Effects of Exercise Interventions on Radiation-Induced Trismus and Dysphagia in Patients With Nasopharyngeal Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND: Trismus and dysphagia are common symptoms in patients with nasopharyngeal carcinoma (NPC); however, the effectiveness of exercise interventions in this population remains unclear. OBJECTIVE: To systematically evaluate the effectiveness of exercise interventions for trismus and dysphagia in patients with NPC. METHODS: Five English databases and 3 Chinese databases were searched. Two reviewers independently assessed the risk of bias using the Cochrane Risk of Bias tool. RevMan (RevMan 5.4.1) and R statistical software (RStudio 2026.04.0+526) were used for data synthesis. RESULTS: Seventeen randomized controlled trials involving 1569 participants were included in this review. The meta-analysis revealed that exercise interventions were more effective than the controls in reducing the incidence (595 participants, risk ratio = 0.54, 95% confidence interval [CI]: 0.44-0.68, P < .0001, I2 = 0, moderate certainty) and severity of trismus (833 participants, risk ratio = 0.47, 95% CI: 0.31-0.70, P = .003, I2 = 5%, moderate certainty), improving swallowing function (293 participants, mean difference = -0.94, 95% CI: -1.19 to -0.69, P < .00001, I2 = 0% low certainty), enhancing the efficacy of dysphagia treatment and quality of life, and reducing the risk of aspiration pneumonia and choking cough. CONCLUSIONS: This review indicates that exercise interventions could significantly reduce the incidence and severity of trismus, improve interincisal distance and swallowing function, enhance the efficacy of dysphagia treatment and quality of life, and decrease the risk of aspiration pneumonia and choking cough. Further studies are needed to strengthen the current evidence. IMPLICATIONS FOR PRACTICE: Exercise interventions could be integrated into the management of patients with NPC to address trismus and dysphagia.