Video game-based interventions for post-stroke dysphagia: a systematic review and meta-analysis

Objective To systematically evaluate the efficacy of video game-based interventions on swallowing function and swallowing-related quality of life in patients with post-stroke dysphagia. Methods A systematic search was conducted in PubMed, Web of Science, Cochrane Library, and Embase from inception to July 13th, 2026. Randomized controlled trials (RCTs) evaluating video game-based training for post-stroke dysphagia were included. The primary outcome was the Functional Oral Intake Scale (FOIS). Secondary outcomes included the Standardized Swallowing Assessment (SSA) and swallowing-related quality of life (SWAL-QOL/DHI). The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results Six randomized controlled trials randomized a total of 309 participants, of whom 300 contributed data to the meta-analysis. Video game-based interventions significantly improved FOIS scores (WMD = 0.78, 95% CI [0.36, 1.21], P = 0.0003; low GRADE certainty), though heterogeneity was substantial ( I 2 = 74%). Sensitivity analysis identified one outlying study; after its exclusion, heterogeneity was reduced to zero, and the effect remained significant and consistent (moderate certainty). Video game-based training also significantly reduced SSA scores (WMD = −2.14, 95% CI [−3.55, −0.74]; moderate GRADE certainty) and improved swallowing-related quality of life (WMD = −15.07, 95% CI [−21.61, −8.52]; low GRADE certainty due to imprecision). Conclusion The evidence suggests that video game-based interventions improve swallowing function and quality of life in post-stroke dysphagia. However, given the limited number of included trials, these findings should be interpreted with caution. Larger, well-designed RCTs are warranted to confirm the clinical utility and to clarify the differential effects of intervention technologies. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261359653 , identifier: CRD420261359653.