Dysphagia最新文献

{"title":"Minimal Clinically Important Difference of the Modified Barium Swallow Impairment Profile (MBSImP) Pharyngeal Total Score in Post-Stroke Dysphagia.","authors":"Hongji Zeng, Chuang Wang, Chen Zhang, Shuguang Liang, Zishang Zeng, Shu Yan, Siyu Luo, Weijia Zhao, Ying Yang, Xi Zeng","doi":"10.1007/s00455-026-11017-3","DOIUrl":"https://doi.org/10.1007/s00455-026-11017-3","url":null,"abstract":"<p><p>The Modified Barium Swallow Impairment Profile (MBSImP) is widely used to quantify swallowing physiology during videofluoroscopic swallowing assessment, but the minimal clinically important difference (MCID) for its pharyngeal total score in post-stroke dysphagia remains unclear. This study estimated the MCID for improvement in the MBSImP pharyngeal total score during inpatient rehabilitation. This prospective multicenter observational study included stroke survivors with dysphagia admitted for inpatient rehabilitation 2 weeks to 3 months after stroke onset. Baseline and 10-day follow-up assessments included the MBSImP pharyngeal total score, Functional Oral Intake Scale (FOIS), Penetration-Aspiration Scale (PAS), and Patient Global Impression of Change (PGIC). The FOIS was used as the primary anchor, while the PAS and PGIC were secondary anchors. Anchor-based estimates were calculated using average change, change difference, linear regression, and receiver operating characteristic analyses. Distribution-based estimates and minimal detectable change were used as complementary context for interpreting the anchor-based estimates. Sensitivity analyses were performed using stricter or collapsed anchor definitions, including collapsed FOIS categories, ≥ 2-level FOIS improvement, collapsed PAS categories, and a stricter PGIC threshold. An exploratory interaction analysis additionally examined whether the MBSImP change associated with exactly 1-level versus exactly 2-level FOIS improvement varied according to baseline FOIS level. A total of 161 participants were included. The MBSImP pharyngeal total score decreased from a median of [9.00 (7.00, 11.00)] to [4.00 (2.00, 6.00)]. The mean improvement, used for anchor-based MCID estimation, was 4.27 points. Changes in the MBSImP pharyngeal total score were significantly correlated with the FOIS, PAS, and PGIC (r > 0.3). The pooled average-change and change-difference estimates under the prespecified anchor definitions were 2.977 and 2.004 points, respectively. Under stricter or category-based anchor definitions, average-change estimates increased to 4.633-5.141 points, whereas change-difference estimates remained comparatively stable at 1.731-2.554 points. ROC-derived cutoffs were 2-3 points under the prespecified definitions and 5 points under the stricter definitions. In the exploratory FOIS analysis, there was no evidence that the contrast between exactly 1-level and exactly 2-level improvement varied by baseline FOIS level (P for interaction = 0.776); findings were similar when restricted to baseline FOIS levels 2-5 (P = 0.503). Clinically important change in the MBSImP pharyngeal total score depended on the anchor definition and intended interpretation. Under the prespecified anchor definitions, average-change estimates were approximately 3 points, whereas stricter functional or swallowing-safety improvement definitions showed estimates close to 5 points. In contrast, change-difference estimates w","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Styloid Process Elongation and Swallowing-associated Symptoms: A Scoping Review.","authors":"Gmnc Ravazzi, M S Kuczera, J S Germiniani, A X Ferraz, W V Nascimento, C M Araujo, R S Sampaio, Flávio Magno Gonçalves, J Stechman-Neto","doi":"10.1007/s00455-026-11016-4","DOIUrl":"https://doi.org/10.1007/s00455-026-11016-4","url":null,"abstract":"<p><p>This scoping review aimed to systematically map the range of swallowing-associated symptoms reported in adults with styloid process elongation and to characterize how the available literature assessed swallowing. The review followed PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidance and the JBI (Joanna Briggs Institute) methodology for scoping reviews. Searches were conducted in EMBASE, PubMed/MEDLINE, Web of Science, Scopus, LILACS, and LIVIVO, as well as in gray literature sources. Eligibility criteria followed the PCC framework: Population (adults aged 18 years or older), Concept (styloid process elongation), and Context (swallowing-associated symptoms). Observational study designs were considered eligible. After removing duplicates, 1,177 unique records were screened; 15 full-text articles were assessed for eligibility, and 12 studies were included in the qualitative synthesis. Most studies did not directly or objectively assess swallowing function; instead, dysphagia, odynophagia, foreign-body sensation, or related pharyngeal complaints were reported as part of broader clinical symptom profiles, imaging investigations or surgical series. Consequently, the available evidence does not establish a definitive causal or associative relationship between styloid process elongation and swallowing dysfunction. Swallowing-associated symptoms are commonly reported in patients with styloid process elongation, but the current literature is heterogeneous and largely based on non-standardized symptom reporting. Prospective studies using standardized dysphagia instruments and objective swallowing assessments are needed to determine whether, and under which anatomical or clinical conditions, styloid process abnormalities contribute to swallowing dysfunction.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Gamified Rehabilitation Interventions in Patients with Post-Stroke Dysphagia: A Meta-Analysis.","authors":"Yongxin Cao, Xiaohan Liu, Jing Zhao, Jie Zhao, Hong Chang","doi":"10.1007/s00455-026-11014-6","DOIUrl":"https://doi.org/10.1007/s00455-026-11014-6","url":null,"abstract":"<p><p>To evaluate the effects of gamified or multicomponent gamified swallowing rehabilitation on functional oral intake and bedside swallowing function in patients with post-stroke dysphagia, and to explore feedback modality, post-stroke duration, and the robustness of the main findings. This meta-analysis was conducted in accordance with the PRISMA guidelines. PubMed, EMBASE, CINAHL, Web of Science, Scopus, the Cochrane Library, CNKI, Wanfang Data, VIP Data, and SinoMed were systematically searched for randomized controlled trials published through December 22, 2025. The Functional Oral Intake Scale (FOIS) was designated as the primary outcome and the Standardized Swallowing Assessment (SSA) as the secondary outcome. All pooled analyses used random-effects models, with exploratory subgroup analyses and leave-one-out sensitivity analyses. Seven RCTs involving 340 participants were included. Gamified or multicomponent gamified swallowing rehabilitation was associated with higher FOIS scores (MD=1.53, 95% CI: 0.58-2.49, P=0.002), with very high between-study heterogeneity (I²=96%). Pooled results from four RCTs showed lower SSA scores after gamified swallowing rehabilitation (MD=- 2.44, 95% CI: - 3.84 to - 1.04, P<0.001; I²=54%). The between-subgroup difference for FOIS according to sEMG use was not statistically significant (P=0.39), whereas the SSA subgroup difference was statistically significant (P=0.01). After excluding Hou et al. (2024) in the sensitivity analysis, the direction of the FOIS effect remained unchanged (MD=1.04, 95% CI: 0.46-1.61, P=0.0004; I²=85%). Current evidence suggests that gamified swallowing rehabilitation may improve FOIS and SSA outcomes in patients with post-stroke dysphagia. However, the number of included studies and participants was limited, heterogeneity for FOIS was very high, several studies had a high risk of bias, and multiple co-intervention components made the independent effect of gamification difficult to isolate. Findings from the sEMG and post-stroke-duration subgroups should therefore be considered exploratory. Further high-quality studies are needed to optimize intervention strategies and reduce heterogeneity.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice Variation in Flexible Endoscopic Evaluation of Swallowing (FEES): An International Survey.","authors":"Yuval Nachalon, Lisa M Evangelista, Dan S Lang, Doron Zaliat, Nogah Nativ-Zeltzer","doi":"10.1007/s00455-026-11012-8","DOIUrl":"https://doi.org/10.1007/s00455-026-11012-8","url":null,"abstract":"<p><p>Flexible endoscopic evaluation of swallowing (FEES) is a cornerstone of instrumental dysphagia assessment, yet substantial practice variation has been documented across clinical settings. This study aimed to characterize variation in FEES protocols and examine associations between clinician and professional characteristics, practice patterns, and confidence in interpreting clinical findings. An online survey was completed by 109 professionals with FEES experience. The final analytic sample included 97 participants. The survey assessed demographic and professional background, protocol components, examination duration, and self-rated confidence in clinical judgements. Substantial heterogeneity was found across FEES protocol components, including inconsistent incorporation of sensory testing, variable dye use, and diverse rating scale adoption. The Penetration-Aspiration Scale was used by 98.9% of respondents, while other scales showed lower adoption rates. Confidence was highest for judging aspiration presence and lowest for aspiration depth. Greater FEES-specific experience was associated with shorter examination duration (p = 0.03), but neither years of experience nor education level significantly predicted overall confidence in judgment. Physician status and higher education were significantly associated with performing formal sensory testing. FEES is implemented with considerable variability in clinical practice. Confidence in judgment appears to be influenced by the complexity of the clinical finding and the availability of structured rating tools rather than by experience or education alone. These findings support the need for clearer definition of core protocol components, development of standardized tools for complex swallowing parameters, and systematic evaluation of training models.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Verbal Cues Enhance Respiratory-Swallow Coordination for Individuals Following Head and Neck Cancer?","authors":"Michelle Lawton, Michael Drinnan, Chris Ward, Brian Saccente-Kennedy, Joanne Patterson","doi":"10.1007/s00455-026-11013-7","DOIUrl":"https://doi.org/10.1007/s00455-026-11013-7","url":null,"abstract":"<p><p>Atypical respiratory-swallow coordination is associated with increased aspiration risk and swallow inefficiency. While verbal cueing has been shown to influence respiratory-swallow coordination in people with Parkinson's disease, its effect in individuals following head and neck cancer remains unclear. This study aimed to explore the effect of verbal cuing on respiratory-swallow coordination in this population. A prospective, with-in subjects' design was employed. Respiratory Inductance Plethysmography, nasal airflow and submental electromyograms were used to capture respiratory-swallow patterning, lung volume at swallow initiation (LVSI) and respiratory pause duration. Participants were verbally cued to swallow at four different points within tidal breathing: high inhalation, low inhalation, high exhalation, low exhalation. Non-cued swallow trials served as a control condition. Eighteen participants contributed a total of 360 analysable swallow trials. A significant increase was observed in optimal phasing (exhale-swallow-exhale) in the high inhalation and high exhalation cued conditions, compared to the non-cued condition OR [95% CI] = 4.74 [1.86, 12.09]; OR [95% CI] = 2.55 [1.11, 5.86] respectively. Verbal cueing significantly increased LVSI at low inhalation relative to non-cued swallows by 19%. In contrast, verbal cues at high and low exhalation significantly decreased LVSI, with mean decreases of 28% and 32%, respectively. This study shows that verbal cueing influences respiratory-coordination in individuals with head and neck cancer and suggests cuing at high inhalation is more likely to elicit optimal respiratory-swallow coordination (exhale-swallow-exhale pattern initiated at mid tidal lung volumes), highlighting the potential for introducing targeted cueing strategies to enhance respiratory-swallow coordination.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory-swallowing Measures and the Impact of Bolus Hold in Individuals with Parkinson's Disease.","authors":"Rabab Rangwala, Bonnie Martin-Harris, Jungwha Julia Lee, Danny Bega, Cagla Kantarcigil","doi":"10.1007/s00455-026-11004-8","DOIUrl":"https://doi.org/10.1007/s00455-026-11004-8","url":null,"abstract":"<p><p>Respiratory and swallowing impairments are common in Parkinson's disease (PD), potentially disrupting respiratory-swallow coordination. This study aimed 1) to examine respiratory-swallowing phase patterns and respiratory cessation duration in individuals with PD across varying bolus consistencies and swallow tasks, and 2) to investigate the influence of the 'bolus hold' verbal cue on these measures. Twenty individuals with PD (mean age = 71.7 years, 6 female) completed 14 swallow trials with varying bolus consistencies (thin, nectar, honey, pudding, solid) and tasks (5mL, 20mL) with each trial presented twice. Respiratory kinematic and airflow measures were recorded using respiratory inductance plethysmography and nasal cannula. Descriptive statistics, estimating equations, and linear models were used to analyze the effects of bolus consistency, swallow task, and bolus hold on phase patterns and cessation duration. Participants exhibited sub-optimal respiratory-swallowing phase patterns but optimal cessation durations, compared to healthy adults. Trends indicated that thicker and smaller boluses were associated with increased EX-EX patterns, and thicker consistencies, nectar (p = 0.049), honey (p = 0.002), pudding (p = 0.002), significantly shortened cessation durations compared to thin liquids. The bolus hold condition trended towards optimal patterns and shorter cessation durations, with significant changes in pattern for thin 5mL (p = 0.035), thin cup sip 20mL (p = 0.020), and pudding (p = 0.025) consistencies, and in cessation duration for thin cup sip 20 mL swallows (p = 0.014). Understanding how these factors contribute to respiratory phase patterns and cessation durations, critical elements for airway protection and bolus clearance, has significant implications for clinical instructions and strategies used with individuals with PD during swallowing rehabilitation.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardization of the Japanese Pediatric Eating Assessment Tool (PediEAT-J): Age-based Norms, Developmental Trajectories and a Clinical Cut-off for Early Screening.","authors":"Tatsuya Nakamura, Junpei Fujimoto, Koichi Ayuzawa, Fumi Onoue, Asako Kaneoka, Suzanne Thoyre, Yosuke Kita","doi":"10.1007/s00455-026-11011-9","DOIUrl":"https://doi.org/10.1007/s00455-026-11011-9","url":null,"abstract":"<p><p>Feeding and swallowing difficulties in early childhood can significantly impact growth and family well-being. Currently, Japan lacks specific screening norms for these issues. To address this gap, we standardized the Japanese version of the Pediatric Eating Assessment Tool (PediEAT-J) and established a clinical cut-off based on caregiver data from 697 children aged 6 to 77 months. Among these, 662 children were typically developing (TD), and 35 had identified feeding problems. Descriptive statistics were calculated for the TD group, with raw scores converted into T-scores (mean = 50, SD = 10). Developmental patterns varied across subscales: Physiologic Symptoms decreased significantly after 12 months; Problematic Mealtime Behaviors peaked at 30-36 months; Selective/Restrictive Eating was most common during early weaning; and Oral Processing was highest at 15-18 months. Receiver operating characteristic (ROC) analysis yielded an area under the curve of 0.835, with optimal cut-offs of 0.74 for sensitivity and 0.84 for specificity. These findings provide the first age-stratified norms for the Japanese population and enable rapid, culturally relevant screening for feeding risks, facilitating early interventions and cross-cultural comparisons in feeding development.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discriminating Isolated Pill Dysphagia from General Oropharyngeal Dysphagia: Psychometric Properties of the Turkish PILL-5.","authors":"Harun Ayas, Müge Müzeyyen Çiyiltepe","doi":"10.1007/s00455-026-11010-w","DOIUrl":"https://doi.org/10.1007/s00455-026-11010-w","url":null,"abstract":"<p><p>Pill swallowing difficulty may occur as an isolated phenotype despite preserved food and liquid swallowing and may require different clinical pathways than general oropharyngeal dysphagia. We translated, culturally adapted, and validated the Turkish PILL-5 (PILL-5(TR)) and tested its ability to discriminate isolated pill swallowing difficulty from healthy adults and oropharyngeal dysphagia. We performed forward-back translation, expert committee review, and cognitive debriefing (n = 30). Adults (N = 348) were classified as healthy controls (n = 175), isolated pill swallowing difficulty (Functional Oral Intake Scale, FOIS = 7; n = 107), or oropharyngeal dysphagia (n = 66). We evaluated internal consistency, test-retest reliability (n = 48; 7-14 days), structural validity using exploratory factor analysis and common-factor-based parallel analysis, convergent validity with the Eating Assessment Tool-10 (EAT-10), the Swallowing Quality of Life questionnaire (SWAL-QOL), and the Dysphagia Handicap Index (DHI), and screening discrimination using receiver operating characteristic (ROC) analyses. PILL-5(TR) showed strong known-groups separation (means: 0.37, 5.81, and 10.47; p < 0.001), and the combined factor-analytic findings supported a predominantly unidimensional structure. Reliability was good (Cronbach's α = 0.865; intraclass correlation coefficient (ICC) = 0.869). In the clinical sample, PILL-5(TR) correlated strongly with EAT-10 (Spearman's ρ = 0.749), moderately with DHI (ρ = 0.387), and inversely with SWAL-QOL (ρ=-0.482) (all p < 0.001). In the study sample, discrimination between isolated cases and healthy controls was excellent (area under the ROC curve [AUC] = 0.992; preliminary threshold ≥ 2; sensitivity 1.00; specificity 0.87), while discrimination between oropharyngeal dysphagia and isolated cases was acceptable (AUC = 0.793; preliminary threshold ≥ 7; sensitivity 0.82; specificity 0.71). PILL-5(TR) is a valid and reliable pill-specific patient-reported measure. The preliminary thresholds may help inform pill-focused screening, triage, and medication-safety counselling in Turkish-speaking populations, but require external validation in more heterogeneous clinical samples.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Saliva in Swallowing: A Systematic Review.","authors":"Jenni Wu, Rebecca Affoo, Danielle Brates, Frank Day, Eva Moffett, Heidi Kletzien, Mary Hitchcock, Michael S Pulia, Nadine P Connor, Nicole Rogus-Pulia","doi":"10.1007/s00455-026-10995-8","DOIUrl":"10.1007/s00455-026-10995-8","url":null,"abstract":"<p><p>Saliva plays a critical role in swallowing by lubricating tissues and helping form and transport the food bolus. While low saliva production (hyposalivation) is linked to difficulty swallowing, emerging evidence shows that changes in saliva's physical and chemical properties may also affect swallowing. However, the mechanisms underlying these relationships remain poorly understood. The aim of this systematic review was to explore relationships between saliva and swallowing by reviewing studies that provided objective measurements of both saliva production and swallowing biomechanics. A comprehensive search of Medline (Ovid and PubMed), CINAHL, Web of Science, and Scopus was conducted, covering all records from database inception through August 22, 2025. We included studies that reported objective measures of saliva-such as flow rate, volume, thickness, pH, and biomarkers-and swallowing biomechanics. Three independent reviewers carried out two stages of screening, reviewed full texts, extracted data, and evaluated the quality of the methods using a modified Oxford Centre for Evidence-Based Medicine (OCEBM) scale. Most studies used a cross-sectional study design and were rated a \"4\" according to the OCEBM scale. In many studies, higher salivary flow rates were linked to increased spontaneous swallowing frequency in healthy adults. However, associations between saliva flow and specific swallowing biomechanical measures were not consistent. Lower levels of the neuropeptide substance p were associated with swallowing difficulties in several patient groups, but results varied across studies. The identified evidence suggests that salivary flow and neuropeptides may impact swallowing function, especially sensory function and spontaneous swallowing frequency. However, these relationships were inconsistent. Differences in the patient populations, saliva collection methods, and swallowing assessments made data synthesis between studies difficult. More standardized, long-term research is necessary to elucidate saliva's role in swallowing and improve clinical assessments for people with salivary dysfunction and dysphagia.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Related Heterogeneity in the Association of Repetitive Peripheral Magnetic Stimulation With Swallowing Recovery: A Retrospective Propensity Score-Matched Study.","authors":"Minako Hashimoto, Shinsuke Nagami, Yuka Tomura, Yoshiyuki Hashimoto, Yuhei Kodani","doi":"10.1007/s00455-026-10993-w","DOIUrl":"https://doi.org/10.1007/s00455-026-10993-w","url":null,"abstract":"<p><p>Repetitive peripheral magnetic stimulation (rPMS) has been used in dysphagia rehabilitation, but comparative evidence and treatment heterogeneity remain unclear. We conducted a single-center retrospective propensity score-matched cohort study of inpatients undergoing dysphagia rehabilitation. Patients treated with rPMS plus individualized usual rehabilitation were matched 1:1 to historical controls treated before rPMS implementation (50 vs. 50). The primary outcome was change in Food Intake LEVEL Scale (FILS) from admission to discharge. Age-related heterogeneity was examined using a treatment-by-age interaction and exploratory stratified analyses (< 80 vs. ≥ 80 years). One control patient lacked discharge FILS and was excluded from the primary analysis (n = 99). Overall, rPMS was not associated with greater FILS improvement (+ 0.48, 95% confidence interval - 0.26 to 1.22; p = 0.202). Exploratory interaction analysis suggested age-related heterogeneity (interaction p = 0.008): in stratified analyses, rPMS was associated with greater improvement among patients aged < 80 years (+ 1.70, 95% confidence interval 0.34 to 3.07; p = 0.015), whereas no association was observed among patients aged ≥ 80 years (-0.52, 95% confidence interval - 1.44 to 0.39; p = 0.258). Cognitive and total Functional Independence Measure change scores were higher in the rPMS group, but residual confounding remained plausible. In this matched observational study, rPMS was not associated with overall improvement in functional oral intake measured by FILS. Exploratory analyses generated a hypothesis of possible age-related heterogeneity, but this signal should not justify age-based treatment selection.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}