多模式治疗引起的吞咽困难严重影响头颈癌幸存者。由于通信技术的进步，几项研究应用了基于远程通信的干预措施，包括吞咽锻炼、教育、监测、反馈、自我管理和交流。在COVID-19大流行的背景下，实施基于家庭的远程康复尤其迫切。然而，远程干预的最佳策略和有效性尚不清楚。本系统综述旨在检验有关远程康复对于减少与吞咽相关的生理和功能障碍、提高遵守度和相关影响因素的证据。为了确定相关文章，我们在PubMed、MEDLINE、CINAHL、Embase和Cochrane Library数据库上进行了系统搜寻，截至2023年7月。两个研究员独立提取数据并使用Joanna Briggs Institute的质量评估工具评估包含在研究中的研究的方法学质量。最初共检索到1465篇文章，最后纳入系统综述的有13篇（0.89%）。质量评估表明，纳入的研究质量中等至良好。结果表明，基于家庭的远程康复改善了吞咽和进食的安全性、营养状况和与吞咽相关的生活质量；减少了负面情绪；改善了吞咽康复的遵守度；被参与者评价为非常满意和有支持性；而且具有成本效益。此外，本综述还调查了影响远程康复效果的因素，包括在吞咽训练策略、强度、频率、持续时间和个体动作能力之间取得平衡；治疗放疗的副作用；提供医学、激励和教育信息的途径；为训练提供反馈；为语言病理学家、家庭成员和其他幸存者提供交流和支持；解决技术问题。基于家庭的远程康复在减少吞咽和进食的安全风险、改善生活质量和遵守度、满足吞咽困难幸存者的信息需求方面显示出巨大的潜力。然而，本综述强调了目前文献的局限性，并且目前的研究还处于初级阶段。此外，由于患者社会人口学、医学、生理和功能性吞咽以及行为因素的多样性，我们建议开发量身定制的远程医疗干预措施，以实现最佳康复效果，同时减少干预的数量和增加准确性。

Multimodal treatment-induced dysphagia has serious negative effects on survivors of head and neck cancer. Owing to advances in communication technologies, several studies have applied telecommunication-based interventions that incorporate swallowing exercises, education, monitoring, feedback, self-management, and communication. It is especially urgent to implement home-based remote rehabilitation in the context of the COVID-19 pandemic. However, the optimal strategy and effectiveness of remote interventions are unclear.This systematic review aimed to examine the evidence regarding the efficacy of telerehabilitation for reducing physiological and functional impairments related to swallowing and for improving adherence and related influencing factors among head and neck cancer survivors.The PubMed, MEDLINE, CINAHL, Embase, and Cochrane Library databases were systematically searched up to July 2023 to identify relevant articles. In total, 2 investigators independently extracted the data and assessed the methodological quality of the included studies using the quality assessment tool of the Joanna Briggs Institute.A total of 1465 articles were initially identified; ultimately, 13 (0.89%) were included in the systematic review. The quality assessment indicated that the included studies were of moderate to good quality. The results showed that home-based telerehabilitation improved the safety of swallowing and oral feeding, nutritional status, and swallowing-related quality of life; reduced negative emotions; improved swallowing rehabilitation adherence; was rated by participants as highly satisfactory and supportive; and was cost-effective. In addition, this review investigated factors that influenced the efficacy of telerehabilitation, which included striking a balance among swallowing training strategy, intensity, frequency, duration, and individual motor ability; treating side effects of radiotherapy; providing access to medical, motivational, and educational information; providing feedback on training; providing communication and support from speech pathologists, families, and other survivors; and addressing technical problems.Home-based telerehabilitation has shown great potential in reducing the safety risks of swallowing and oral feeding, improving quality of life and adherence, and meeting information needs for dysphagia among survivors of head and neck cancer. However, this review highlights limitations in the current literature, and the current research is in its infancy. In addition, owing to the diversity of patient sociodemographic, medical, physiological and functional swallowing, and behavioral factors, we recommend the development of tailored telemedicine interventions to achieve the best rehabilitation effects with the fewest and most precise interventions.©Wenwen Yang, Yifei Du, Mengran Chen, Sufang Li, Fan Zhang, Peiyang Yu, Xiaoxia Xu. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 08.09.2023.