Effectiveness of swallowing rehabilitation exercises in older adults with swallowing disorders: systematic review and network meta-analysis of randomized controlled trials.

Purpose: This study aimed to evaluate the comparative effectiveness of swallowing rehabilitation exercises in older adults with dysphagia to identify the most beneficial interventions.

Materials And Methods: A systematic review and network meta-analysis were conducted using six databases (PubMed, Embase, CINAHL, Cochrane Library, PsycINFO, and Airiti Library) searched on 15 August 2024. Randomized controlled trials involving adults aged ≥65 years with dysphagia were included. Study characteristics, interventions, and outcomes were extracted, and the Risk of Bias 2.0 tool was used for quality assessment.

Results: The Masako maneuver showed the greatest improvement in dysphagia severity ( = 1.57, : 1.16-1.98). Expiratory muscle strength training (EMST) significantly reduced aspiration risk ( = 0.71, I: 0.35-1.06). Tongue resistance exercises improved anterior (D = 4.24) and posterior tongue strength ( = 4.45). No significant effects were found for upper esophageal sphincter opening, laryngeal closure, or swallowing-related quality of life.

Conclusions: Swallowing rehabilitation exercises offer functional benefits for older adults with dysphagia. Specific exercises target different aspects of swallowing physiology. Further studies are needed to examine long-term efficacy and optimal training combinations.

Systematic Review Registration: This review has been registered in the PROSPERO (CRD42023409297).