Principles of neural plasticity and motor learning in swallowing exercise protocols for older adults: A mapping...

This study aimed to map swallowing exercise protocols for healthy older adults based on the principles of neural plasticity and motor learning.

The search strategy was run in MEDLINE, CINAHL, Cochrane CENTRAL, Embase, and Web of Science from inception to 6 May 2025. Two researchers independently screened for interventional studies involving swallowing exercises targeting the oropharyngeal, upper oesophageal, and respiratory structures relevant to swallowing in healthy older adults. The reviewers then mapped the eligible studies for adherence to the 10 principles of neural plasticity and principles of motor learning using validated operational definitions.

Twenty studies were included for mapping. Studies showed good adherence to principles of neural plasticity like 'use it or lose it', 'repetition matters', and 'salience matters'. However, no study addressed the interference and gaps identified in the application of 'intensity', 'specificity', and 'transference' concepts. Furthermore, gaps were also observed for recommended guidelines across five practice conditions of principles of motor learning, except 'target complexity'. Lastly, gaps were also noted for all the four feedback conditions of principles of motor learning.

This mapping review identified common trends and gaps in how principles of neural plasticity and principles of motor learning are integrated into swallowing exercise protocols of healthy older adults, offering valuable insights into concepts that meet or fall short of established guidelines.