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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)
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)
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)
  1. Key: Pen/Asp penetration/ aspiration, QOL Quality of Life, LOSH Length of stay in hospital, NI No information, RLNP Recurrent Laryngeal nerve paralysis, AP aspiration pneumonia, AL Anastomatic leak, CG control group, TG treatment group, PS pyrifom sinus, UES Upper oesophageal sphincter, Pts participants, H/e however, F/u Follow up