4):1117–27.PubMedCrossRef Zou F, Chen X, Niu L, Wang Y, Chen J, Li C, et al. Effect of Repetitive Transcranial Magnetic Stimulation on post-stroke Dysphagia in Acute Stage. Dysphagia. 2023;38(4):1117–27.PubMedCrossRef
41.
go back to reference Farpour S, Asadi-Shekaari M, Borhani Haghighi A, Farpour HR. Improving swallowing function and ability in Post Stroke Dysphagia: a Randomized Clinical Trial. Dysphagia. 2023;38(1):330–9.PubMedCrossRef Farpour S, Asadi-Shekaari M, Borhani Haghighi A, Farpour HR. Improving swallowing function and ability in Post Stroke Dysphagia: a Randomized Clinical Trial. Dysphagia. 2023;38(1):330–9.PubMedCrossRef
42.
go back to reference Lee KW, Kim SB, Lee JH, Lee SJ, Ri JW, Park JG. The effect of early neuromuscular electrical stimulation therapy in acute/subacute ischemic stroke patients with Dysphagia. Ann Rehabil Med. 2014;38(2):153–9.PubMedPubMedCentralCrossRef Lee KW, Kim SB, Lee JH, Lee SJ, Ri JW, Park JG. The effect of early neuromuscular electrical stimulation therapy in acute/subacute ischemic stroke patients with Dysphagia. Ann Rehabil Med. 2014;38(2):153–9.PubMedPubMedCentralCrossRef
43.
go back to reference Duncan S, McAuley DF, Walshe M, McGaughey J, Anand R, Fallis R, et al. Interventions for oropharyngeal dysphagia in acute and critical care: a systematic review and meta-analysis. Intensive Care Med. 2020;46(7):1326–38.PubMedPubMedCentralCrossRef Duncan S, McAuley DF, Walshe M, McGaughey J, Anand R, Fallis R, et al. Interventions for oropharyngeal dysphagia in acute and critical care: a systematic review and meta-analysis. Intensive Care Med. 2020;46(7):1326–38.PubMedPubMedCentralCrossRef
44.
go back to reference Hwang CH, Choi KH, Ko YS, Leem CM. Pre-emptive swallowing stimulation in long-term intubated patients. Clin Rehabil. 2007;21(1):41–6.PubMedCrossRef Hwang CH, Choi KH, Ko YS, Leem CM. Pre-emptive swallowing stimulation in long-term intubated patients. Clin Rehabil. 2007;21(1):41–6.PubMedCrossRef
45.
go back to reference Siao SF, Ku SC, Tseng WH, Wei YC, Chang YC, Hsiao TY, et al. Effects of a swallowing and oral-care program on resuming oral feeding and reducing pneumonia in patients following endotracheal extubation: a randomized, open-label, controlled trial. Crit Care (London England). 2023;27(1):283.CrossRef Siao SF, Ku SC, Tseng WH, Wei YC, Chang YC, Hsiao TY, et al. Effects of a swallowing and oral-care program on resuming oral feeding and reducing pneumonia in patients following endotracheal extubation: a randomized, open-label, controlled trial. Crit Care (London England). 2023;27(1):283.CrossRef
46.
go back to reference Kosilek RP, Schmidt K, Baumeister SE, Gensichen J. Frequency and risk factors of post-intensive care syndrome components in a multicenter randomized controlled trial of German sepsis survivors. J Crit Care. 2021;65:268–73.PubMedCrossRef Kosilek RP, Schmidt K, Baumeister SE, Gensichen J. Frequency and risk factors of post-intensive care syndrome components in a multicenter randomized controlled trial of German sepsis survivors. J Crit Care. 2021;65:268–73.PubMedCrossRef
47.
go back to reference Howard MM, Block ES, Mishreki D, Kim T, Rosario ER. The effect of sensory level Versus Motor Level Electrical Stimulation of pharyngeal muscles in Acute Stroke patients with Dysphagia: a Randomized Trial. Dysphagia. 2023;38(3):943–53.PubMedCrossRef Howard MM, Block ES, Mishreki D, Kim T, Rosario ER. The effect of sensory level Versus Motor Level Electrical Stimulation of pharyngeal muscles in Acute Stroke patients with Dysphagia: a Randomized Trial. Dysphagia. 2023;38(3):943–53.PubMedCrossRef
48.
go back to reference Li H, Zhao L, Yuan X, Zhang Q, Pang Y, Li H. Effect of transcranial direct current stimulation combined with respiratory training on dysphagia in post-stroke patients. Technol Health Care. 2023;31(1):11–9.PubMedCrossRef Li H, Zhao L, Yuan X, Zhang Q, Pang Y, Li H. Effect of transcranial direct current stimulation combined with respiratory training on dysphagia in post-stroke patients. Technol Health Care. 2023;31(1):11–9.PubMedCrossRef
49.
go back to reference Bengisu S, Demir N, Krespi Y. Effectiveness of Conventional Dysphagia Therapy (CDT), Neuromuscular Electrical Stimulation (NMES), and Transcranial Direct Current Stimulation (tDCS) in Acute Post-stroke Dysphagia: a comparative evaluation. Dysphagia. 2024;39(1):77–91.PubMedCrossRef Bengisu S, Demir N, Krespi Y. Effectiveness of Conventional Dysphagia Therapy (CDT), Neuromuscular Electrical Stimulation (NMES), and Transcranial Direct Current Stimulation (tDCS) in Acute Post-stroke Dysphagia: a comparative evaluation. Dysphagia. 2024;39(1):77–91.PubMedCrossRef
Metadata
Title
Dysphagia Rehabilitation in Dysphagic Patients with Acute or Critical Illness: A Systematic Review and Meta-Analysis
Authors
Akira Kuriyama
Shinichi Watanabe
Yukiko Katayama
Taisuke Yasaka
Akira Ouchi
Yuki Iida
Fumihito Kasai
Publication date
25-04-2024
Publisher
Springer US
Published in
Dysphagia
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-024-10700-7