The effect of breathing training on swallowing function in patients with neurogenic dysphagia: a systematic review and meta-analysis

Abstract

Purpose: This study aimed to systematically review various breathing training methods for patients with neurogenic dysphagia, and assess their clinical efficacy to improve swallowing function in individuals with neurological disorders such as stroke.

Methods: Relevant studies were retrieved from nine databases (PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, Wanfang, China Science and Technology Journal Database, and China Biomedical Literature Database). Articles included in the review were published from the date of establishment of each database up to January 2024. Eleven randomized control trials (RCTs) and five quasi-experimental studies that met the inclusion criteria were included in this systematic review. Data and information were extracted independently by two reviewers, with disagreements resolved through consensus with a third coauthor. The primary outcome assessed was swallow function occurrence. The quality of the included studies was evaluated using the Cochrane risk of bias assessment tool and the JBI quality assessment tool.

Results: The meta-analysis results showed that expiratory muscle strength training can improve swallowing function (standard mean deviation = -0.89, 95% confidence interval [-1.23, -0.55], Z = 5.11, P < 0.01).

Conclusion: This paper categorized and summarized specific respiratory muscle groups targeted in different breathing training methods, providing guidance for clinicians in designing personalized regimens. The study showed that expiratory muscles strength training is the main method for improving respiratory strength and coordination between swallowing and breathing, reducing the risk of aspiration. More research is needed to assess the effectiveness of independent breathing training.

Keywords: Breathing exercises; Deglutition; Neurodysphagia; Systematic review.