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Neuromuscular-related interventions for post-stroke dysphagia: a comprehensive narrative review

Zhou M, Dong B, Zhou H, Zhang W, Fu A, Sun Z, Wu X

Frontiers in neuroscience, 2026

Abstract

Objective: To systematically review the efficacy, mechanisms, and application characteristics of neuromuscular-related interventions for post-stroke dysphagia (PSD), and to examine strategy selection across different swallowing stages to inform individualized rehabilitation strategies.

Methods: PubMed, Web of Science, Embase, and MEDLINE were systematically searched for studies published between 1995 and 2025. Titles and abstracts were screened, and the full texts of eligible studies were retrieved for further analysis. Interventions related to neural and muscular regulation were categorized and synthesized into four main groups: exercise training and behavioral interventions; peripheral neuromuscular stimulation; central nervous system modulation techniques; and other adjunctive interventions.

Results: A total of 293 publications were included, of which 56.63% were randomized controlled trials. The interventions were summarized into four major categories comprising more than 10 techniques. Exercise training and behavioral interventions (e.g., oral motor exercises) enhanced swallowing muscle strength and coordination. Peripheral neuromuscular stimulation (e.g., neuromuscular electrical stimulation and acupuncture) enhanced or modulated swallowing function by directly stimulating relevant nerves or muscles. Central nervous system modulation techniques (e.g., transcranial magnetic stimulation and transcranial direct current stimulation) influenced swallowing-related neural…

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