{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:01:33Z","timestamp":1790341293841,"version":"4.1.0"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare rehabilitation interventions for dysphagia after head and neck cancer treatment using network meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE, EMBASE, Cochrane Library, Scopus, and Web of Science were searched from inception to 21 July 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review methods<\/jats:title>\n                    <jats:p>Randomised controlled trials evaluating swallowing exercise, neuromuscular electrical stimulation combined with exercise (NMES+ex), speech therapy combined with exercise (Speech+ex) or telerehabilitation were included. Random-effects network meta-analyses estimated Hedges\u2019 g standardised mean differences (SMDs) and treatment rankings across four outcome domains. Confidence was assessed using the Confidence in Network Meta-Analysis framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one trials were included in the systematic review; 18 trials involving 1139 participants contributed to connected networks. Exercise improved clinician-rated swallowing compared with usual care (SMD 0.98, 95% confidence interval 0.28 to 1.69) and instrumental swallowing compared with telerehabilitation (SMD 1.24, 0.07 to 2.42). No other comparisons were statistically significant. Speech+ex ranked highest for clinician-rated outcomes, exercise for instrumental outcomes and NMES+ex for patient-reported quality of life and symptom\/handicap outcomes. In sensitivity analyses separating exercise types, prophylactic exercise ranked highest for instrumental and quality-of-life outcomes. Confidence ranged from moderate to very low and was very low for all patient-reported comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rehabilitation effects varied by outcome domain, with no consistently superior intervention. Exercise showed benefits for selected clinician-rated and instrumental outcomes, but sparse networks, imprecision and inconsistency limit certainty. These findings support individualised intervention selection and adequately powered trials using standardised outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692155261487949","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:08:39Z","timestamp":1790165319000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative effectiveness of dysphagia rehabilitation in head and neck cancer: A network meta-analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4272-7489","authenticated-orcid":false,"given":"Jong Mi","family":"Park","sequence":"first","affiliation":[{"name":"Yonsei University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seo Yeon","family":"Yoon","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine"},{"name":"Yonsei Institute for Digital Health, Yonsei University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6241-7392","authenticated-orcid":false,"given":"Sang Chul","family":"Lee","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5234-2454","authenticated-orcid":false,"given":"Yong Wook","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine"},{"name":"Yonsei Institute for Digital Health, Yonsei University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1102236"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/medsci11020042"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-020-00479-6"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.05.050"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10030442"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-022-10445-1"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.01.097"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692155231166326"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/15459683231166940"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13901"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01626-4"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.54724\/lc.2022.e9"},{"key":"e_1_3_3_14_2","article-title":"Rob 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne JA","year":"2019","unstructured":"Sterne JA, Savovi\u0107 J, Page MJ, et al. 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