Neuromuscular-related interventions for post-stroke dysphagia: a comprehensive narrative review

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Post-stroke dysphagia (PSD) is a common complication affecting swallowing function.
• Effective rehabilitation strategies are crucial for improving patient outcomes and quality of life.

Purpose of the Study:

• To systematically review the efficacy, mechanisms, and application characteristics of neuromuscular interventions for PSD.
• To examine strategy selection across different swallowing stages for individualized rehabilitation.

Main Methods:

• Systematic search of PubMed, Web of Science, Embase, and MEDLINE (1995-2025).
• Categorization of interventions into exercise/behavioral, peripheral neuromuscular stimulation, central nervous system modulation, and adjunctive therapies.
• Analysis of 293 publications, including 56.63% randomized controlled trials.

Main Results:

• Interventions enhanced swallowing muscle strength, coordination, and nerve/muscle stimulation.
• Central nervous system techniques modulated cortical excitability and neural networks.
• Analysis explored rehabilitation techniques across clinical stages, integrating central/peripheral neuromodulation.

Conclusions:

• Neuromuscular interventions are widely used for PSD, with notable efficacy for transcranial magnetic stimulation, acupuncture, and neuromuscular electrical stimulation.
• Future strategies should integrate pathology, clinical manifestations, and lesion localization for multimodal therapies combining central and peripheral approaches.