Efficacy of Respiratory Training in Elderly Patients With Dysphagia: A Systematic Review and Meta-Analysis

IF 1.5 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-07-29 DOI:10.1111/coa.70002

Yi Su, Bo Liu, Jing Zhang

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引用次数: 0

Abstract

Objective

To evaluate the efficacy of respiratory training in elderly patients with dysphagia through a systematic review and meta-analysis of existing research data and outcomes.

Methods

Databases including PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang were searched for studies from their inception to 2024. Included studies were randomised controlled trials involving elderly patients (aged ≥ 65 years) with diagnosed dysphagia who underwent respiratory training, such as expiratory muscle strength training or inspiratory muscle training, with a follow-up period of at least 6 months. The quality of the included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions, and meta-analysis was conducted using RevMan 5.3.

Results

Ten RCTs were included, with five rated as high quality (Grade A), four as moderate quality (Grade B) and one as low quality (Grade C). The meta-analysis revealed significant improvements in the respiratory training group compared with the control group: forced expiratory volume in the first second (relative risk = 0.07, 95% confidence interval [CI; 0.05, 0.08], p < 0.000), peak expiratory flow (mean difference [MD] = −3.99, 95% CI [−4.88, −3.11], p < 0.000) and Penetration–Aspiration Scale score (MD = −2.16, 95% CI [−2.35, −1.98], p < 0.000).

Conclusion

Respiratory training substantially improves respiratory and swallowing function in elderly patients with dysphagia and reduces the risk of aspiration, demonstrating greater efficacy than conventional care. These findings suggest a broad potential for the application of respiratory training in dysphagia rehabilitation for elderly patients.

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呼吸训练对老年吞咽困难患者的疗效：系统回顾和荟萃分析。

目的：通过对现有研究数据和结果的系统回顾和荟萃分析，评价呼吸训练对老年吞咽困难患者的疗效。方法：检索PubMed、EMBASE、Web of Science、Cochrane Library、中国知网（CNKI）、万方等数据库自成立至2024年的研究。纳入的研究是随机对照试验，涉及诊断为吞咽困难的老年患者（年龄≥65岁），接受呼吸训练，如呼气肌力量训练或吸气肌训练，随访期至少6个月。采用Cochrane干预措施系统评价手册评估纳入研究的质量，使用RevMan 5.3进行meta分析。结果：纳入10项rct，其中5项为高质量（A级），4项为中等质量（B级），1项为低质量（C级）。meta分析显示呼吸训练组与对照组相比有显著改善：第一秒用力呼气量(相对风险= 0.07,95%可信区间[CI；结论：呼吸训练可明显改善老年吞咽困难患者的呼吸和吞咽功能，降低误吸风险，效果优于常规护理。这些发现表明呼吸训练在老年患者吞咽困难康复中的应用具有广阔的潜力。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.