Effect of a Video-Guided Swallowing Exercise Program on Adherence in Stroke Patients with Dysphagia: A Randomized Controlled Trial

Abstract

To compare swallowing exercise adherence, swallowing function, and media satisfaction between stroke patients with dysphagia using a video-guided exercise program on mobile electronic devices versus those using a handbook. Randomized controlled trial. Forty-four stroke patients with dysphagia were randomized to either a video-guided intervention group (n = 23) or a handbook-based control group (n = 21). The prescribed exercises included lip exercises, tongue range of motion and strengthening, chin tuck against resistance (CTAR), and Masako exercises, performed as three sets of ten repetitions daily. Baseline swallowing function was assessed using the Functional Oral Intake Scale (FOIS), and adherence was self-reported via logbooks. Outcomes were reassessed at 1-month follow-up. Forty participants completed the study (21 intervention, 19 control). Baseline characteristics were comparable, except for a higher prevalence of left hemiparesis and a longer time since stroke onset in the intervention group. Exercise adherence was significantly higher in the intervention group (median 42.9% [IQR 24.6, 78.4]) compared to the control group (19.4% [IQR 0, 38.7]; p = 0.009). Both groups showed FOIS score improvements, with no significant between-group difference. Media satisfaction did not differ significantly. A video-guided swallowing exercise program delivered via mobile devices significantly improved adherence compared to handbook-based instruction. This approach may offer a feasible and accessible strategy for post-stroke dysphagia rehabilitation.