Preventive measures for the progression of dysphagia in patients with cancer of head and neck subjected to radiotherapy: a systematic review with meta-analysis.
Amanda Guterres Beuren, Émille Dalbem Paim, Nathália da Silva Flores and 2 others
PMID 37132697WHAT IT FOUND
Swallowing exercises during radiotherapy for head and neck cancer improved oral intake scores in a meta-analysis of two trials with 33 patients per arm.
Two of the four included studies found no benefit, and the evidence is rated low quality.
Key findings
01The meta-analysis found that the exercise group had higher Functional Oral Intake Scale scores than the control group (mean weighted difference 1.27, 95% CI 0.74 to 1.80; Cohen D 3.17), based on two studies with 33 patients per arm.
02The four included studies were split: two reported benefit and two found no significant difference in swallowing function.
03The quality of evidence was rated low due to risk of bias (no blinding of participants or therapists) and imprecision from small samples and 34% dropout.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 4 studies were identified and only 2 could be pooled in the meta-analysis. 33 patients per arm in the meta-analysis is a very small sample. 34% of participants dropped out across the studies. Neither participants nor therapists were blinded in any of the four studies. The exercise protocols differed substantially between studies (different exercises, frequencies, and durations). Low adherence to the exercises was reported as a confounding factor. GRADE quality of evidence was rated low due to risk of bias and imprecision.
The easy way to misread this
Do not read the positive meta-analysis as proof that swallowing exercises prevent dysphagia progression. It pooled only two studies with 33 patients per arm, 34% dropped out, neither group was blinded, and the two other included studies found no benefit. The specific exercises varied between studies and adherence was low.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →