| ObjectiveNonpharmacological interventions are the recommendation for dysphagia after Stroke,according to current guidelines.There are many forms of nonpharmacological interventions for dysphagia after Stroke,but the preferred means remain controversial and are not stated in the guidelines.Therefore,we evaluated the comparative effects and ranks of all major nonpharmacological interventions,according to different assessment methods,in stroke patients with deglutition disorders.MethodsThe Cochrane Central Register of Controlled Trials(CENTRAL)、EMbase、Medline、China National Knowledge Infrastructure(CNKI)、Chinese Biomedical Database(CBM)、Wanfang Database、Chinese Scientific Journal Database(VIP),were searched for randomized controlled trials on nonpharmacological treatments for Dysphagia after Stroke.We assessed the trials’ methodological quality using the Cochrane Risk of Bias tool.A Bayesian network meta-analysis and a comparative effects ranking were performed with Aggregate Data Drug Information System software.ResultsA total of 5267 items were obtained from the databases,and 53 studies comprising 5270 participants were included in the analysis.Based on the ranking probabilities,improved swallowing therapy with electrical stimulation,peripheral magnetic stimulation and EMG biofeedback are best with Standardized Swallowing Assessment;for Water swallow test and effective rate,acupuncture with deep insertion ranked best;as for the VFSS,combined psychosocial therapies ranked best.Most of the included studies had unclear risk of methodological quality problems.ConclusionDifferent interventions have their own sets of advantages for addressing Dysphagia after Stroke.These results can be utilized as evidence-based interventions for healthcare workers and patients to manage Stroke.While as for the unclear risk of methodological quality problems,the accuracy of the results needs further confirmation and the quality of the RCT needs to be improved. |
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