Table 3 Summary of Reported Primary and Secondary Outcomes
From: Exercise-based dysphagia rehabilitation for adults with oesophageal cancer: a systematic review
Authors, year | Oral intake | Respiratory | Instrumental Swallow Outcomes | Nutrition | Time to return to oral intake: Days (average +/− SD) | LOHS after surgery: Days (average ± SD) | Quality Assess-ment | Tidier Check-list | ||
|---|---|---|---|---|---|---|---|---|---|---|
Penetration/ Aspiration | Pharyngeal Residue | Biomechanical Change to Swallow | ||||||||
Okumura et al., 2016 [37] | FOAMS scores suggest primary mode of intake prior to and following surgery for all participants was oral means of nutrition. | AP: CG = 3pts (21.4%) TG = 3pts (25%) p = 0.83 Rehospitalisation for pneumonia within 3 months after surgery: CG =3 (21.4%), TG = 0. | Not reported h/e FOAM scores of 4,5,6 post- surgery and post- rehab suggest compensatory strategies needed, which may indicate risk of pen/asp. Number of participants with these scores not provided. | 4 participants had pyriform sinus residue prior to prehabilitation; the volume decreased significantly following prehabilitation, with a p value of 0.047 Between start of rehab post-surgery and post rehab: volume of laryngeal vestibule and PS residue decreased significantly (p values of 0.031 and 0.027, respectively) | From prior to prehab to post prehab, and from post-surgery to post-rehabilitation: the TG’s maximum superior excursion of hyoid bone increased significantly during swallowing with p values of 0.03 and 0.046 respectively. No significant difference between the maximum anterior excursion of the hyoid bone or the anteroposterior diameters of the UES | Not reported. Body weight change 3 months after surgery (%, average +/− SD) was CG: 90.6% +/− 5.5 TG: 91.4% +/−  5.8 (p value = 0.36) | CG: 9.6+/− 5.3 TG: 11+/−  5.5 (P = 0.32) | CG: 32.4 ± 12.2 TG: 36.1 ± 10.7 (p = 0.22) | ROBINS-I: Serious Downs & Black: 13 (poor) | 9 |
Tsubosa et al., 2005 [69] | Data provided not clear. | 1 participant developed ‘severe‘AP. Other severities of AP not mentioned. No post-discharge AP. | Data available for 2 participants only: in 1 participant mild aspiration improved to normal. In 2nd participant, severe penetration and aspiration did not improve, but severe silent aspiration improved to normal. | Limited f/u data available h/e no improvement noted in the 1 participant with mild vallecular and PS residue | NI | NI | One participant: diet recovered to ‘independence’ on the 6th day. Otherwise, unclear when oral intake recommenced. | 25.3 days for 8 participants. 96 days for remaining participant. No further detail given. | ROBINS-I: Critical Downs & Black: 1 (poor) | 5 |
Takatsu et al., 2020 [70] | NI | NI | NI | NI | NI | NI | Start of oral intake significantly earlier in treatment group TG: 8 days (6–13) CG: 11 days (8–14) | CG: 22 days (17–27) TG: 19 days (15–27.5) | ROBINS-I: Serious Downs & Black: 15 (fair) | 10 |