Restorative Exercise Models in Dysphagia and Obstructive Sleep Apnea: A Review

Abstract

<h3>Objective(s)</h3> Restorative dysphagia exercise approaches hold merit in research and practice within speech-language pathology given strong evidence for targeted interventions leading to improved deglutition. Restorative exercise approaches for obstructive sleep apnea (OSA) share common anatophysiologic bases with dysphagia; however, have received limited scientific attention to establish their utility as non-invasive treatment alternatives for OSA. Researchers' primary aim was to provide a summary of the current state-of-science on the biomechanics of OSA with a summary of therapeutic targets relative to muscle physiology. A secondary aim was assessing the physiologic adaptations following restorative dysphagia exercise relative to exercise models for treatment of OSA for comparative analysis. Clinical research and scope-of-practice implications of exercise benefits reflected in similar biomechanical profiles and muscular adaptations in OSA and dysphagia are discussed. <h3>Data Sources</h3> Literature was identified using hand-searched and database-driven methods from PubMed, Google Scholar, and Medline. <h3>Study Selection</h3> (1) systematic reviews/meta-analysis; (2) author(s) quantified measures of article strengths/weaknesses; (3) published after 2011; (4) available in English. <h3>Data Extraction</h3> Authors independently assessed articles for eligibility and evidence strength using The Scottish Intercollegiate Guidelines Network (SIGN) tool. Average SIGN ratings across intervention categories were obtained. <h3>Data Synthesis</h3> Study results were categorized and assessed for strength of evidence with SIGN and conclusions on therapeutic targets and the physiologic adaptations relative to specific targets. A majority of studies were systematic reviews and meta-analyses. Researchers identified sources of variation and consistency in outcome measures across studies, leading to a quantitative and qualitative synthesis of findings within dysphagia and OSA outcome measures. <h3>Conclusions</h3> Preliminary findings point to potential adjuvant treatment avenues in some patients with OSA and potential co-recruitment of OSA-related muscles during restorative dysphagia exercises. Findings point to common therapeutic targets and anatophysiologic goals within dysphagia and OSA exercise interventions. <h3>Author(s) Disclosures</h3> Nicholas Stocker is first author, Laura L.O. Froeschke is second author, Raymond Kraus is third author.