Effectiveness of gamified swallowing exercise in adults with dysphagia: protocol for a systematic review and meta-analysis.

Abstract

<h4>Background</h4>Dysphagia is a common health problem that affects the quality of life of millions of people. Several studies have shown that gamified swallowing exercise has a demonstrated potential to improve training adherence and swallowing function among adults with dysphagia. However, this evidence has not been fully systematically synthesized. This systematic review and meta-analysis aims to systematically examine the effectiveness of gamified swallowing exercise in improving swallowing function among adults with dysphagia.<h4>Methods</h4>The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) 2015 checklist was followed to report the protocol. We will conduct the first retrieval in PubMed, Web of Science, Embase, CINAHL, Scopus, the Cochrane Library, JBI, SinoMed, CNKI, and Wanfang on March 1, 2025. Before completing the systematic review, all target databases will be re-searched to capture the relevant publications, and the timing of the secondary retrieval will be reported in the final review. This systematic review aims to synthesize evidence from randomized controlled trials (RCTs) evaluating the effectiveness of gamified swallowing exercise in adult dysphagia populations. The primary outcomes of interest include swallowing function, while the secondary outcomes encompass adherence, nutritional status, and quality of life. Methodological quality will be rigorously assessed using the Cochrane Risk of Bias tool 2.0. Data analyses will be conducted using RevMan 5.4 software, with the random-effects model being prioritized. The protocol will incorporate three analytical approaches: (1) subgroup analysis to explore heterogeneity sources, with the Instrument for the Credibility of Effect Modification ANalyses (ICEMAN) applied to evaluate subgroup effect credibility; (2) iterative sensitivity analyses, including leave-one-out meta-analyses, to examine the robustness of the results; and (3) evidence certainty grading using the GRADEpro GDT software. To ensure methodological rigor, all procedures-including study selection, data extraction, quality assessment, and evidence evaluation-will be independently performed by two reviewers.<h4>Discussion</h4>This review will synthesize existing studies to evaluate the effects of gamified swallowing exercise on adults with dysphagia, thereby providing valuable reference for healthcare providers to promote the clinical practice of swallowing rehabilitation.<h4>Systematic review registration</h4>PROSPERO CRD42024617169.