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Master Thesis

Efficacité de quatre exercices de déglutition dans la dysphagie d’origine vasculaire : une méta-analyse

Abstract : Question : This meta-analysis aims at evaluating and summarizing the effects of four swallowing exercises in stroke patients with dysphagia : Expiratory Muscle Strength Training (EMST), Chin Tuck Against Resistance (CTAR), Shaker Exercise and Iowa Oral Performance Instrument (IOPI).
Methods : 566 nonduplicate records were identified by searching EMBASE, Pubmed and the Cochrane Library. Eleven randomised controlled trials were included. The data included basic population characteristics, penetration-aspiration scores (PAS) and mesures of swallowing ability.
Results : Two exercises significantly improved swallowing ability : EMST (Standardized Mean Difference (SMD)= -0.76, 99% CI= -1.39 to -0.12; P=0.002) and IOPI (SMD= -0.62, 99% CI= -1.21 to -0.02 ; P=0.008). CTAR (SMD= -0.80, 99% CI= -1.96 to 0.36; P=0.07) and Shaker exercise (SMD= -0.85, 99% CI=-1.83 to 0.12; P=0.02) did not significantly improve swallowing ability. Three exercises significantly reduced aspiration (assessed as PAS) : EMST (mean difference (MD)= -0.88, 99% Confidence Interval (CI)= -1.58 to -0.19; P=0.001). CTAR (MD= -1.37, 99% CI = -1.98 to -0.76; P<0.00001), and Shaker exercise (MD= -1.17, 99% CI= -1.74 to -0.60 ; P<0.00001). IOPI did not significantly reduce aspiration (assessed as PAS) (MD=-0.26, 99% CI = -1.25 to 0.73; P=0.5).
Conclusion: In dysphagic patients following stroke, EMST and IOPI might have improved swallowing ability. Shaker exercise, CTAR and EMST might have reduced aspiration during swallowing. However, the quality of this evidence remains weak. Further randomized controlled trials involving a larger sample size are needed.
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https://dumas.ccsd.cnrs.fr/dumas-02951524
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Submitted on : Monday, September 28, 2020 - 5:03:55 PM
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Sophie Janicaud. Efficacité de quatre exercices de déglutition dans la dysphagie d’origine vasculaire : une méta-analyse. Sciences cognitives. 2020. ⟨dumas-02951524⟩

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