The authors state that “previous studies have focused on oral screen training during primary rehabilitation within the first 3 months post-stroke.” This is incorrect. Multiple peer-reviewed and internationally published studies, Hägg intervention = 4.3 mL/s; p = 0.043). Because swallowing itself is rehabilitative, a near-normal baseline in the control group (≥ 10 mL/s) makes further improvement likely even without intervention, whereas the more impaired intervention group faced greater functional challenges. This imbalance confounds interpretation of treatment effects. Only one outcome reached the authors' own criterion for statistical significance (p < 0.05), in contrast with the studies cited above, which typically report much stronger significance levels (often p ≤ 0.01 or ≤ 0.001). It is therefore misleading to present the current results as evidence that the intervention lacks efficacy. The authors suggest that discrepancies from earlier results might reflect “use of a different device.” Yet, a RCT by Hägglund et al. 7 with this device (Muppy) showed no measurable benefit after end-of-treatment. Thus, all the superior results in previous studies were achieved with IIQoro. Given the number and nature of these issues, I respectfully suggest that the article's peer review may not have included expertise in dysphagia rehabilitation or neuromuscular oral-motor training. The editorial board may wish to consider inviting further expert review or issuing a corrigendum to clarify methodological details. I appreciate the authors' efforts to explore post-stroke rehabilitation strategies. However, for the benefit of clinical accuracy and scientific clarity, it is important that readers are not misled regarding the scope of prior evidence or the appropriate use of the IQoro method. Yours sincerely, Mary Hägg Associate Professor, Uppsala University. DDS, Specialist in Orofacial Medicine. Mary Hägg is the inventor. The author declares no conflicts of interest. QoroR is patented and CE-marked by MYoroface AB. This article is linked with Dalum (2026). doi: https://doi.org/10.1111/ger.70042. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
Mary Hägg (Tue,) studied this question.