{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:07:21Z","timestamp":1793916441297,"version":"4.8.0"},"reference-count":39,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"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":["Neurorehabil Neural Repair"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Comparative therapeutic benefits of combined and single neurostimulation therapies including neuromuscular electrical stimulation (NMES), pharyngeal electrical stimulation (PES), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and traditional dysphagia therapy (TDT) remain unknown in post-stroke dysphagia (PSD) rehabilitation. Therefore, we performed the first network meta-analysis (NMA) to determine comparative effectiveness of combined and single neurostimulation and traditional dysphagia therapies for PSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A frequentist NMA model was performed with therapy effect sizes presented as standardized mean differences (SMD) and corresponding 95% confidence interval (95% CI) for therapy comparisons while netrank function ranked the therapies in R-Software. Meta-regression models for study characteristics were analyzed using Bayesian NMA Model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 50 randomized controlled studies with 2250 participants were included. NMES\u2009+\u2009TDT 3.82 (95% CI, 1.62-6.01), tDCS\u2009+\u2009TDT 3.34 (95% CI, 1.09-5.59), rTMS\u2009+\u2009TDT 3.32 (95% CI, 1.18-5.47), NMES 2.69 (95% CI, 0.44-4.93), and TDT 2.27 (95% CI, 0.12-4.41) demonstrated very large effect in improving swallowing function. NMES\u2009+\u2009TDT \u22120.50 (95% CI, \u22120.68 to \u22120.32, rTMS\u2009+\u2009TDT \u22120.44 (95% CI, \u22120.67 to \u22120.21), TDT \u22120.28 (95% CI, \u22120.46 to \u22120.10), and NMES \u22120.19 (95% CI, \u22120.34 to \u22120.04) demonstrated medium to small effect in reducing pharyngeal transit time (PTT). rTMS \u22120.51 (95% CI, \u22120.93 to \u22120.08) demonstrated medium effect in reducing oral transit time (OTT). No significant therapy comparison differences were found for reducing aspiration\/penetration. The highest ranked therapy was NMES\u2009+\u2009TDT for better swallowing function and reduction of PTT, rTMS for reduction of OTT, and tDCS\u2009+\u2009TDT for reduction of aspiration\/penetration. Therapeutic effects of the therapies were moderated by frequency, sessions, and duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined therapies including NMES\u2009+\u2009TDT, tDCS\u2009+\u2009TDT, and rTMS\u2009+\u2009TDT demonstrate better therapeutic effect for improved swallowing function and reduction of PTT, OTT, and aspiration\/penetration for PSD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683231166940","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T11:51:25Z","timestamp":1681991485000},"page":"194-204","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Comparative Effectiveness of Combined and Single Neurostimulation and Traditional Dysphagia Therapies for Post-Stroke Dysphagia: A Network Meta-Analysis"],"prefix":"10.1177","volume":"37","author":[{"given":"Kondwani Joseph","family":"Banda","sequence":"first","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Taipei"},{"name":"Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko-Chiu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Interaction Design, National Taipei University of Technology, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiu-Ju","family":"Jen","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Taipei"},{"name":"Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin","family":"Chu","sequence":"additional","affiliation":[{"name":"Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei"},{"name":"Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Chung","family":"Pien","sequence":"additional","affiliation":[{"name":"Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei"},{"name":"Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruey","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Taipei"},{"name":"Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei"},{"name":"Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tso-Ying","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Taipei"},{"name":"Nursing Research Center, Department of Nursing, Taipei Medical University Hospital, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Kai","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Han","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei"},{"name":"International Master\/PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei"},{"name":"Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4882-3503","authenticated-orcid":false,"given":"Kuei-Ru","family":"Chou","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Taipei"},{"name":"Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei"},{"name":"Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei"},{"name":"Psychiatric Research Center, Taipei Medical University Hospital, Taipei"},{"name":"Neuroscience Research Center, Taipei Medical University, 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