Evidence map›Paper›PMID 39906244›Full record

ArticleHealth science reports2025

Effects of Expiratory Muscle Strength Training on Swallowing in Survivors of Critical Illness: A Protocol for a Systematic Review and Meta-Analysis.

Philip Skurok, Brian W Johnston, Emma Brown, Caroline Timothy, Christopher Morse, Peter Turton

Abstract read
In one paragraph

Article in Health science reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Philip SkurokIntensive Care Unit Warrington and Halton Hospitals NHS Trust Warrington UK.
Brian W JohnstonLiverpool Centre for Cardiovascular Sciences University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0003-1634-3297
Emma BrownIntensive Care Unit Warrington and Halton Hospitals NHS Trust Warrington UK.
Caroline TimothyIntensive Care Unit Warrington and Halton Hospitals NHS Trust Warrington UK.
Christopher MorseDepartment of Sport and Exercise Sciences, Institute of Sport Manchester Metropolitan University Manchester UK.
Peter TurtonIntensive Care Unit Warrington and Halton Hospitals NHS Trust Warrington UK.ORCID https://orcid.org/0009-0009-6387-8797

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Post Extubation Dysphagia (PED) is a common consequence of mechanical ventilation. Muscular weakness and atrophy are potential causes. Expiratory Muscle Strength Training (EMST) is a technique whereby a subject exhales against a resistance, strengthening the muscles of expiration. There is evidence that EMST causes activation and hypertrophy of the muscles of swallowing, with clinical evidence that it improves swallowing in certain populations. The aim of this systematic review is to collate the existing literature concerning evaluation of swallowing after extubation, and whether EMST positively affects these measures. Methods: We will perform a systematic review of the literature by searching electronic databases (Pubmed, Medline, EMBASE, and the Cochrane Library), for articles where EMST has been performed (alone or in conjunction with inspiratory muscle training), in patients who have been liberated from a period of mechanical ventilation. We will identify studies that evaluate swallowing after extubation, listing the methods used to evaluate swallowing and data will be extracted from studies evaluating the impact EMST has on these measures. Results: We will undertake meta-analysis if data permits. Risk of bias will be assessed using the Risk of Bias 2 tool or the Newcastle Ottawa Score for randomized and non-randomized trials. We will use The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence. Conclusion: The results of this systematic review will enable us to assess the current literature on the use of EMST in critical care, and whether the intervention improves swallowing and respiratory outcomes.

Indexed as

critical caredysphagiaexpiratory muscle trainingextubationmechanical ventilationrespiratory muscle training

Identifiers

PMID39906244
PMCPMC11790605

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.