Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Goodnight Hall, 1300 University Ave, Madison, WI, 53706, USA.
Department of Surgery-Otolaryngology, Clinical Science Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA.
Dysphagia. 2021 Feb;36(1):1-32. doi: 10.1007/s00455-020-10104-3. Epub 2020 Mar 5.
Optimal exercise doses for exercise-based approaches to dysphagia treatment are unclear. To address this gap in knowledge, we performed a scoping review to provide a record of doses reported in the literature. A larger goal of this work was to promote detailed consideration of dosing parameters in dysphagia exercise treatments in intervention planning and outcome reporting.
We searched PubMed, Scopus[Embase], CINAHL, and Cochrane databases from inception to July 2019, with search terms relating to dysphagia and exercises to treat swallowing impairments. Of the eligible 1906 peer-reviewed articles, 72 met inclusionary criteria by reporting, at minimum, both the frequency and duration of their exercise-based treatments.
Study interventions included tongue exercise (n = 16), Shaker/head lift (n = 13), respiratory muscle strength training (n = 6), combination exercise programs (n = 20), mandibular movement exercises (n = 7), lip muscle training (n = 5), and other programs that did not fit into the categories described above (n = 5). Frequency recommendations varied greatly by exercise type. Duration recommendations ranged from 4 weeks to 1 year. In articles reporting repetitions (n = 66), the range was 1 to 120 reps/day. In articles reporting intensity (n = 59), descriptions included values for force, movement duration, or descriptive verbal cues, such as "as hard as possible." Outcome measures were highly varied across and within specific exercise types.
We recommend inclusion of at least the frequency, duration, repetition, and intensity components of exercise dose to improve reproducibility, interpretation, and comparison across studies. Further research is required to determine optimal dose ranges for the wide variety of exercise-based dysphagia interventions.
针对吞咽障碍治疗的基于运动的方法，最佳运动剂量尚不清楚。为了解决这方面的知识空白，我们进行了范围综述，以记录文献中报告的剂量。这项工作的一个更大目标是在吞咽障碍运动治疗的干预计划和结果报告中促进对剂量参数的详细考虑。
我们从成立到 2019 年 7 月，在 PubMed、Scopus[Embase]、CINAHL 和 Cochrane 数据库中进行了搜索，搜索词与吞咽障碍和治疗吞咽障碍的运动有关。在符合条件的 1906 篇同行评议文章中，有 72 篇文章符合纳入标准，至少报告了他们基于运动的治疗的频率和持续时间。
研究干预措施包括舌部运动（n=16）、Shaker/头提升（n=13）、呼吸肌力量训练（n=6）、组合运动方案（n=20）、下颌运动练习（n=7）、唇部肌肉训练（n=5）和其他不符合上述类别描述的方案（n=5）。不同运动类型的推荐频率差异很大。推荐的持续时间从 4 周到 1 年不等。在报告重复次数的文章中（n=66），范围是每天 1 到 120 次。在报告强度的文章中（n=59），描述包括力、运动持续时间或描述性的口头提示的值，如“尽可能用力”。结果测量在特定运动类型之间和内部都有很大差异。
我们建议至少包括运动剂量的频率、持续时间、重复次数和强度组成部分，以提高研究之间的可重复性、解释和比较。需要进一步研究以确定广泛的基于运动的吞咽障碍干预措施的最佳剂量范围。
