Dose in Exercise-Based Dysphagia Therapies: A Scoping Review.

This was a scoping review, not a systematic review with formal quality appraisal. It maps what was reported rather than proving that any dose works. The included studies used different exercises, patient groups, dose combinations and outcome measures. Direct comparisons between doses were not possible. Only 79% of included articles reported all four dose components. The authors express concern about reproducibility of the remaining studies. The search included peer-reviewed articles up to July 2019. Unavailable full texts were excluded. Single cases, case series with fewer than 10 people, treatments shorter than 4 weeks, and exercise combined with stimulation were excluded. Outcome methods were inconsistent, including different ways of scoring videofluoroscopy and custom measures. Pooled conclusions about treatment effects were not possible.

The supplied article text does not include a conflict-of-interest declaration. The publication type lists research support from NIH extramural funding.

Do not read the tables as proof that a specific swallowing exercise dose is effective. The review did not appraise study quality, the studies used very different doses and outcomes, and the authors state that no best or most effective dose could be determined.