Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trials
BackgroundResistance exercise shows potential for improving swallowing function in post-stroke dysphagia (PSD), though optimal dose-response parameters remain unclear. While the American College of Sports Medicine (ACSM) framework effectively guides exercise prescriptions in healthy populations, its...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2025.1623298/full |
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| author | Yu Ye Kairui Wu Yingquan Liu Hongjie Ji Hongtao Li Bo Jiang Fangyuan Xu Xuejun Li Peijia Hu Hongliang Cheng |
| author_facet | Yu Ye Kairui Wu Yingquan Liu Hongjie Ji Hongtao Li Bo Jiang Fangyuan Xu Xuejun Li Peijia Hu Hongliang Cheng |
| author_sort | Yu Ye |
| collection | DOAJ |
| description | BackgroundResistance exercise shows potential for improving swallowing function in post-stroke dysphagia (PSD), though optimal dose-response parameters remain unclear. While the American College of Sports Medicine (ACSM) framework effectively guides exercise prescriptions in healthy populations, its application to PSD rehabilitation lacks meta-analytical validation. This study evaluates varying resistance exercise dosages on swallowing outcomes in PSD patients.MethodsWe systematically searched PubMed, Embase, Web of Science, and Cochrane for randomized controlled trials (RCTs) investigating resistance training in PSD. Interventions were stratified using ACSM compliance criteria (6/8 and 7/8 thresholds) into high-adherence versus low/uncertain-adherence groups. Subgroup analyses employed random-effects meta-analyses.ResultsAnalysis included 19 RCTs (n = 566). Using 6/8 ACSM criteria, 11 studies comprised the high-adherence group and eight the low/uncertain group. High-adherence interventions demonstrated improved positively oriented scores [SMD = −1.72 (95% CI −3.26 to −0.18)], enhanced safety [SMD = −0.93 (95% CI −1.54 to −0.32)], and worsened negatively oriented scores [SMD = 2.27 (95% CI 0.66–3.87)]. Low-adherence groups showed non-significant improvements in positively oriented scores [SMD = −0.47 (95% CI −1.02 to 0.09)], negatively oriented scores [SMD = 0.43 (95% CI −0.09–0.94)], and safety [MD = −1.85 (95% CI −3.83 to 0.13)]. Applying stricter 7/8 criteria reclassified nine studies as high-adherence and 10 as low/uncertain. High-adherence groups exhibited greater positively oriented scores improvement [SMD = −2.15 (95% CI −4.11 to −0.20)], safety enhancement [MD = −1.05 (95% CI −1.58 to −0.51)], and negatively oriented scores decline [SMD = 2.85 (95% CI 0.82–4.89)]. Low-adherence groups maintained non-significant outcomes: positively oriented scores [SMD = −0.33 (95% CI −0.75 to 0.10)], negatively oriented scores [SMD = 0.32 (95% CI −0.09–0.74)], and safety [MD = −1.39 (95% CI −2.84 to 0.07)].ConclusionResistance exercise demonstrates superior therapeutic effects over non-resistance interventions for PSD. High adherence to ACSM-recommended dosages yields significantly greater improvements in swallowing function and safety compared to low/uncertain adherence regimens. These findings validate the clinical utility of ACSM guidelines for optimizing resistance exercise prescriptions in PSD rehabilitation.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251041450. |
| format | Article |
| id | doaj-art-d535c687ec3b465eb10989a76db59435 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-08-01 |
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| spelling | doaj-art-d535c687ec3b465eb10989a76db594352025-08-20T03:44:27ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-08-011610.3389/fphys.2025.16232981623298Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trialsYu Ye0Kairui Wu1Yingquan Liu2Hongjie Ji3Hongtao Li4Bo Jiang5Fangyuan Xu6Xuejun Li7Peijia Hu8Hongliang Cheng9Graduate School of Anhui University of Chinese Medicine, Anhui, ChinaGraduate School of Anhui University of Chinese Medicine, Anhui, ChinaGraduate School of Anhui University of Chinese Medicine, Anhui, ChinaGraduate School of Anhui University of Chinese Medicine, Anhui, ChinaGraduate School of Guangzhou University of Chinese Medicine, Guangdong, ChinaGraduate School of Anhui University of Chinese Medicine, Anhui, ChinaGraduate School of Anhui University of Chinese Medicine, Anhui, ChinaThe Second Affiliated Hospital of Anhui University of Chinese Medicine, Anhui, ChinaThe Second Affiliated Hospital of Anhui University of Chinese Medicine, Anhui, ChinaThe Second Affiliated Hospital of Anhui University of Chinese Medicine, Anhui, ChinaBackgroundResistance exercise shows potential for improving swallowing function in post-stroke dysphagia (PSD), though optimal dose-response parameters remain unclear. While the American College of Sports Medicine (ACSM) framework effectively guides exercise prescriptions in healthy populations, its application to PSD rehabilitation lacks meta-analytical validation. This study evaluates varying resistance exercise dosages on swallowing outcomes in PSD patients.MethodsWe systematically searched PubMed, Embase, Web of Science, and Cochrane for randomized controlled trials (RCTs) investigating resistance training in PSD. Interventions were stratified using ACSM compliance criteria (6/8 and 7/8 thresholds) into high-adherence versus low/uncertain-adherence groups. Subgroup analyses employed random-effects meta-analyses.ResultsAnalysis included 19 RCTs (n = 566). Using 6/8 ACSM criteria, 11 studies comprised the high-adherence group and eight the low/uncertain group. High-adherence interventions demonstrated improved positively oriented scores [SMD = −1.72 (95% CI −3.26 to −0.18)], enhanced safety [SMD = −0.93 (95% CI −1.54 to −0.32)], and worsened negatively oriented scores [SMD = 2.27 (95% CI 0.66–3.87)]. Low-adherence groups showed non-significant improvements in positively oriented scores [SMD = −0.47 (95% CI −1.02 to 0.09)], negatively oriented scores [SMD = 0.43 (95% CI −0.09–0.94)], and safety [MD = −1.85 (95% CI −3.83 to 0.13)]. Applying stricter 7/8 criteria reclassified nine studies as high-adherence and 10 as low/uncertain. High-adherence groups exhibited greater positively oriented scores improvement [SMD = −2.15 (95% CI −4.11 to −0.20)], safety enhancement [MD = −1.05 (95% CI −1.58 to −0.51)], and negatively oriented scores decline [SMD = 2.85 (95% CI 0.82–4.89)]. Low-adherence groups maintained non-significant outcomes: positively oriented scores [SMD = −0.33 (95% CI −0.75 to 0.10)], negatively oriented scores [SMD = 0.32 (95% CI −0.09–0.74)], and safety [MD = −1.39 (95% CI −2.84 to 0.07)].ConclusionResistance exercise demonstrates superior therapeutic effects over non-resistance interventions for PSD. High adherence to ACSM-recommended dosages yields significantly greater improvements in swallowing function and safety compared to low/uncertain adherence regimens. These findings validate the clinical utility of ACSM guidelines for optimizing resistance exercise prescriptions in PSD rehabilitation.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251041450.https://www.frontiersin.org/articles/10.3389/fphys.2025.1623298/fullpost-stroke dysphagiaresistance exerciseACSM recommendationsexercise doseswallowing functionswallowing safety |
| spellingShingle | Yu Ye Kairui Wu Yingquan Liu Hongjie Ji Hongtao Li Bo Jiang Fangyuan Xu Xuejun Li Peijia Hu Hongliang Cheng Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trials Frontiers in Physiology post-stroke dysphagia resistance exercise ACSM recommendations exercise dose swallowing function swallowing safety |
| title | Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trials |
| title_full | Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trials |
| title_fullStr | Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trials |
| title_full_unstemmed | Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trials |
| title_short | Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trials |
| title_sort | effects of resistance exercise on patients with post stroke dysphagia based on acsm recommendations a systematic review of randomized controlled trials |
| topic | post-stroke dysphagia resistance exercise ACSM recommendations exercise dose swallowing function swallowing safety |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2025.1623298/full |
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