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Background-Optimal exercise doses for exercise-based approaches to dysphagia treatment are unclear. To address this gap in knowledge, we performed a scoping review to provide a record of doses reported in the literature. A larger goal of this work was to promote detailed consideration of dosing parameters in dysphagia exercise treatments in intervention planning and outcome reporting.Methods-We searched PubMed, Scopus[Embase], CINAHL, and Cochrane databases from inception to July 2019, with search terms relating to dysphagia and exercises to treat swallowing impairments. Of the eligible 1906 peer-reviewed articles, 72 met inclusionary criteria by reporting, at minimum, both the frequency and duration of their exercise-based treatments.Results-Study interventions included tongue exercise (n=16), Shaker/head lift (n=13), respiratory muscle strength training (n=6), combination exercise programs (n=20), mandibular movement exercises (n=7), lip muscle training (n=5), and other programs that did not fit into the categories described above (n=5). Frequency recommendations varied greatly by exercise type. Duration recommendations ranged from 4 weeks to 1 year. In articles reporting repetitions (n=66), the range was 1 to 120 reps/day. In articles reporting intensity (n=59), descriptions included values for force, movement duration, or descriptive verbal cues, such as "as hard as possible." Outcome measures were highly varied across and within specific exercise types.Conclusions-We recommend inclusion of at least the frequency, duration, repetition, and intensity components of exercise dose to improve reproducibility, interpretation, and comparison across studies. Further research is required to determine optimal dose ranges for the wide variety of exercise-based dysphagia interventions.

Swallowing symptoms after thyroidectomy are underreported in the literature. This study revealed that as many as 80% of patients who have thyroidectomy may experience swallowing-related symptoms after surgery, and many develop compensatory strategies to manage or reduce the burden of these symptoms. Considering the large number of individuals who may experience subjective dysphagia, preoperative counseling should include education and management of such symptoms.

Objective Aging results in progressive changes in deglutitive functions, which may be due in part to alterations in muscle morphology and physiology. Mastication is a critical component of bolus formation and swallowing, but aging effects on masticatory function have not been well studied. Study Design The purpose of this study was to: 1) quantify the effects of aging on mastication; 2) determine the effects of tongue exercise on mastication in young adult and old rats. We hypothesized that there would be significant differences in mastication characteristics (number of bites, interval between bites, time to eat) as a function of age and that tongue exercise would resolve pre-exercise differences between age groups. Methods We expanded the established model of progressive, 8-week tongue exercise training to include a mastication measurement: acoustic recordings of vermicelli pasta biting from 17 old and 17 young adult rats, randomized into training and control groups. Results We found that: 1) mastication characteristics were impacted by age; specifically in older rats, time to eat and number of bites were increased and intervals between bites were decreased, suggesting increased oral motor processing requirements for bolus formation; 2) tongue exercise did not impact mastication behaviors in young adult or old rats. Conclusion Tongue exercise may not have been specific enough to mastication to result in behavioral changes or exercise dose may not have been sufficient. Nevertheless, results were noteworthy in expanding the established rat model of aging and have relevant clinical implications for future translation to human populations.