Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors

Kraaijenga, Sophie A. C.; Molen, Lisette van der; Stuiver, Martijn M.; Takes, Robert P.; Al‐Mamgani, Abrahim; Brekel, Michiel W. M. van den; Hilgers, Frans J. M.

doi:10.1002/hed.24710

Cited by 42 publications

(58 citation statements)

References 55 publications

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“…Although tongue base pressure increased by 3.16% after 8 weeks of training, this increment was not statistically significant. This result is similar to previous studies [9, 25]. In previous studies, the effects of the combination of 3 resistance exercises including JOE against resistance were investigated.…”

Section: Discussionsupporting

confidence: 81%

Effects of Resistive Jaw-Opening Exercise with Elastic Bands on Suprahyoid Muscle Activation in Normal Subjects

Oh¹,

Kwon²

2018

Folia Phoniatr Logop

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Objective: The effect of a resistive jaw-opening exercise using an elastic band on suprahyoid muscle activity and tongue strength was examined in healthy volunteers. Methods: Twenty-one adults wore an elastic loop around their head and mandible. To prescribe the appropriate elastic band resistance, the 10-repetition maximum (10 RM) was measured among 4 bands at baseline. Band loops, starting with the highest resistance value band, were sequentially applied to determine the suitability for 10 RM. During the exercise, the participants were required to open their jaw maximally and maintain the position for 10 s; then, they rested for 10 s. This procedure was repeated for 20 min, 3 days per week for 8 weeks to test suprahyoid muscle activation during effortful swallowing; isometric tongue pressures of the tongue tip and base at baseline, after 4, and after 8 weeks of training were measured. Results: Peak suprahyoid muscle activation amplitudes during effortful swallow and isometric pressures at the tongue tip significantly increased after 8 weeks. Conclusion: The 8-week resistive jaw-opening exercise significantly improved strength of the suprahyoid muscle and tongue pressures in healthy subjects. These positive results warrant further investigation of the therapeutic effects and feasibility of this resistive exercise.

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Section: Discussionsupporting

confidence: 81%

Effects of Resistive Jaw-Opening Exercise with Elastic Bands on Suprahyoid Muscle Activation in Normal Subjects

Oh¹,

Kwon²

2018

Folia Phoniatr Logop

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“…These exercises ideally include targeted swallowing exercises, preferably with progressive load, to increase swallowing muscle function, as well as overall physical exercises to increase overall muscle strength and mass. 50 One has to keep in mind, however, that the time period between diagnosis and start of treatment is short and may be too short to effectively build up muscle mass-if possible, exercises should therefore be continues during treatment. Second, patients should be encouraged to adhere to a high protein diet to facilitate muscle growth.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia, a strong determinant for prolonged feeding tube dependency after chemoradiotherapy for head and neck cancer

et al. 2019

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Background Sarcopenia might be a relevant lead for optimization of the condition of patients with head and neck cancer (HNC) before chemoradiotherapy (CRT) to prevent long‐term functional swallowing impairment, such as feeding tube dependency. Methods Regression analyses were performed to assess the association between skeletal muscle mass index (SMI), as a measure of sarcopenia, and prolonged (>90 days) feeding tube dependency in 128 patients with HNC treated with primary CRT. Results Sixty‐one patients (48%) became prolonged feeding tube‐dependent. Lower SMI increased the risk of prolonged feeding tube dependency in multivariable analysis (risk ratio 1.08; 95% confidence interval 1.02‐1.14, P = .01) adjusted for body mass index, abnormal diet, and socioeconomic status. Conclusions Sarcopenia contributes to the risk of prolonged feeding tube dependency of patients with HNC treated with primary CRT. As sarcopenia might be a modifiable factor prior to treatment, it should be explored as a target for pretreatment patients' condition.

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“…RT radiotherapy, PSE prophylactic swallowing exercises against resistance at a target level of 60-70% [45] of the 1RM (i.e., in this study, the maximum chin-tuck strength that can be generated). These chin-tucks are divided into 30 sets of five repetitions with an effortful swallow at every fifth repetition.…”

Section: Methodsmentioning

confidence: 94%

Study protocol for a randomized controlled trial: prophylactic swallowing exercises in head-and-neck cancer patients treated with (chemo)radiotherapy (PRESTO trial)

Baudelet

Steen

Duprez

et al. 2020

Trials

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Background: Dysphagia is a common and serious complication after (chemo)radiotherapy (CRT) for head-and-neck cancer (HNC) patients. Prophylactic swallowing exercises (PSE) can have a significantly positive effect on posttreatment swallowing function. However, low adherence rates are a key issue in undermining this positive effect. This current randomized trial will investigate the effect of adherence-improving measures on patients' swallowing function, adherence and quality of life (QOL). Methods: This ongoing trial will explore the difference in adherence and swallowing-related outcome variables during and after PSE in HNC patients performing the same therapy schedule, receiving different delivery methods. One hundred and fifty patients treated in various hospitals will be divided into three groups. Group 1 performs PSE at home, group 2 practices at home with continuous counseling through an app and group 3 receives face-to-face therapy by a speech and language pathologist. The exercises consist of tongue-strengthening exercises and chintuck against resistance with effortful swallow. The Iowa Oral Performance Instrument and the Swallowing Exercise Aid are used for practicing. Patients are evaluated before, during and after treatment by means of strength measurements, swallowing and QOL questionnaires. Discussion: Since low adherence rates undermine the positive impact of PSE on post-treatment swallowing function, there is need to develop an efficient PSE protocol maximizing adherence rates.

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Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors

Abstract: Feasibility and compliance were high. Some objective and subjective effects of progressive load on muscle strength and swallowing function could be demonstrated.

Cited by 42 publications

References 55 publications

Effects of Resistive Jaw-Opening Exercise with Elastic Bands on Suprahyoid Muscle Activation in Normal Subjects

Effects of Resistive Jaw-Opening Exercise with Elastic Bands on Suprahyoid Muscle Activation in Normal Subjects

Sarcopenia, a strong determinant for prolonged feeding tube dependency after chemoradiotherapy for head and neck cancer

Study protocol for a randomized controlled trial: prophylactic swallowing exercises in head-and-neck cancer patients treated with (chemo)radiotherapy (PRESTO trial)

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