Tongue Strength Exercise and Swallowing in Oral Cancer

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DESCRIPTION (provided by applicant): Treatment for oral cancer can result in devastating swallowing problems. High-dose chemoradiotherapy has been utilized as primary treatment for tumors of the oral cavity and oropharynx to preserve organ function. Quality of life, however, can become significantly reduced after primary treatment with chemoradiotherapy, with significant decrements in ability to eat. Radiotherapy to the oral cavity and oropharynx can cause changes in swallowing, particularly the oral phase of the swallow, resulting in reduced ability to propel foods and liquids through the oral cavity. Further, there appears to be a relationship between oral tongue strength and oral phase swallowing. The primary objective of this pilot study is to examine the effects of tongue strengthening exercises with traditional swallow therapy (experimental group) vs. traditional therapy (control group) alone on tongue strength and swallowing in oral cancer patients treated with chemoradiotherapy. Our hypothesis is that the experimental group will improve in tongue strength and oropharyngeal swallow functioning, and that improved tongue strength will correlate with swallow functioning. A secondary aim is to examine the effects of the exercise programs on quality of life, utilizing the Head and Neck Cancer Inventory, a health status assessment instrument that is patient-rated with domains of social disruption, aesthetics, speech, and eating. This randomized study will examine the effects of two 6-week exercise programs on tongue strength and swallowing in 52 patients who have undergone primary chemoradiotherapy for cancer treatment. Patients in both groups will undergo a 6-week exercise program one month post-chemoradiotherapy. All patients will undergo baseline (4 weeks post-chemoradiotherapy) and post-baseline (10 weeks post-chemoradiotherapy) videofluoroscopic swallow study (VFSS), tongue strength, xerostomia assessment, and quality of life questionnaire. Dependant variables include maximum tongue strength, temporal swallow measures of oral and pharyngeal transit times, bolus volume and viscosity, the Oropharyngeal Swallow Efficiency (OPSE) measure, and quality of life ratings.