Restorative dysphagia exercise approaches hold merit in research and practice within
speech-language pathology given strong evidence for targeted interventions leading
to improved deglutition. Restorative exercise approaches for obstructive sleep apnea
(OSA) share common anatophysiologic bases with dysphagia; however, have received limited
scientific attention to establish their utility as non-invasive treatment alternatives
for OSA. Researchers’ primary aim was to provide a summary of the current state-of-science
on the biomechanics of OSA with a summary of therapeutic targets relative to muscle
physiology. A secondary aim was assessing the physiologic adaptations following restorative
dysphagia exercise relative to exercise models for treatment of OSA for comparative
analysis. Clinical research and scope-of-practice implications of exercise benefits
reflected in similar biomechanical profiles and muscular adaptations in OSA and dysphagia
Literature was identified using hand-searched and database-driven methods from PubMed,
Google Scholar, and Medline.
(1) systematic reviews/meta-analysis; (2) author(s) quantified measures of article
strengths/weaknesses; (3) published after 2011; (4) available in English.
Authors independently assessed articles for eligibility and evidence strength using
The Scottish Intercollegiate Guidelines Network (SIGN) tool. Average SIGN ratings
across intervention categories were obtained.
Study results were categorized and assessed for strength of evidence with SIGN and
conclusions on therapeutic targets and the physiologic adaptations relative to specific
targets. A majority of studies were systematic reviews and meta-analyses. Researchers
identified sources of variation and consistency in outcome measures across studies,
leading to a quantitative and qualitative synthesis of findings within dysphagia and
OSA outcome measures.
Preliminary findings point to potential adjuvant treatment avenues in some patients
with OSA and potential co-recruitment of OSA-related muscles during restorative dysphagia
exercises. Findings point to common therapeutic targets and anatophysiologic goals
within dysphagia and OSA exercise interventions.
Nicholas Stocker is first author, Laura L.O. Froeschke is second author, Raymond Kraus
is third author.