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Review
. 2024 Mar;281(3):1069-1081.
doi: 10.1007/s00405-023-08280-7. Epub 2023 Oct 16.

Effect of respiratory training on swallowing function in swallowing disorders: a systematic review and meta-analysis

Yinuo Dai #  1 , Jianzheng Cai #  1 , Haifang Wang  2 , Yingying Zhang  3 , Chunyan Niu  1 , Yalan Wang  1
Affiliations
Review

Effect of respiratory training on swallowing function in swallowing disorders: a systematic review and meta-analysis

Yinuo Dai et al. Eur Arch Otorhinolaryngol. 2024 Mar.

Abstract

Purpose: To determine the clinical efficacy of different respiratory training interventions on swallowing function in patients with swallowing disorders through the systematic review.

Methods: We reviewed the literature regarding the application of respiratory training therapy in patients with swallowing disorders, followed by a PRISMA search of published literature in five databases (PubMed, Web of Science, The Cochrane Library, CINAHL and EMBASE) in December 2022. Two reviewers performed study selection, quality evaluation, and risk of bias, followed by data extraction and detailed analysis.

Results: A total of six randomized controlled studies with a total sample size of 193 cases were included. Respiratory training improved swallowing safety (PAS (n = 151, SMD = 0.69, 95% CI - 1.11 to - 0.26, I2 = 36, p < 0.001)) and swallowing efficiency [residual (n = 63, SMD = 1.67, 95% CI - 2.26 to - 1.09, I2 = 23%, p < 0.001)] compared to control groups. The results of the qualitative analysis conducted in this study revealed that respiratory training enhanced hyoid bone movement but had no effect on swallowing quality of life.

Conclusions: Respiratory training interventions may improve swallowing safety and efficiency in patients with dysphagia. However, the level of evidence is low, and there is a limited amount of research on the effectiveness and physiology of this intervention to improve swallowing function. In the future, there is a need to expand clinical studies, standardize measurement tools, and improve study protocols.

Keywords: Breathing exercises; Deglutition disorders; Meta-analysis; Rehabilitation; Respiratory muscles.

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Conflict of interest statement

The authors declare that no commercial or financial conflict of interests.

Figures

Fig. 1
Fig. 1
Flow diagram for article inclusion PRISMA
Fig. 2
Fig. 2
Risk of bias assessment of included studies
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Fig. 3
(GRADE) tool assessment of the quality of the evidence
Fig. 4
Fig. 4
Respiratory training versus control group: Penetration Aspiration Scale
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Fig. 5
Respiratory training versus control group: Functional Dysphagia Scale
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Fig. 6
Respiratory training versus control group: residual
See this image and copyright information in PMC

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