The Influence of Physical Exercise on Head and Neck Structures and Functions Related to Swallowing: A Scoping Review Protocol.

Background: Dysphagia (swallowing impairment) can lead to malnutrition, dehydration, aspiration pneumonia, social isolation and even death. Current interventions for dysphagia include rehabilitation that improves swallowing physiology and function. Physical exercise is known to directly benefit skeletal muscles and may also benefit non-targeted skeletal muscles involved in swallowing, as these muscles are often engaged during vigorous exercise. Implementing physical exercise as a dysphagia intervention may help counteract sarcopenic dysphagia and delay symptoms associated with frailty. The objective of this review is to describe current evidence exploring the impact of different forms of physical exercise on structures and functions related to swallowing in both adult humans and animals.

Methods: This study will use PRISMA-ScR protocol guidelines and JBI methods to ensure proper reporting. Quantitative studies (experimental and quasi-experimental study designs) and case studies/series that examined either mature animal models or adults who engaged in physical exercise programs. This review will assess any physiological or functional changes to the head and neck structures involved in swallowing assessed by swallowing-related outcome measures and consider physical exercise programs for the intervention. Studies that include children do not provide details regarding exercises (e.g., dose and type of exercise), or qualitative studies will be excluded. The following databases were searched on 7 April 2024 by an experienced health sciences librarian: MEDLINE, Embase, CINAHL and Scopus. English language articles will be included in the review with no restrictions on publication date. Title and abstract screening will be performed, followed by full-text screening according to the inclusion criteria. Data regarding type and dose of exercise, along with its effect on the structures involved in swallowing, will be extracted using a proposed data charting tool and presented in tables and figures as appropriate.

Discussion: This scoping review aims to comprehensively describe existing literature examining the relationship between physical exercise and swallowing-related structures and functions. A detailed synthesis of the current evidence is essential to advance multidisciplinary approaches to dysphagia care, including the integration of physical exercise. Such efforts will enable clinicians to take proactive steps in supporting adults to maintain swallowing function.

Review Registration Number: Open Science Framework: https://osf.io/w98t6/ WHAT THIS PAPER ADDS?: What is already known on this subject Currently, there are various head-and-neck specific exercises that manage and improve dysphagia. While these interventions are effective, they are not easily accessible to patients, making it challenging to integrate them into their daily routines without access to speech-language pathologists, who are often underfunded. Physical exercise helps maintain targeted muscles; however, evidence on whether these benefits extend to non-targeted muscles remains limited. What this paper adds to existing knowledge This protocol provides a comprehensive synthesis of the existing evidence on the relationship between physical exercise and swallowing-related structures and functions. The resulting scoping review will inform researchers of key areas for future research. What are the potential or actual clinical implications of this work? This scoping review will provide speech-language pathologists with the existing literature regarding the role of physical exercise on swallowing. This will allow clinicians to adapt current interventions to include interdisciplinary approaches, such as physical exercise, into dysphagia care.