{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:12:55Z","timestamp":1791331975540,"version":"4.3.1"},"reference-count":57,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund (HMRF)","doi-asserted-by":"publisher","award":["19200461"],"award-info":[{"award-number":["19200461"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund (HMRF)","doi-asserted-by":"publisher","award":["P0033873"],"award-info":[{"award-number":["P0033873"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004377","name":"The Hong Kong Polytechnic University","doi-asserted-by":"publisher","award":["19200461"],"award-info":[{"award-number":["19200461"]}],"id":[{"id":"10.13039\/501100004377","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004377","name":"The Hong Kong Polytechnic University","doi-asserted-by":"publisher","award":["P0033873"],"award-info":[{"award-number":["P0033873"]}],"id":[{"id":"10.13039\/501100004377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Swallowing disorders, especially dysphagia, might lead to malnutrition and dehydration and could potentially lead to fatal aspiration. Benchmark swallowing assessments, such as videofluoroscopy or endoscopy, are expensive and invasive. Wearable technologies using acoustics and accelerometric sensors could offer opportunities for accessible and home-based long-term assessment. Identifying valid swallow events is the first step before enabling the technology for clinical applications. The objective of this review is to summarize the evidence of using acoustics-based and accelerometric-based wearable technology for swallow detection, in addition to their configurations, modeling, and assessment protocols. Two authors independently searched electronic databases, including PubMed, Web of Science, and CINAHL. Eleven (n = 11) articles were eligible for review. In addition to swallowing events, non-swallowing events were also recognized by dry (saliva) swallowing, reading, yawning, etc., while some attempted to classify the types of swallowed foods. Only about half of the studies reported that the device attained an accuracy level of &gt;90%, while a few studies reported poor performance with an accuracy of &lt;60%. The reviewed articles were at high risk of bias because of the small sample size and imbalanced class size problem. There was high heterogeneity in assessment protocol that calls for standardization for swallowing, dry-swallowing and non-swallowing tasks. There is a need to improve the current wearable technology and the credibility of relevant research for accurate swallowing detection before translating into clinical screening for dysphagia and other swallowing disorders.<\/jats:p>","DOI":"10.3390\/ijerph20010170","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T02:09:03Z","timestamp":1671761343000},"page":"170","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Swallow Detection with Acoustics and Accelerometric-Based Wearable Technology: A Scoping Review"],"prefix":"10.3390","volume":"20","author":[{"given":"Bryan Pak-Hei","family":"So","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim Tin-Chun","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangchao","family":"Liu","sequence":"additional","affiliation":[{"name":"Physical Education Department, University of International Business and Economics, Beijing 100029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5393-6609","authenticated-orcid":false,"given":"Calvin Chi-Kong","family":"Yip","sequence":"additional","affiliation":[{"name":"School of Medical and Health Sciences, Tung Wah College, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Jung","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8692-2206","authenticated-orcid":false,"given":"Wing-Kai","family":"Lam","sequence":"additional","affiliation":[{"name":"Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8805-1157","authenticated-orcid":false,"given":"Duo Wai-Chi","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5651-9352","authenticated-orcid":false,"given":"Daphne Sze Ki","family":"Cheung","sequence":"additional","affiliation":[{"name":"School of Nursing, The Hong Kong Polytechnic University, Hong Kong"},{"name":"Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7446-0569","authenticated-orcid":false,"given":"James Chung-Wai","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong"},{"name":"Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23337214211041801","DOI":"10.1177\/23337214211041801","article-title":"Evaluation of Spontaneous Swallow Frequency in Healthy People and Those With, or at Risk of Developing, Dysphagia: A Review","volume":"7","author":"Bulmer","year":"2021","journal-title":"Gerontol. Geriatr. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"83-IN15","DOI":"10.1016\/0003-9969(65)90060-9","article-title":"The frequency of deglutition in man","volume":"10","author":"Lear","year":"1965","journal-title":"Arch. Oral Biol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/0003-9969(95)00004-9","article-title":"The prediction of saliva swallowing frequency in humans from estimates of salivary flow rate and the volume of saliva swallowed","volume":"40","author":"Rudney","year":"1995","journal-title":"Arch. Oral Biol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"154S","DOI":"10.1378\/chest.129.1_suppl.154S","article-title":"Cough and aspiration of food and liquids due to oral-pharyngeal dysphagia: ACCP evidence-based clinical practice guidelines","volume":"129","author":"Hammond","year":"2006","journal-title":"Chest"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1007\/s00455-021-10350-z","article-title":"A retrospective analysis of swallowing function and physiology in patients living with dementia","volume":"37","author":"Alomari","year":"2022","journal-title":"Dysphagia"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"102501","DOI":"10.1016\/j.amjoto.2020.102501","article-title":"Oropharyngeal dysphagia in elderly population suffering from mild cognitive impairment and mild dementia: Understanding the link","volume":"41","author":"Kulamarva","year":"2020","journal-title":"Am. J. Otolaryngol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1111\/joor.13030","article-title":"Effect of dysphagia rehabilitation in patients receiving enteral nutrition at home nursing care: A retrospective cohort study","volume":"47","author":"Furuya","year":"2020","journal-title":"J. Oral Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Okuni, I., and Ebihara, S. (2022). Are Oropharyngeal Dysphagia Screening Tests Effective in Preventing Pneumonia?. J. Clin. Med., 11.","DOI":"10.3390\/jcm11020370"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.2147\/CIA.S107750","article-title":"European Society for Swallowing Disorders\u2013European Union Geriatric Medicine Society white paper: Oropharyngeal dysphagia as a geriatric syndrome","volume":"11","author":"Baijens","year":"2016","journal-title":"Clin. Interv. Aging"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1177\/000348940711601112","article-title":"Dysphagia in the elderly: Preliminary evidence of prevalence, risk factors, and socioemotional effects","volume":"116","author":"Roy","year":"2007","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2147\/CIA.S97481","article-title":"Oropharyngeal dysphagia in older persons\u2013from pathophysiology to adequate intervention: A review and summary of an international expert meeting","volume":"11","author":"Wirth","year":"2016","journal-title":"Clin. Interv. Aging"},{"key":"ref_12","first-page":"44","article-title":"Management of acid-related disorders in patients with dysphagia","volume":"117","author":"Howden","year":"2004","journal-title":"Am. J. Med. Suppl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1177\/0884533609332005","article-title":"Senescent swallowing: Impact, strategies, and interventions","volume":"24","author":"Ney","year":"2009","journal-title":"Nutr. Clin. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1016\/j.cgh.2019.10.029","article-title":"Prevalence and characteristics of dysphagia based on a population-based survey","volume":"18","author":"Adkins","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/jtxs.12101","article-title":"The blind scientists and the elephant of swallowing: A review of instrumental perspectives on swallowing physiology","volume":"46","author":"Steele","year":"2015","journal-title":"J. Texture Stud."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.radi.2019.10.011","article-title":"Clinical practice guidelines for videofluoroscopic swallowing studies: A systematic review","volume":"26","author":"Boaden","year":"2020","journal-title":"Radiography"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.bjorl.2021.03.002","article-title":"Protocols and assessment procedures in fiberoptic endoscopic evaluation of swallowing: An updated systematic review","volume":"88","author":"Prikladnicki","year":"2021","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_18","first-page":"299","article-title":"Clinical non-instrumental evaluation of dysphagia","volume":"27","author":"Maccarini","year":"2007","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1007\/s00455-007-9127-y","article-title":"Clinical utility of the 3-ounce water swallow test","volume":"23","author":"Suiter","year":"2008","journal-title":"Dysphagia"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"476","DOI":"10.5535\/arm.2014.38.4.476","article-title":"Usefulness of the simplified cough test in evaluating cough reflex sensitivity as a screening test for silent aspiration","volume":"38","author":"Lee","year":"2014","journal-title":"Ann. Rehabil. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/0269215515576779","article-title":"The reliability and validity of cervical auscultation in the diagnosis of dysphagia: A systematic review","volume":"30","author":"Lagarde","year":"2016","journal-title":"Clin. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1002\/jhm.2313","article-title":"Bedside diagnosis of dysphagia: A systematic review","volume":"10","author":"Robbins","year":"2015","journal-title":"J. Hosp. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.pmrj.2012.01.002","article-title":"Diagnostic accuracy of bedside swallow evaluation versus videofluoroscopy to assess dysphagia in individuals with tetraplegia","volume":"4","author":"Shem","year":"2012","journal-title":"PMR"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1109\/THMS.2015.2408615","article-title":"Dysphagia screening: Contributions of cervical auscultation signals and modern signal-processing techniques","volume":"45","author":"Dudik","year":"2015","journal-title":"IEEE Trans. Hum.-Mach. Syst."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zahnd, E., Movahedi, F., Coyle, J.L., Sejdi\u0107, E., and Menon, P.G. (2016, January 11\u201317). Correlating tri-accelerometer swallowing vibrations and hyoid bone movement in patients with dysphagia. Proceedings of the ASME International Mechanical Engineering Congress and Exposition, Phoenix, AZ, USA.","DOI":"10.1115\/IMECE2016-66133"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s00455-008-9160-5","article-title":"Variability of swallow-associated sounds in adults and infants","volume":"24","author":"Reynolds","year":"2009","journal-title":"Dysphagia"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/BF00262760","article-title":"Methodology for detecting swallowing sounds","volume":"9","author":"Takahashi","year":"1994","journal-title":"Dysphagia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.bjorl.2017.12.008","article-title":"Diagnostic validity of methods for assessment of swallowing sounds: A systematic review","volume":"84","author":"Taveira","year":"2018","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"953","DOI":"10.11124\/JBIES-21-00242","article-title":"Best practice guidance and reporting items for the development of scoping review protocols","volume":"20","author":"Peters","year":"2022","journal-title":"JBI Evid. Synth."},{"key":"ref_30","first-page":"313","article-title":"Measuring frequency of spontaneous swallowing","volume":"30","author":"Afkari","year":"2007","journal-title":"Australas. Phys. Eng. Sci. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.artmed.2007.11.007","article-title":"Recognition of dietary activity events using on-body sensors","volume":"42","author":"Amft","year":"2008","journal-title":"Artif. Intell. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1109\/JSEN.2015.2469095","article-title":"AutoDietary: A Wearable Acoustic Sensor System for Food Intake Recognition in Daily Life","volume":"16","author":"Bi","year":"2016","journal-title":"IEEE Sens. J."},{"key":"ref_33","unstructured":"Fontana, J.M., Melo, P.L., and Sazonov, E.S. (September, January 30). Swallowing detection by sonic and subsonic frequencies: A comparison. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Boston, MA, USA."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/joor.12264","article-title":"A novel automated detection system for swallowing sounds during eating and speech under everyday conditions","volume":"42","author":"Fukuike","year":"2015","journal-title":"J. Oral Rehabil."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3532","DOI":"10.1109\/JSEN.2019.2894744","article-title":"Development of Swallowing-Movement-Sensing Device and Swallowing-State-Estimation System","volume":"19","author":"Kurihara","year":"2019","journal-title":"IEEE Sens. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.medengphy.2009.07.001","article-title":"Swallow segmentation with artificial neural networks and multi-sensor fusion","volume":"31","author":"Lee","year":"2009","journal-title":"Med. Eng. Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.bspc.2012.03.005","article-title":"Automatic food intake detection based on swallowing sounds","volume":"7","author":"Makeyev","year":"2012","journal-title":"Biomed. Signal Process. Control"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1109\/TBME.2009.2033037","article-title":"Automatic Detection of Swallowing Events by Acoustical Means for Applications of Monitoring of Ingestive Behavior","volume":"57","author":"Sazonov","year":"2010","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1109\/TBME.2008.2010504","article-title":"Segmentation of Dual-Axis Swallowing Accelerometry Signals in Healthy Subjects with Analysis of Anthropometric Effects on Duration of Swallowing Activities","volume":"56","author":"Sejdic","year":"2009","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"EL127","DOI":"10.1121\/1.4812434","article-title":"Acoustic discrimination of healthy swallows from upper airway movements","volume":"134","author":"Skowronski","year":"2013","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1121\/1.1777872","article-title":"Exploiting independent filter bandwidth of human factor cepstral coefficients in automatic speech recognition","volume":"116","author":"Skowronski","year":"2004","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1049\/el:20031003","article-title":"Coupled microphone-accelerometer sensor pair for dynamic noise reduction in MMG signal recording","volume":"39","author":"Silva","year":"2003","journal-title":"Electron. Lett."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"8704","DOI":"10.1038\/s41598-020-65492-1","article-title":"Non-invasive identification of swallows via deep learning in high resolution cervical auscultation recordings","volume":"10","author":"Khalifa","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.eswa.2016.12.035","article-title":"Learning from class-imbalanced data: Review of methods and applications","volume":"73","author":"Haixiang","year":"2017","journal-title":"Expert Syst. Appl."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s00455-016-9758-y","article-title":"Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: The IDDSI framework","volume":"32","author":"Cichero","year":"2017","journal-title":"Dysphagia"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1007\/s00455-018-09974-5","article-title":"Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study","volume":"34","author":"Steele","year":"2019","journal-title":"Dysphagia"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Shieh, W.-Y., Wang, C.-M., Cheng, H.-Y.K., and Wang, C.-H. (2019). Using wearable and non-invasive sensors to measure swallowing function: Detection, verification, and clinical application. Sensors, 19.","DOI":"10.3390\/s19112624"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"5095","DOI":"10.1038\/s41598-018-23486-0","article-title":"Non-invasive quantification of human swallowing using a simple motion tracking system","volume":"8","author":"Hashimoto","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Matsuo, T., and Matsuyama, M. (2021). Detection of poststroke oropharyngeal dysphagia with swallowing screening by ultrasonography. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0248770"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"108932","DOI":"10.1016\/j.compscitech.2021.108932","article-title":"Design of flexible strain sensor with both ultralow detection limit and wide sensing range via the multiple sensing mechanisms","volume":"213","author":"Chen","year":"2021","journal-title":"Compos. Sci. Technol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2100341","DOI":"10.1002\/mame.202100341","article-title":"Highly Stretchable, Tough, and Conductive Ag@Cu Nanocomposite Hydrogels for Flexible Wearable Sensors and Bionic Electronic Skins","volume":"306","author":"Chen","year":"2021","journal-title":"Macromol. Mater. Eng."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"52811","DOI":"10.1021\/acsami.1c17789","article-title":"Flexible Stannum-Doped SrTiO3 Nanofiber Membranes for Highly Sensitive and Reliable Piezoresistive Pressure Sensors","volume":"13","author":"Gao","year":"2021","journal-title":"Acs Appl. Mater. Interfaces"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"913213","DOI":"10.3389\/fpsyt.2022.913213","article-title":"Wrist accelerometry for monitoring dementia agitation behaviour in clinical settings: A scoping review","volume":"13","author":"Cheung","year":"2022","journal-title":"Front. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Chen, K.-C., Jeng, Y., Wu, W.-T., Wang, T.-G., Han, D.-S., \u00d6z\u00e7akar, L., and Chang, K.-V. (2021). Sarcopenic dysphagia: A narrative review from diagnosis to intervention. Nutrients, 13.","DOI":"10.3390\/nu13114043"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Cheung, C.-W.J., Chan, W.-H.R., Chiu, M.-W., Law, S.-Y., Lee, T.-H., and Zheng, Y.-P. (2010, January 1\u20136). A three-month study of fall and physical activity levels of intellectual disability using a transfer belt-based motion recording sensor. Proceedings of the 6th World Congress of Biomechanics (WCB 2010), Singapore.","DOI":"10.1007\/978-3-642-14515-5_355"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"So, B.P.-H., Lai, D.K.-H., Cheung, D.S.-K., Lam, W.-K., Cheung, J.C.-W., and Wong, D.W.-C. (2022). Virtual Reality-Based Immersive Rehabilitation for Cognitive-and Behavioral-Impairment-Related Eating Disorders: A VREHAB Framework Scoping Review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19105821"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1044\/2017_AJSLP-17-0040","article-title":"Flow and grit by design: Exploring gamification in facilitating adherence to swallowing therapy","volume":"26","author":"Constantinescu","year":"2017","journal-title":"Am. J. Speech-Lang. Pathol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/1\/170\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:48:30Z","timestamp":1760147310000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/1\/170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,22]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["ijerph20010170"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20010170","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,22]]}}}