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Methods: Patients were randomly assigned to control (conventional rehabilitation) or experimental (additional biofeedback-based respiratory-swallow coordination training) for three phases over 30 min/day, 6 days/week, for two weeks. Outcomes included FOIS, PAS, respiratory-swallow coordination, and videofluoroscopic temporal/kinematic parameters at baseline, post-treatment, and one-month follow-up. Results: FOIS improved in both groups, with greater gains and higher ≥2-point responders in the experimental group; PAS ≥6 decreased and optimal respiratory-swallow patterns increased after treatment. Conclusion: The bimodal signal biofeedback approach effectively enhances coordination and swallowing function.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/respiratory-swallow-coordination-training-using-bimodal-signal-biofeedback-for-patients-with-post-stroke-dysphagia-a-randomized-controlled-trial/456009/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/respiratory-swallow-coordination-training-using-bimodal-signal-biofeedback-for-patients-with-post-stroke-dysphagia-a-randomized-controlled-trial/456009.png","ImageObject",300,407,{"name":42,"@type":43},"Putri","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",15,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the objective of the study?","Question",{"text":63,"@type":64},"To investigate the effects of respiratory-swallow coordination training with bimodal signal biofeedback on swallowing function in patients with post-stroke dysphagia.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were patients assigned to groups and how long was the training?",{"text":68,"@type":64},"Patients were randomly assigned to a control group or an experimental group. Training was delivered in three phases at 30 min/day, 6 days/week, for two consecutive weeks.",{"name":70,"@type":61,"acceptedAnswer":71},"Which outcomes were used to evaluate effectiveness?",{"text":72,"@type":64},"Functional Oral Intake Scale (FOIS), Rosenbek Penetration-Aspiration Scale (PAS), respiratory-swallow coordination, and videofluoroscopic swallowing study temporal and kinematic parameters.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},456009,1790976804,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146,"preview_page_count":4},962085571259,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","AnnAls of Medicine  \n2026, Vol. 58, no. 1, 2607218  \n[https://doi.org/10.1080/07853890.2025.2607218](https://doi.org/10.1080/07853890.2025.2607218)  \nRESEARCH ARTICLE     \nRespiratory-swallow coordination training using bimodal signal biofeedback for patients with post-stroke dysphagia: a randomized controlled trial  \nLian Wanga,b , Jia Qiaob , Zhenhai Weic, Xiaoqin Liud, Xiaomei Weib and Zulin Doub  \nadepartment of Rehabilitation Medicine, Union Hospital, Tongji Medical college, Huazhong University of science and Technology, Wuhan, Hubei, china; bdepartment of Rehabilitation Medicine, The Third Affiliated Hospital of sun Yat-sen University, Guangzhou, Guangdong, china; cdepartment of Rehabilitation Medicine, The Third Affiliated Hospital of southern Medical University, Guangzhou, Guangdong, china; ddepartment of Rehabilitation Medicine, West china second University hospital, sichuan University, sichuan, china  \nABSTRACT  \nObjective: The purpose was to investigate the effects of respiratory-swallow coordination training with bimodal signal biofeedback on swallowing function in patients with post-stroke dysphagia.  \nMethods: Post-stroke dysphagia Patients were randomly assigned to either the control group or the experimental group. The control group received conventional rehabilitation, while the experimental group underwent additional respiratory-swallow coordination training based on biofeedback. The training protocol consisted of three phases, conducted at an intensity of 30 min/day, 6 days/week, for two consecutive weeks. Outcome measures included the Functional Oral Intake Scale (FOIS) score, the Rosenbek Penetration-Aspiration Scale (PAS) score, respiratory-swallow coordination, and videofluoroscopic swallowing study temporal and kinematic parameter. Assessments were conducted at baseline, post-treatment, and at a one-month follow-up.  \nResults: Thirty patients were enrolled. Both groups showed significant improvement in FOIS scores from baseline to both two-week post-treatment and one-month follow-up (p \u003C 0.001). Compared to the controls, the experimental group demonstrated significantly greater FOIS scoreimprovement at both post-treatment and follow-up (p \u003C 0.001). The proportion of patients with a≥2-point increase in FOIS scores was significantly higher in the experimental group than in the control group at both post-treatment (p \u003C 0.01) and one-month follow-up (p \u003C 0.01). After two weeks of treatment, the percentage of PAS scores ≥6 was significantly lower in the experimental group than in the control group (p \u003C 0.001). Additionally, the percentage of optimal respiratory-swallow pattern was significantly higher in the experimental group than in the control group (p \u003C 0.001). Conclusion: Bimodal signal biofeedback-based respiratory-swallow coordination training can effectively improve respiratory-swallow coordination and swallowing function inpatients with post-stroke dysphagia.  \nIntroduction  \nARTICLE HISTORY  \nReceived 22 August 2025 Accepted 15 December 2025  \nKEYWORDS  \nStroke; dysphagia; respiratory-swallow coordination; biofeedback  \nSwallowing and respiration are essential physiological activities for sustaining life. They share certain anatomical structures and are regulated by central pattern generators (CPGs) in the brainstem [1–3] . Swallowing and respiration are highly coordinated. The physiological basis of their coordination lies in the interaction between the swallowing CPG and the respiratory CPG [4] . This results in a brief, well-timed pause in respiration—known as swallowing apnea (SA)—to accommodate the swallow, which typically occurs during the expiratory phase and is often followed by a brief post-swallow expiration [5–9] . During swallowing, the respiratory-swallow pattern, defined by respiratory phases before and after SA, is a key indicator of respiratory-swallow coordination.  \nCONTACT Zulin dou  [douzul@163.com](douzul@163.com)  department of Rehabilitation Medicine, The Third Affiliated Hos","cbCaieYdKYcr0Sic","https://ap.wps.com/l/cbCaieYdKYcr0Sic","pdf",906100,11,"English","# ABSTRACT\n# Objective\n# Methods\n## Training protocol\n## Outcome measures\n# Results\n# Conclusion\n# Introduction\n# ARTICLE HISTORY\n# KEYWORDS","[{\"question\":\"What was the objective of the study?\",\"answer\":\"To investigate the effects of respiratory-swallow coordination training with bimodal signal biofeedback on swallowing function in patients with post-stroke dysphagia.\"},{\"question\":\"How were patients assigned to groups and how long was the training?\",\"answer\":\"Patients were randomly assigned to a control group or an experimental group. Training was delivered in three phases at 30 min/day, 6 days/week, for two consecutive weeks.\"},{\"question\":\"Which outcomes were used to evaluate effectiveness?\",\"answer\":\"Functional Oral Intake Scale (FOIS), Rosenbek Penetration-Aspiration Scale (PAS), respiratory-swallow coordination, and videofluoroscopic swallowing study temporal and kinematic parameters.\"}]","Respiratory-swallow coordination training using bimodal signal biofeedback for patients with post-stroke dysphagia: a randomized controlled trial | PDF",1790744927,28]