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Restorative Exercise Models in Dysphagia and Obstructive Sleep Apnea: A Review

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      Objective(s)

      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 are discussed.

      Data Sources

      Literature was identified using hand-searched and database-driven methods from PubMed, Google Scholar, and Medline.

      Study Selection

      (1) systematic reviews/meta-analysis; (2) author(s) quantified measures of article strengths/weaknesses; (3) published after 2011; (4) available in English.

      Data Extraction

      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.

      Data Synthesis

      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.

      Conclusions

      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.

      Author(s) Disclosures

      Nicholas Stocker is first author, Laura L.O. Froeschke is second author, Raymond Kraus is third author.

      Keywords

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