Dosages of Swallowing Exercises Prescribed in Stroke Rehabilitation: A Medical Record Audit.
Jacinda Choy, Fereshteh Pourkazemi, Caitlin Anderson and 1 others
PMID 35951119WHAT IT FOUND
A medical record audit of 42 patients with post-stroke dysphagia found that swallowing exercise dosages were inconsistent and lower than in research studies.
In the statistical analysis, patient age predicted improvement in oral intake, but the number of exercise repetitions did not.
Key findings
01Frequency, duration, and exercise type were routinely reported in medical records, but intensity, session time, and home exercise adherence were inconsistently recorded.
02Patients received a median of 44.5 swallowing exercise repetitions per session, with indirect exercises prescribed far more frequently than direct swallow-specific exercises.
03In regression analysis, age was the only factor significantly associated with improvement in the Functional Oral Intake Scale; the number of exercise repetitions per day was not.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was small (42 patients), which reduced statistical power and may explain the lack of association between dosage and outcome. The study was conducted at a single site with limited speech pathology staffing (1.5 full-time equivalent across all wards), so results may not reflect broader practice. Retrospective data collection means that actual clinical practice may not have been fully captured, particularly regarding exercise intensity and home adherence. The patient population had mild-to-moderate dysphagia (83% had a FOIS of 5 on admission), so findings may not apply to more severe cases. The measure of dosage (mean repetitions per day) did not account for the rate of dosing or differences in exercise difficulty.
Declared interests
The study received support from a non-U.S. government source. No specific commercial funding or conflicts of interest were declared by the authors in the provided text.
The easy way to misread this
Do not conclude that swallowing exercise dosage is ineffective because it did not predict improvement in this study. The analysis was underpowered due to a small sample size, and the authors explicitly state that the lack of statistical significance may be due to these methodological limitations rather than a true absence of effect.