Abstract Number: Esoc2026lb76 Interventions for Treating Swallowing Impairment After Stroke: An Update to a Cochrane Systematic Review

Abstract Background and aims Interventions for post stroke dysphagia (PSD) could improve patient health and wellbeing, and socio-economic outcomes but there has been insufficient evidence to offer clinicians specific guidance. Our aim was to assess individual interventions versus usual care on the primary outcome of swallowing impairment (SI) for patients with acute/subacute PSD. Methods We searched databases and trial registries for publications up to 31st July 2025. Following the Cochrane handbook, we screened and extracted data and assessed risk of bias from RCTs of interventions for people with PSD within six months; a third reviewer settled any differences. We included available papers in all languages and excluded confounded trials and those exploring compensatory mechanisms. We used random-effects models to calculate odds ratios (ORs), mean differences (MDs), and standardised mean differences (SMDs), and provided 95% confidence intervals (CIs) for each. We contacted authors for missing data. We explored the effect of individual interventions (acupuncture, behavioural interventions, drug therapies, neuromuscular electrical stimulation, pharyngeal electrical stimulation, physical stimulation, theta burst stimulation, transcranial direct current stimulation, transcranial magnetic stimulation, vagus nerve stimulation and combinations of these interventions) on SI and 10 secondary outcomes (dysphagia, aspiration, chest infection, decannulation, nutrition, length of stay, institutionalisation, functional outcome, and case fatality). Results We added 140 studies (8840 participants) for a total of 181 studies (n=11,500). Analysis of the effect, certainty of evidence and implications to practice and research will be discussed. Conclusions This review provides a robust framework for evaluating swallowing therapy for acute/subacute PSD. Results will be presented at the conference. Conflict of interest