Respiratory-swallow coordination training using bimodal signal biofeedback for patients with post-stroke dysphagia: a randomized controlled trial.

In 30 seconds

This randomized controlled trial evaluated whether adding bimodal signal biofeedback-based respiratory-swallow coordination training to conventional rehabilitation improved swallowing in patients with post-stroke dysphagia. Thirty patients were assigned to conventional rehabilitation alone or rehabilitation plus training delivered for 30 minutes daily, six days per week, for two weeks. Both groups improved on the Functional Oral Intake Scale (FOIS), but improvement was greater with added training at treatment completion and one-month follow-up (p < 0.001). The experimental group also had a lower proportion with PAS scores ≥6 after treatment and more optimal respiratory-swallow patterns.

Key findings

• FOIS improvement was greater with added training than with conventional rehabilitation at post-treatment and one-month follow-up (p < 0.001).
• A ≥2-point FOIS increase occurred in a significantly higher proportion of the experimental group at post-treatment and follow-up (both p < 0.01).
• After two weeks, the experimental group had a lower percentage of PAS scores ≥6 than controls (p < 0.001).
• Optimal respiratory-swallow patterns were more frequent with added training than with conventional rehabilitation (p < 0.001).

Why it matters

Post-stroke dysphagia can affect oral intake and airway protection. This trial suggests that targeting coordination between breathing and swallowing with biofeedback may improve functional intake and swallowing-related measures beyond conventional rehabilitation alone, with differences also reported at one-month follow-up. The findings support further consideration of respiratory-swallow coordination as a rehabilitation target, while the small trial warrants cautious interpretation.

What to keep in mind

Only 30 patients were enrolled, and follow-up was limited to one month.