Oropharyngeal Exercise Intervention for Swallowing Function in Older Adults: A Systematic Review and Meta-Analysis.

Abstract

Background: Although swallowing function is crucial for older adults, the effects of oropharyngeal exercise interventions on older adults without stroke or cancer remain uncertain.

Methods: A systematic search of five major databases was conducted to identify randomised controlled trials involving oropharyngeal exercise interventions conducted on older adults. The primary outcomes investigated were the changes in maximum tongue pressure (MTP) and the results from the repetitive saliva swallowing test (RSST). The secondary outcomes examined were swallowing pressure and oral motor coordination (oral diadochokinesis, DDK). A subgroup analysis was conducted to compare outcomes between dementia and non-dementia populations. Data synthesis was performed by conducting a random-effects meta-analysis.

Results: Eleven randomised controlled trials were included (n = 622). The oropharyngeal exercise intervention groups exhibited greater improvements in MTP (k = 11, standard mean difference [SMD] = 0.74, 95% confidence interval [CI] = 0.31-1.17) and RSST results (k = 4, SMD = 0.63, 95% CI = 0.28-0.98) than the control group. Positive outcomes were reported in both dementia and non-dementia subgroups. Oropharyngeal exercise interventions also led to increased efficacy for swallowing pressure (k = 4, SMD = 0.71, 95% CI = 0.20-1.22) and oral DDK (k = 3, syllable/pa/, SMD = 1.00, 95% CI = 0.34-1.67; syllable/ta/, SMD = 0.72, 95% CI = 0.02-1.43; syllable/ka/, SMD = 0.83, 95% CI = 0.16-1.42).

Conclusion: Our findings suggested that oropharyngeal exercise intervention is beneficial as a rehabilitative measure for patients with dysphagia and as a preventive measure for healthy older adults.