{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T21:52:03Z","timestamp":1791064323535,"version":"4.1.0"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010816","name":"Anhui Provincial Department of Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010816","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Resistance exercise shows potential for improving swallowing function in post-stroke dysphagia (PSD), though optimal dose-response parameters remain unclear. While the American College of Sports Medicine (ACSM) framework effectively guides exercise prescriptions in healthy populations, its application to PSD rehabilitation lacks meta-analytical validation. This study evaluates varying resistance exercise dosages on swallowing outcomes in PSD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched PubMed, Embase, Web of Science, and Cochrane for randomized controlled trials (RCTs) investigating resistance training in PSD. Interventions were stratified using ACSM compliance criteria (6\/8 and 7\/8 thresholds) into high-adherence versus low\/uncertain-adherence groups. Subgroup analyses employed random-effects meta-analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analysis included 19 RCTs (n = 566). Using 6\/8 ACSM criteria, 11 studies comprised the high-adherence group and eight the low\/uncertain group. High-adherence interventions demonstrated improved positively oriented scores [SMD = \u22121.72 (95% CI \u22123.26 to \u22120.18)], enhanced safety [SMD = \u22120.93 (95% CI \u22121.54 to \u22120.32)], and worsened negatively oriented scores [SMD = 2.27 (95% CI 0.66\u20133.87)]. Low-adherence groups showed non-significant improvements in positively oriented scores [SMD = \u22120.47 (95% CI \u22121.02 to 0.09)], negatively oriented scores [SMD = 0.43 (95% CI \u22120.09\u20130.94)], and safety [MD = \u22121.85 (95% CI \u22123.83 to 0.13)]. Applying stricter 7\/8 criteria reclassified nine studies as high-adherence and 10 as low\/uncertain. High-adherence groups exhibited greater positively oriented scores improvement [SMD = \u22122.15 (95% CI \u22124.11 to \u22120.20)], safety enhancement [MD = \u22121.05 (95% CI \u22121.58 to \u22120.51)], and negatively oriented scores decline [SMD = 2.85 (95% CI 0.82\u20134.89)]. Low-adherence groups maintained non-significant outcomes: positively oriented scores [SMD = \u22120.33 (95% CI \u22120.75 to 0.10)], negatively oriented scores [SMD = 0.32 (95% CI \u22120.09\u20130.74)], and safety [MD = \u22121.39 (95% CI \u22122.84 to 0.07)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Resistance exercise demonstrates superior therapeutic effects over non-resistance interventions for PSD. High adherence to ACSM-recommended dosages yields significantly greater improvements in swallowing function and safety compared to low\/uncertain adherence regimens. These findings validate the clinical utility of ACSM guidelines for optimizing resistance exercise prescriptions in PSD rehabilitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>, identifier CRD420251041450.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2025.1623298","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T05:32:12Z","timestamp":1754458332000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of resistance exercise on patients with post-stroke dysphagia based on ACSM recommendations: a systematic review of randomized controlled trials"],"prefix":"10.3389","volume":"16","author":[{"given":"Yu","family":"Ye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kairui","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingquan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjie","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongtao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangyuan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuejun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peijia","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongliang","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e0148424","DOI":"10.1371\/journal.pone.0148424","article-title":"Dysphagia in acute stroke: incidence, burden and impact on clinical outcome","volume":"11","author":"Arnold","year":"2016","journal-title":"PLoS One"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1050","DOI":"10.1002\/lio2.483","article-title":"Effect of respiratory muscle training on dysphagia in stroke patients-A retrospective pilot study","volume":"5","author":"Arnold","year":"2020","journal-title":"Laryngoscope Investig. 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